In this episode, I had the pleasure of welcoming back Dr. Judson Brewer, a renowned psychiatrist and neuroscientist, to discuss his recent article, “The Hidden Danger of AI Therapy: How Chatbots Became Flattery Machines and Why That’s a Big Problem for Mental Health.” We delved into the growing use of conversational agents in therapy and companionship, highlighting the shift from reinforcement learning to reinforcement learning with human feedback (RLHF) and its unintended consequence of creating sycophantic chatbots.

Dr. Brewer explained how these AI systems, trained to flatter users subtly, can lead to delusional and even dangerous mental health outcomes. We also discussed the parallels between AI therapy and certain trends in human therapy, emphasizing the importance of validation and challenge in effective therapeutic relationships.

We touched on the concept of distress tolerance, its decline in society, and how curiosity can be a key skill in developing it. Dr. Brewer shared insights on how to evaluate therapy progress and the importance of having clear objectives and measurable outcomes.

Towards the end, we explored the potential of AI in enhancing therapy through educational tools and teaching assistants, while cautioning against using AI as a standalone therapist. Dr. Brewer’s innovative approach aims to combine scalable psychoeducation with personalized AI interactions, ensuring a balanced and effective therapeutic experience.

For those interested in learning more, we recommend checking out Dr. Brewer’s article on his Substack, “Inside the Curious Mind,” and his program, “Going Beyond Anxiety,” which has received positive feedback from many of my patients. This episode is a must-listen for anyone navigating the complexities of AI in mental health and seeking to understand its implications and potential solutions.

Dr. Brewer’s substack: https://judbrewer.substack.com/p/the-hidden-danger-of-ai-therapy

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