We Spoke to People Who Started Using ChatGPT As Their Therapist (2023)

In February, Dan, a 37-year-old EMT from New Jersey, started using ChatGPT to write stories. He was excited by the creative potential of the OpenAI tool to write fiction, but eventually, his own real-life experiences and struggles started making their way into his conversations with the chatbot.

His therapist, who had been helping him address issues with complex trauma and job-related stress, had suggested he change his outlook on the events that upset him—a technique known as cognitive reframing. “It wasn't something I was good at. I mean, how can I just imagine things went differently when I'm still angry? How can I pretend that I wasn't wronged and abused?” Dan told Motherboard.

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But ChatGPT was able to do this flawlessly, he said, providing answers which his therapist, seemingly, could not. Dan described the experience of using the bot for therapy as low stakes, free, and available at all hours from the comfort of his home. He admitted to staying up until 4 am sharing his issues with the chatbot, a habit which concerned his wife that he was “talking to a computer at the expense of sharing [his] feelings and concerns” with her.

Motherboard agreed to keep several sources in this story pseudonymous to speak about their experiences using ChatGPT for therapy.

Large language models, such as OpenAI’s ChatGPT or Google’s Bard, have seen a recent influx of interest for their therapeutic potential—unsurprisingly touted by utopian Big Tech influencers as being able to deliver “mental health care for all.” Using pattern-matching and data scraping, these AI models produce human-like speech that is believable enough to convince some people that it can act as a form of mental health support. As a result, social media is full of anecdotes and posts by people who say they have started using ChatGPT as a therapist.

In January, Koko, a San Francisco-based mental health app co-founded by Robert Morris, came under fire for revealing that it had replaced its usual volunteer workers with GPT-3-assisted technology for around 4,000 users. According to Morris, its users couldn’t tell the difference, with some rating its performance higher than with solely human responses. And in Belgium, a widow told the press that her husband killed himself after an AI chatbot encouraged him to do so.

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Amid a growing demand for mental health care, and a lack of existing funding and infrastructure for equitable care options, having an affordable, infinitely scalable option like ChatGPT seems like it would be a good thing. But the mental health crisis industry is often quick to offer solutions that do not have a patient’s best interests at heart.

Venture capital and Silicon Valley-backed apps like Youper and BetterHelp are rife with data privacy and surveillance issues, which disproportionately affect BIPOC and working-class communities, while ignoring the more systemic reasons for people’s distress.

“They are doing this in the name of access for people that society has pushed to the margins, but [we have to] look at where the money is going to flow,” Tim Reierson, a whistleblower at Crisis Text Line who was fired after revealing its questionable monetization practices and data ethics, told Motherboard.

In 1966, German American scientist Joseph Weizenbaum ran an experiment at MIT. ELIZA, known today as the world’s first therapy chatbot, was initially created to parody therapists, parroting their (often frustrating) open-ended speech using a natural language processing program. While it was supposed to reveal the “superficiality” of human-to-computer interaction, it was embraced by its users.

Technology’s role in the patient-therapist relationship is almost as old as the history of therapy itself, as explored by Hannah Zeavin in her book The Distance Cure. And, as she points out, finding mental support which doesn’t involve the usual waiting lists, commute, and cost for office-bound care has long been the goal for low-income people, historically found through crisis lines and radio.

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But not all teletherapies are created equal. Presently, it is unclear how ChatGPT will be integrated into the future of mental health care, how OpenAI will address its overwhelming data privacy concerns and how well-suited it is for helping people in distress.

Nevertheless, with healthcare costs rising and news headlines hyping up the abilities of AI language models, many have turned to unproven tools like ChatGPT as a last resort.

Gillian, a 27-year-old executive assistant from Washington, started using ChatGPT for therapy a month ago to help work through her grief, after high costs and a lack of insurance coverage meant that she could no longer afford in-person treatment. “Even though I received great advice from [ChatGPT], I did not feel necessarily comforted. Its words are flowery, yet empty,” she told Motherboard. “At the moment, I don't think it could pick up on all the nuances of a therapy session.”

These kinds of experiences have led to some people “jailbreaking” ChatGPT specifically to administer therapy that appears less stilted, friendlier and more human-like.

For most people, AI chatbots are seen as a tool that can supplement therapy, not a complete replacement. Dan, for example, stated that it may have its best uses in emergency or crisis situations. “AI is an amazing tool, and I think that it could seriously help a lot of people by removing the barriers of availability, cost, and pride from therapy. But right now, it's a Band-Aid and not a complete substitute for genuine therapy and mental health,” he said. “As a supplement or in an emergency, however, it may be exactly the right tool to get a person through a bad spell.”

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Dr Jacqueline Nesi, a psychologist and assistant professor at Brown University who studies the role of social media in adolescents’ mental health and development, warned that ChatGPT should not be used for professional medical or diagnostic advice. She also noted that using the chatbot for therapy could lead to a loss of the “therapeutic alliance”—the positive relationship of trust between therapists and patients.

“Although it may feel like a user has a therapeutic relationship with ChatGPT, there is likely something lost when there isn't a real human on the other side,” she told Motherboard.

This loss of intimacy is also in the hands of funders and AI engineers. ChatGPT deals poorly with ambiguous information, resorting rather easily and dangerously to making biased, discriminatory assumptions—which may break users’ trust in the tool. In March, the Distributed AI Research Institute (DAIR) issued a statement warning that synthetic AI “reproduces systems of oppression and endangers our information ecosystem.” A recent MIT Technology Review article by Jessica Hamzelou also revealed that AI systems in healthcare are prone to enforcing medical paternalism, ignoring their patient’s needs.

“I think marginalized communities, including rural populations, are more likely to be the ones with barriers to access, so might also be more likely to turn to ChatGPT for their needs, if they have access to technology in the first place,” Jessica Gold, a psychiatrist at Washington University in St. Louis, told Motherboard. “As a result, patients turn to what they can find, and find quickly.”

For those communities seeking mental health care, this can become a double-edged sword—using ChatGPT may be more accessible, but at the cost of less accountability and quality control.

Dr Amanda Calhoun, an expert on the mental health effects of racism in the medical field, stated that the quality of ChatGPT therapy compared to IRL therapy depends on what it is modelled after. “If ChatGPT continues to be based on existing databases, which are white-centered, then no,” she told Motherboard. “But what if ChatGPT was ‘trained’ using a database and system created by Black mental health professionals who are experts in the effects of anti-Black racism? Or transgender mental health experts?”

All mental health experts who spoke to Motherboard said that while using ChatGPT for therapy could jeopardize people’s privacy, it was better than nothing, revealing a larger mental care industry in crisis. Using ChatGPT as therapy, according to Emma Dowling, author of The Care Crisis, is an example of a “care fix”—an outsourcing of care to apps, self-care handbooks, robots and corporatized hands.

With GPT-4’s recent release, OpenAI stated that it worked with “50 experts from domains such as AI alignment risks, cybersecurity, biorisk, trust and safety” to improve its security, but it isn’t yet clear how this will be implemented, if at all, for people seeking mental help.

FAQs

We Spoke to People Who Started Using ChatGPT As Their Therapist? ›

We Spoke to People Who Started Using ChatGPT As Their Therapist. Mental health experts worry the high cost of healthcare is driving more people to confide in OpenAI's chatbot, which often reproduces harmful biases. In February, Dan, a 37-year-old EMT from New Jersey, started using ChatGPT to write stories.

Who started talking therapy? ›

Talk therapy was essentially invented by Sigmund Freud, or, perhaps a little more historically honestly, by a woman called Anna O. and her doctor, Freud's friend and colleague Joseph Breuer. Anna O. was Joseph Breuer's patient from 1880 through 1882.

When did we start using psychotherapy? ›

Purposeful, theoretically based psychotherapy was probably first developed in the Middle East during the 9th century by the Persian physician and psychological thinker, Rhazes, who was at one time the chief physician of the Baghdad bimaristan.

Do therapists tell their spouses? ›

Knowing that you can say anything to your therapist and it will remain in the room helps you feel safe and builds trust between you and the therapist. For this reason, all therapists are legally and ethically bound to keep their sessions confidential and not share with anyone else what was talked about.

How do you build a therapeutic relationship with a client? ›

HOW TO BUILD A THERAPEUTIC ALLIANCE
  1. do not look to blame or judge your client.
  2. help your client develop the skills for insight and facilitate change from within.
  3. provide an environment that accepts their emotional experience.
  4. provide feedback that is informative for their development.

What is the therapeutic alliance model? ›

The therapeutic alliance, also referred to as the working alliance, is a description of the interaction between the health care professional and their patients. The therapeutic alliance is considered an important aspect of the therapeutic process and can have an impact on treatment outcomes.

What did people do before therapists? ›

Before psychotherapy became popular, mental health conditions were often treated as curses, possessions, or hysteria. Many women were still treated for “female hysteria” until the 1980s.

Who was the first therapist ever? ›

Austrian physician Franz Anton Mesmer (1734-1815) received some of the earliest recognition as a founder of psychotherapy. Known for his process of “mesmerism,” he focused on treating patients by using hypnosis.

What is the oldest method of psychotherapy? ›

Key Points Introspection Method: Introspection means observing one's own behavior through self-analysis.
  • This method is the most subjective in nature.
  • It is one of the oldest method of psychology.

How was the first time with a therapist? ›

During your first session, your therapist will ask questions to understand what you're struggling with and what brought you in to see them. You'll likely talk about some of your past (family history, traumatic experiences) and how your symptoms or feelings are manifesting today, and how long they have been showing up.

What was the first psychotherapy used as a treatment method? ›

Psychoanalysis was developed by Sigmund Freud and was the first form of psychotherapy.

Why does my therapist watch my hands? ›

Hands. Your client's hands can give you clues about how they're reacting to what comes up in the session. Trembling fingers can indicate anxiety or fear. Fists that clench or clutch the edges of clothing or furniture can suggest anger.

Is it normal to want to be friends with your therapist? ›

It's natural and not uncommon to feel close to your therapist and want to be friends with them. However, building a personal relationship with them goes against most mental health counseling codes of ethics. It may also impact your therapeutic process and lessen therapy's benefits.

Do therapists think about me between sessions? ›

Your therapist's relationship with you exists between sessions, even if you don't communicate with each other. She thinks of your conversations, as well, continuing to reflect on key moments as the week unfolds. She may even reconsider an opinion she had or an intervention she made during a session.

What are three 3 requirements of a therapeutic relationship? ›

Edward Bordin, defined a good therapeutic relationship as consisting of three essential qualities: an emotional bond of trust, caring, and respect; agreement on the goals of therapy; and collaboration on the "work" or tasks of the treatment.

What is a difficult client in therapy? ›

Therapy is much more difficult with coerced, reluctant, or challenging clients. These are typically clients who are not necessarily ready to make a change in their life, but have been forced to do so by the court system, the child welfare system, or their spouse or significant other.

How long does it take to build trust in therapy? ›

However, a study conducted by SDL found that it takes two years on average for clients to trust a company or individual. In therapy, however, trust must be established much sooner – within the first few sessions – if treatment is to be successful.

Which therapy is considered the best? ›

Cognitive behavioral therapy is considered the gold standard in psychotherapy.

What are 5 types of therapy? ›

Approaches to psychotherapy fall into five broad categories:
  • Psychoanalysis and psychodynamic therapies. ...
  • Behavior therapy. ...
  • Cognitive therapy. ...
  • Humanistic therapy. ...
  • Integrative or holistic therapy.

What causes clients to feel tense in therapy? ›

Numerous issues can make clients feel anxious or tense in therapy. Some of the most common include: Reluctance to seek treatment. Many clients pursue treatment at the behest of someone else, such as a partner.

What is the first thing a therapist asks? ›

During the first session, your therapist may ask you: What are your symptoms? What brought you to therapy? What do you feel is wrong in your life?

What are the 3 basic tasks of the therapist? ›

Therapist Job Responsibilities:

Diagnoses and treats mental health disorders. Creates individualized treatment plans according to patient needs and circumstances. Meets with patients regularly to provide counseling, treatment and adjust treatment plans as necessary.

How old is the youngest therapist? ›

Last month, Dafne became the world's youngest psychologist as she graduated from Mexico's Monterrey Institute of Technology (ITESM). At just 13 years old, she's the country's most famous child prodigy.

Who is the father of modern therapy? ›

Sigmund Freud (1856-1939) Sigmund Freud was a late 19th and early 20th century neurologist. He is widely acknowledged as the father of modern psychology and the primary developer of the process of psychoanalysis.

Why is psychoanalysis not used anymore? ›

In fact, one of the main reasons for the decline of psychoanalysis is that the ideas of Freud and his followers have gained little empirical support. Freud's theoretical model of the mind and of child development has been challenged and refuted by a wide range of evidence.

Which therapy focuses most on the past? ›

Psychoanalytic or Psychodynamic Therapy

The psychodynamic therapy approach explores unconscious feelings or thoughts and the impact of the past on the present. It is the oldest type of psychotherapy and closest to what Freud created.

What are the 4 stages of psychotherapy? ›

ABSTRACT - The unfolding of the psychotherapeutic relationship is considered to proceed in four main stages: Commitment, Process, Change and Termination.

Why is it hard to start therapy? ›

It is common to have mixed feelings about starting therapy. Our instincts lead us to stay away from uncomfortable thoughts and feelings. Hesitation about beginning therapy may indicate the presence of something very important to understand about ourselves.

Is starting therapy hard? ›

Therapy isn't always hard, but sometimes, it can be. After you've been going for a while, your sessions may start to feel more challenging. The middle of therapy is usually harder than the beginning. In the beginning, it usually feels really good to spend time with your therapist.

What is the difference between a psychologist and a therapist? ›

Psychologists can do research, which is a very important contribution academically and clinically, to the profession. A therapist is a broader umbrella term for professionals who are trained—and often licensed—to provide a variety of treatments and rehabilitation for people.

What are the two main forms of psychotherapy used by therapists today? ›

There are many forms of psychotherapy, but the two most popular forms are psychodynamic therapy and cognitive behavioral therapy.

Who were the only people to offer psychotherapy before the 1950s? ›

Before the 1950s, psychotherapy was offered only by: psychiatrists.

Who invented positive psychotherapy method? ›

Positive psychotherapy (PPT after Peseschkian, since 1977) is a psychotherapeutic method developed by psychiatrist Nossrat Peseschkian and co-workers in Germany beginning in 1968.

Why do therapists go silent? ›

Done supportively, silence can exert some positive pressure on the client to stop and reflect. Non-verbal signals of patience and empathy by the therapist can encourage the client to express thoughts and feelings that would otherwise be covered up by too much anxious talk.

Why does my therapist stare at me in silence? ›

Therapists usually want to find ways to help you go deeper. When they respond with silence or a question, that's usually what they're trying to do: get you to hear yourself and reflect on what you just said. They want you to keep going.

How do you know if a client is dissociating? ›

How to spot dissociation in clients
  • If the client feels in a fog.
  • The client consistently asks therapist to repeat the questions.
  • The client feels as though they are a long way away.
  • The client cannot hear your voice, or you sound faint.
  • The client loses time, or cannot remember the previous session.
May 18, 2016

Can a therapist ever be friends with a client? ›

Client-therapist friendships can be unethical, according to codes of ethics from many bodies that govern therapists, including the American Psychological Association [APA]. By becoming friends with a client, a therapist can risk disciplinary action from governing bodies or losing licensure.

Do therapist get attached to clients? ›

According to new research, 72 percent of therapists surveyed felt friendship toward their clients. 70 percent of therapists had felt sexually attracted to a client at some point; 25 percent fantasized about having a romantic relationship.

Is it OK for a therapist to hug a client? ›

Can your therapist initiate a hug? A therapist can hug a client if they think it may be productive to the treatment. A therapist initiating a hug in therapy depends on your therapist's ethics, values, and assessment of whether an individual client feels it will help them.

Can you overshare to a therapist? ›

Sharing something you think is too sensitive or personal can be uncomfortable. But know you're not alone in thinking you've disclosed too much in therapy. When this happens, it can help to explore why you think you've overshared and talk it over with your therapist.

Is it OK to text your therapist between sessions? ›

There's no rule that says that you can't contact a therapist in between sessions.

Is it okay to tell a therapist what you think you have? ›

The short answer is that you can tell your therapist anything – and they hope that you do. It's a good idea to share as much as possible, because that's the only way they can help you.

What is professional intimacy? ›

Professional intimacy relates to physical, psychological, emotional and/or spiritual elements that create a sense of closeness within the therapeutic relationship. The client's disclosure of their personal information also constitutes professional intimacy.

How do therapists build trust? ›

You build trust by connecting with your clients and actively listening to their concerns and challenges. It not only allows you to gather the information that is helpful for therapy, but shows that you genuinely desire to understand your client's views with empathy.

What is an example of transference in therapy? ›

For example, transference in therapy happens when a patient attaches anger, hostility, love, adoration, or a host of other possible feelings onto their therapist or doctor. Therapists know this can happen. They actively try to monitor for it.

What do therapists struggle with? ›

5 Biggest Challenges for Licensed Mental Health Counselors
  • Healing past trauma.
  • Learning new and better coping skills.
  • Understanding critical thinking.
  • Feel more comfortable entering social situations.
  • Learning stress management.
  • Fighting substance abuse.
  • Increasing emotional health.

Why would a therapist reject a client? ›

There are various reasons a therapist might be unable to work with you, such as lacking expertise in a key area you need support with, what insurance they accept, or conflicts of interest. There are various reasons a therapist may refuse treatment. Although it may feel like rejection, it's typically not personal.

When a therapist loves a client? ›

It's common for a therapist to feel some degree of friendship and even attraction toward a client. You spend a lot of time with every client, learning about their lives and sharing personal information. However, while experiencing attraction is relatively common, acting on this attraction is unethical.

Can therapy fix trust issues? ›

Therapy is one popular approach for addressing trust issues. It can help people open up and get to the root of what could be causing their issue. A therapist might help someone with trust issues learn new ways of thinking to combat their negative feelings.

What is the fastest way to build trust? ›

Ten of the most effective ways to build trust
  1. Value long-term relationships. Trust requires long-term thinking. ...
  2. Be honest. ...
  3. Honor your commitments. ...
  4. Admit when you're wrong. ...
  5. Communicate effectively. ...
  6. Be vulnerable. ...
  7. Be helpful. ...
  8. Show people that you care.

What to do when a client doesn't trust you? ›

  1. Be brutally honest, with your [prospective] client and yourself. ...
  2. Be generous with your knowledge. ...
  3. Manage Expectations. ...
  4. Be responsive but don't always respond immediately. ...
  5. Anticipate what your client will need. ...
  6. Do what you say you will and when. ...
  7. Be A Problem Solver (read more)
May 7, 2010

Which clients do therapists like the most? ›

Key points
  • A older study once showed that therapists prefer clients who are married women, age 20-40 with post-high school education and a professional job.
  • A more recent study shows therapists prefer clients who are motivated and open-minded above all other qualities.
Dec 30, 2009

What is the gold standard of therapy? ›

Taking into account the number of publications/studies, academic programs, and/or practicing professionals, cognitive behavioral therapy (CBT) is arguably the gold standard of the psychotherapy field.

What is the most effective form of therapy? ›

Cognitive behavioral therapy is considered the gold standard in psychotherapy. Numerous clinical trials have found CBT to be effective for a spectrum of emotional health challenges, from anxiety and depression to addiction and schizophrenia.

What is the most popular form of therapy today? ›

What Is the Most Common Type of Therapy? The most common type of therapy right now may be cognitive behavioral therapy (CBT). As mentioned above, CBT explores the relationship between a person's feelings, thoughts, and behaviors. It often focuses on identifying negative thoughts and replacing them with healthier ones.

Do therapists ever get tired of or become annoyed with clients? ›

Therapists do get frustrated with clients from time to time, but some can handle difficult clients better than others. This may be due to training or inherent personality traits.

What are signs of transference in a client? ›

An obvious sign of transference is when a client directs emotions at the therapist. For example, if a client cries and accuses the therapist of hurting their feelings for asking a probing question, it may be a sign that a parent hurt the client regarding a similar question/topic in the past.

What is the name of the psychologist who was the first to use talk therapy? ›

Sigmund Freud (1856-1939)

He is the father of psychoanalytic psychology and was the first to investigate the processes of the unconscious mind. He is thought to have invented talk therapy.

What is talking therapy Freud? ›

Psychoanalysis, also known as “talk therapy,” is a type of treatment based on the theories of Sigmund Freud, who is frequently called the “father of psychoanalysis.” Freud developed this treatment modality for patients who did not respond to the psychological or medical treatments available during his time.

When did speech teletherapy start? ›

Telepractice platform

Telepractice was approved by the American Speech-Language-Hearing Association (ASHA) as an appropriate method of service delivery in 2005 and was added to its directory of special interest groups (SG-18) (2011.)

Who is the father of psychoanalysis and talk therapy? ›

Sigmund Freud is best known as the creator of the therapeutic technique known as psychoanalysis. The Austrian-born psychiatrist greatly contributed to the understanding of human psychology in areas such as the unconscious mind, sexuality, and dream interpretation.

Who first called his therapy methods behavior therapy? ›

The first use of the term behaviour modification appears to have been by Edward Thorndike in 1911. His article Provisional Laws of Acquired Behavior or Learning makes frequent use of the term "modifying behavior". Through early research in the 1940s and the 1950s the term was used by Joseph Wolpe's research group.

Who was the first chatbot psychologist? ›

ELIZA was one of the first chatterbots (later clipped to chatbot). It was also an early test case for the Turing Test, a test of a machine's ability to exhibit intelligent behavior equivalent to, or indistinguishable from, that of a human.

What technique did Freud use in therapy? ›

Developed by Freud, free association is a psychoanalytic technique that involves encouraging the patient to talk openly about whatever is on their mind in a stream-of-consciousness fashion. 6 This open-ended approach is believed to help unconscious thoughts, fears, shame, and motivations come to light.

Why is psychoanalysis therapy not really used anymore? ›

In fact, one of the main reasons for the decline of psychoanalysis is that the ideas of Freud and his followers have gained little empirical support. Freud's theoretical model of the mind and of child development has been challenged and refuted by a wide range of evidence.

Who was the first to use telehealth? ›

The first people to use video communication for medical purposes were clinicians at the University of Nebraska. In 1959, the university established a two-way television setup to transmit information to medical students across campus, and five years later linked with a state hospital to perform video consultations.

How long has virtual therapy been around? ›

Those who define online therapy as offering any sort of authoritative mental health advice via the internet claim its history started in 1986 with the creation of Dear Uncle Ezra, a Cornell University question and answer forum where people frequently discussed mental health issues.

When did telehealth start in mental health? ›

Probably one of the earliest and most famous uses of hospital-based telemedicine was in the late 1950s and early 1960s when a closed-circuit television link was established between the Nebraska Psychiatric Institute and Norfolk State Hospital for psychiatric consultations.

What is Sigmund Freud's most famous theory? ›

Experts consider the Oedipus complex as Freud's most contentious theory. According to Freud, it's the unconscious desire that begins during the phallic stage of development, between the ages of three to six. A child feels a sexual pull for their opposite-sex parent and jealously for their same-sex parent.

What are Freud's 3 theories? ›

According to Freud's psychoanalytic theory, the id is the primitive and instinctual part of the mind that contains sexual and aggressive drives and hidden memories, the super-ego operates as a moral conscience, and the ego is the realistic part that mediates between the desires of the id and the super-ego.

What is Freud most famous for? ›

Sigmund Freud (1856-1939) was the founder of psychoanalysis, a theory of how the mind works and a method of helping people in mental distress.

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