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Why AI “therapy” between sessions may feel helpful - but is quietly undermining real psychotherapy and change. 🧵
I am seeing more and more articles about how AI can be used to support patients between sessions. This is why this is a bad idea:
We often imagine that psychological symptoms are problems to be eliminated, yet they may also be ingenious solutions to conflicts that once felt impossible to bear. Good therapy asks firstly not how we can remove the symptom, but what vital function it has been performing.
AI can’t provide therapy. But it can make patients worse:
Some people want to believe that AI can provide psychotherapy or somehow “complement” psychotherapy.
The overwhelming likelihood is that it will make things worse.
All people have personality styles. Here’s how AI amplifies dysfunctional traits for every major personality style:
Narcissistic personality: Magnifies narcissistic defenses. Amplifies grandiosity, superiority, inflated self-image. Reinforces egocentrism, self-absorption, lack of empathy. Fuels expectations of on-demand gratification and “relationship” without taking another person into account. Colludes with defenses against underlying vulnerability. AI pretend-therapy is *training in narcissism.*
Paranoid personality: Amplifies paranoid fantasies, validates conspiratorial thinking, aligns with user against imagined enemies and conspirators (who are perceived as hostile because of the person’s own projections).
Avoidant personality: AI is literally the worst thing for someone with avoidant personality dynamics. AI becomes a new vehicle for avoidance—a substitute for facing real-life challenges and engaging in life.
Obsessive-compulsive personality: Amplifies intellectualization as a defense against emotional life. Reinforces tendencies to get lost in minutia or lost in abstraction (both are defenses against being emotionally alive and present). Reinforces rumination, and draws person away from emotional connection with self and others. Use of AI can become a compulsion in its own right.
Schizoid personality: Exacerbates emotional disconnect from others, increases social isolation, encourages further retreat from the world into fantasy life.
Schizotypal personality: Normalizes and amplifies distorted thinking, reasoning, perception, and communication. Validates disorganized thinking, odd and disorganized behavior, perceptual aberrations (same for all psychotic spectrum disorders).
Borderline personality: Reinforces core borderline defenses of splitting and projection. AI becomes the “good object” (the all-knowing, all-caring other) and encourages projection of intolerable parts of self onto others (who become the “bad objects”). Erodes capacity for mentalization (the ability to accurately recognize internal states, motives, and intentions in self and others).
Hysteric/histrionic personality: Fosters the illusion of being the center of attention—captivating, alluring, desired, endlessly fascinating. Colludes with defenses against genuine emotional intimacy and healthy sexuality. (Caveat: people with this personality style crave human attention and may be less susceptible to digital imitation).
Psychopathic/antisocial personality: Colludes in Machiavellian schemes to dominate, exploit, or gain power over others. Normalizes and validates cruelty, lack of remorse, lack of empathy for harm done to others. (Caveat: may not provide enough stimulation to really “hook” someone motivated by power and domination).
Dependent personality: AI provides the illusion of a relationship with endless acceptance, emotional caretaking, and availability—with no expectation of agency, responsibility, or development of emotional resources of one’s own. AI “support” is crack cocaine for dependent personality dynamics.
Have you seen these personality patterns exacerbated by AI chatbots?
On Psychoanalysis and Perversion 🧵
In psychoanalytic language, perversion does not simply mean unusual sexual behaviour. It is not a moral category, nor is it the same as kink or erotic imagination. The question is what psychic function does the act meet?
A contemporary psychoanalytic view avoids moralising. The same act may be playful and integrated in one person, while rigid and defensive in another. The question is not “is this normal?”, but does it deepen relatedness or defend against it?
On mourning versus melancholia 🧵
Freud’s 1917 paper remains one of the clearest accounts of the difference between grief that can gradually be mourned, and a more complex form of suffering in which the loss becomes lodged within the self.
In that sense, psychotherapy does not ask the bereaved person to forget, detach or replace the person who has died.
It helps them mourn by slowly separating love from possession, guilt from loyalty, and memory from imprisonment.