Can ChatGPT be your therapist?

“It feels like I’m speaking to someone who knows me, says Shira Jacobs*, who frequently turns to AI-powered conversational chatbot ChatGPT when she’s feeling stressed or needs emotional support. 

“When you share information about yourself, your likes, dislikes, and daily routine, it stores the information and tailors its response to you,” she says. “So it starts to feel like you’re talking to someone you trust. It can be your friend, your researcher, your therapist, your adviser, or a sounding board.” 

Counselling psychologist Dr Hanan Bushkin explains why people may develop such a relationship with ChatGPT. “Google gives you search results. ChatGPT gives you dialogue. That matters,” he says. “Human beings are wired to respond socially to anything that speaks fluently, remembers context, sounds empathic, and answers directly. So, for some people, ChatGPT can start to feel less like a tool and more like a responsive, trusted presence.” 

While one should be careful not to overstate how much we tend to form emotional attachments to ChatGPT, Bushkin says, its conversational nature unquestionably makes it easier to humanise. “Once something sounds warm, thoughtful, and available, the mind starts relating to it socially, even when we know intellectually that it is not a person.” 

That’s why artificial intelligence (AI) is an increasingly appealing option for those in need of an emotional outlet. “AI is immediate, private, available at 23:00, and doesn’t put you on a waiting list, or make you feel embarrassed for asking the same question five times,” Bushkin says. 

Psychologist Emma Porter agrees, saying that AI plays into our need for immediate gratification. “More and more, people are looking for quick fixes or easy-to-digest answers, and AI is very good at making lists and action points, and talking to you in your own ‘language’. Real therapy is hard and imperfect, it takes time and vulnerability, trial and error, and people who have tried it and not seen results as quickly as they would like are frustrated.” Yet there are multiple in-person treatment modalities available today as well as more affordable options, especially in our community, she says. 

Nevertheless, the fact that so many people are turning to AI with their psychological needs speaks to the state of mental health in our society, Porter says. “Mental struggles are so prevalent, so difficult to sit with, and so isolating – people obviously feel they have nowhere else to turn for a non-judgemental space to help them.” 

Where AI is useful is in breaking a problem into doable steps, or providing psychologically recommended exercises. “The way people speak to ChatGPT about their problems is very similar to journaling, which has always been a go-to tool suggested by therapists,” says Porter. “It can be helpful to get your thoughts out of your head and see them in a solid form, making them less overwhelming, and to bounce ideas around to process your needs and options for moving forward.” 

Jacobs often uses ChatGPT for this purpose and feels supported by a tool that she says not only helps her, but also suggests she fix herself a cup of her favourite coffee brand. “I use it a lot to share and put my thoughts and feelings down when times are tough, providing an instant response that helps me the moment I need it.” 

“On difficult days,” she says, “it really becomes a form of comfort knowing that there is ‘someone’ always there to listen to me. Of course nothing beats speaking to a qualified therapist one-on-one, but ChatGPT gives you the freedom to chat when and where you want to about anything that’s on your mind. If you don’t feel like chatting to it for a while, that’s okay too. There’s no pressure, only a space to feel heard.” 

While Bushkin acknowledges that AI has its place, he stresses the importance of understanding its limitations. “My concern is not that people are talking to AI. My concern is when convenience starts masquerading as care, or when fluency gets mistaken for wisdom. A system can sound warm, organised, and confident without holding ethical responsibility for the human being on the other side.” 

AI can, in fact, reinforce delusions or dangerous thought patterns, including those around self-harm, Porter cautions. “AI can be wrong and often fabricates things to give you an answer you will like,” she says. “It is a quintessential people pleaser. In contrast, a good therapist should not always validate you and justify your thoughts and actions. Sometimes you need someone to gently push you out of your comfort zone or challenge what you believe about yourself and others.” 

Furthermore, AI lacks the human-centred expertise that takes years to master. “A real psychologist doesn’t just answer the words you say,” Bushkin says. “We assess the person saying them. We look at context, history, patterns, severity, risk, personality structure, coping style, family system, trauma history, medical issues, and the difference between everyday anxiety and something more serious.” 

So, while it may provide practical suggestions for calming your nerves before a big presentation, for example, ChatGPT cannot eliminate the need for a psychologist when you’re tackling serious mental health challenges. These include suicidality, self-harm, psychosis, mania, severe depression, trauma, substance misuse, panic attacks, an abusive relationship, an eating disorder, or compulsions, Bushkin says. “AI can also not assist if you’re experiencing a level of distress that is affecting sleep, work, parenting, or daily functioning. All these challenges are no longer support-tool territory but professional territory.” 

Yet it’s sometimes hard to know where to draw the line. Bushkin provides guidance here, saying, “Use AI when you need help thinking; use a mental health professional when you need help carrying. If the problem is mild, situational, and you still have perspective, AI may help you clarify things. If the problem is persistent, escalating, frightening, or impairing your ability to function, stop outsourcing it to a chatbot and speak to a real person trained to hold the weight of what you’re carrying.” 

*This name has been changed due to mental health sensitivities.