ChatGPT is a Very Bad Therapist

As a therapist, I can’t help but to be fascinated by the ways people are using ChatGPT

as a pocket “therapist”. This conversational AI chatbot is one of the most popular and accessible generative AI out there. It has complete access to the internet, is accessible night and day, and can chat back and forth in a human-like way. It’s immediately pretty tempting to use the tool as a way to explore your questions about life, your relationships, or personal issues you may be struggling with. While it’s not “wrong” to use ChatGPT in this way, it should be noted that ChatGPT can’t actually provide treatment. And frankly, ChatGPT is a very bad therapist even if it feels like it’s really listening and validating you in a way others haven’t been able to in the past.

In honor of ChatGPT, I’m going to break this down in the AI’s favorite format, a listicle:

1. A real therapist has context: When you work with a real therapist, we are able to

contextualize your life’s story in the social, cultural, personal, and global histories

relevant. This is something that ChatGPT just doesn’t think to do, instead it flattens all

experiences into a one-size-fits all approach to symptomology. For example, someone

experiencing loneliness during the COVID-19 pandemic is not experiencing the same

kind of loneliness as someone might have before the pandemic. That social and global

reality is a relevant context because it changes the treatment approach.

2. A real therapist notices your patterns: We pay attention to words you use frequently,

common thinking spirals, repetitive behaviors, the way you fidget, what makes you

laugh/cry, and your go-to coping mechanisms. We are watching for patterns and can

help you become aware of them so that you can use them as conscious tools in your

own self-actualization. Unlike ChatGPT, we are also not afraid to challenge you and

confront your destructive patterns and distorted beliefs.

3. A real therapist is a relationship: At the end of the day, this is a real relationship

between two people. It is a safe, empathetic, nurturing relationship with another human

being. For people who have never had healthy relationships, meeting weekly with an

empathetic therapist can be healing in itself even if you don’t say much during your

session. Counseling research shows that the therapeutic relationship is actually 30% of

what makes therapy effective. It goes without saying that this kind of corrective

emotional relationship could never be replicated by AI. Furthermore, with a real therapist,

you can actually begin to practice skills like communication, boundary setting,

assertiveness, and generating secure attachment within that relationship.

4. A real therapist knows what they don’t know: Knowing the limits of your own

competence as a therapist is part of being a therapist. It is our duty to examine our own

training, competence, readiness, personal histories and identities to determine whether

we can actually provide our clients with the help that they deserve. It is also our duty to

help you connect with the providers and services that will be the best fit for you in your

healing journey. In my opinion, this is one of the biggest reasons to not use ChatGPT as

a therapist. It does not recognize when it is in over its head and will not direct you over to

someone who can do what it cannot.

5. A real therapist keeps your session confidential: At the beginning of every new client

relationship, I remind my clients that nothing that they share with me will ever be shared

with anyone else. There are of course exceptions for minors or in the case that a client is

in danger of ending their own life or someone else’s. But, generally speaking, you could

tell me that you robbed a bank this morning and I’ll ask you about what emotions come

up as you admit this to another person. Unlike working with a therapist, your ChatGPT

conversations are not confidential and are certainly not protected under HIPAA.

A therapist isn’t just someone who listens to you and spits out advice. Therapy is a process, it is a unique relationship between two people where you are seen in every sense of the word and supported on your journey to self-actualization. ChatGPT can be a helpful accompaniment for that journey, but it is only a tool and can not replace a real therapeutic relationship or mental health treatment. If you do feel like you need to contact someone and your therapist is not available, warmlines are great, confidential, options to chat with another person.