🧠 Why Therapy Chatbots Could Make Your Anxiety Worse

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In today’s Sunday Special:

• 📜The Prelude

• 💭Therapy Through the Unconscious Mind

• 💬Therapy Through the Conscious Mind

• 🤗Are Therabots Viable?

• 🔑Key Takeaway

Read Time: 7 minutes

🎓Key Terms

• Therabots: Offer mental health support by leveraging simplified therapeutic techniques to manage stress, anxiety, or depression.

• Large Language Models (LLMs): AI Models pre-trained on vast amounts of high-quality datasets to generate human-like text.

🩺 PULSE CHECK

📜THE PRELUDE

As candlelight flickers across the patterned wallpaper, a patient lies motionless on the couch, surrounded by richly detailed Persian rugs. Just out of sight, a shadow wearing wire-rimmed glasses leans forward, pen poised to catch each confession as it falls.

It’s Austrian neurologist Sigmund Freud. He’s invited the patient to unpack whatever surfaces: strange dreams, buried memories, or relentless worries. Freud listens for several hours, interpreting every confession as a crucial clue to the unconscious mind: a deep reservoir of desires and fears that aren’t immediately accessible but profoundly shape our behavior.

He refers to this process as The Talking Cure: exploring one’s thoughts and feelings to relieve oneself of psychological distress. This method of therapy has given millions a structured way to understand themselves and resolve inner conflicts.

In 2024, approximately 35% of Americans tried using conversational chatbots for mental health support, which raises a critical question: “Can AI truly replicate The Talking Cure?” To answer that, we’ll briefly trace the evolution of therapy and examine how today’s Therabots make emotional support feel real.

💭THERAPY THROUGH THE UNCONSCIOUS MIND

⦿ 1️⃣ The Inner Conflicts?

Freud believed that psychological symptoms, such as paralysis or phobias, often arise from inner conflicts that a person isn’t consciously aware of. These inner conflicts might involve feelings of anger, guilt, or fear.

Imagine a 28-year-old woman who can’t move her right hand despite having no physiological causes like nerve damage or joint disorder. While conversing with a therapist, she reveals feeling terrified of making a mistake at work. After gentle probing, she illuminates two internal conflicts:

1. Guilt: She received a promotion, but doesn’t feel like she earned it.

2. Resentment: She resents her boss and the expectations placed on her.

These unconscious feelings and thoughts contradict her self-image as a loyal colleague, so her mind pushes them outside of her awareness. When at work, she uses her right hand to sign market reports. To protect her self-image, her unconscious mind disables the right hand.

⦿ 2️⃣ The Inner Solution?

Freud’s solution was Psychoanalysis: a technique designed to bring unconscious conflicts into conscious awareness so they can be understood and resolved. Basically, symptoms exist for a reason in the unconscious, and once that reason is understood consciously, the symptoms can be resolved.

Once the 28-year-old woman recognizes that she can’t move her right hand because of guilt over her promotion and resentment toward her boss, her mind no longer needs to protect her. As a result, movement returns to her right hand.

💬THERAPY THROUGH THE CONSCIOUS MIND

⦿ 3️⃣ Behavioral vs. Cognitive Therapy?

In the late 1950s, American psychologist B. F. Skinner pioneered Behaviorism: the belief that a behavior changes when it’s rewarded or punished. For example, Ralph fears dogs, and every time a dog barks at him, he runs away. Ralph’s fear of dogs persists because avoiding dogs reduces his anxiety, which negatively reinforces the running away and makes him more likely to continue avoiding dogs. To treat this, a behavioral therapist uses Graded Exposure: gradually guiding Ralph to face dogs in a controlled way through photos, videos, and eventually a real dog. By repeatedly confronting the feared stimulus without causing harm, his anxiety naturally diminishes.

In the late 1960s, American psychiatrist Aaron Beck developed Cognitive Therapy (CT): the view that our thoughts influence our behaviors. For example, if you think: “I always mess everything up!” you might feel sad, anxious, or hopeless, and avoid trying new things. To address this, a cognitive therapist would help identify the unhealthy thoughts, examine the evidence behind them, and replace them with more balanced beliefs. For instance, the assumption: “I always mess everything up!” might be challenged by asking yourself:

• 🔴 “Is it really true that I mess everything up?”

• 🟢 “Can I think of times when I succeeded?”

• 🔵 “Is there a more balanced way to think about this?”

⦿ 4️⃣ Behavioral + Cognitive Therapy?

In the late 1970s, mental health professionals merged these therapeutic methods to form Cognitive Behavioral Therapy (CBT), which helps you challenge unhealthy thoughts and adopt new behaviors to break habitual fears. By combining approaches, it addresses both what you think and what you do. For example, Ralph not only gradually faces his fear of dogs by petting a real dog, but he also learns to challenge thoughts like: “All dogs will bite me!”

🤗ARE THERABOTS VIABLE?

⦿ 5️⃣ How Therabots Are Trained.

Therabots are built on LLMs. An LLM is essentially a sophisticated autocomplete machine trained on the entire internet. In other words, it’s a statistical tool designed to predict the probability of a sequence of words.

To train an LLM, it’s shown millions of sentences with the last word covered up. For example, when given: “I feel anxious when I speak in front of a {BLANK}!” it must ask itself: given the words so far, what’s the most likely next word? In this case, it might predict: “{CROWD}!”

Each time the LLM guesses wrong, it adjusts thousands of Weights: numerical values that help it decide which words are more important for making better guesses in the future. These numerical values control how tens of thousands of words relate to each other within an LLM, helping form the NN: a highly interdependent framework that processes all the words using:

1. 📍Attention Mechanisms: calculate how much each word within a sentence should pay attention to every other word. Consider the following sentence: “I feel overwhelmed when my workload piles up.” In this case, the words “overwhelmed” and “workload” would pay more attention to each other because they’re closely related.

2. 📌Transformer Layers: Further clarify the meaning of each word within a sentence to develop a deeper understanding of the context. Consider the following sentence: “I feel lonely when my friends cancel plans.” In this case, it examines the word “cancel” and determines that “friends” are important because they’re doing the canceling. It also determines that “plans” are important because they’re what’s being canceled. So, it understands that “cancel” directly connects to “friends” and “plans.”

⦿ 6️⃣ The Promises and Pitfalls?

Therabots are trained on vast amounts of high-quality datasets filled with books, articles, and podcasts rich in emotional language and emotional reasoning. While they can’t “feel,” they can mimic emotional understanding by recognizing the data-driven patterns that underpin emotional scenarios, enabling them to predict appropriate emotional reactions better than humans. However, they can’t fully grasp the depth and nuance of lived human experience. They can’t recognize how you suddenly joke when discussing trauma or hesitate before mentioning your best friend.

🔑KEY TAKEAWAY

Therabots can analyze our words, but they can’t perceive the subtle emotional shifts that reveal when we’re subconsciously suppressing our true thoughts and feelings. Therapy ultimately depends on uncovering those unspoken truths.

📒FINAL NOTE

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