The Artificial Third: A Broad View of the Effects of Introducing Generative Artificial Intelligence on Psychotherapy

Abstract

This paper explores a significant shift in the field of mental health in general and psychotherapy in particular following generative artificial intelligence’s new capabilities in processing and generating humanlike language. Following Freud, this lingo-technological development is conceptualized as the “fourth narcissistic blow” that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, interrelationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act following the emergence of what we term the artificial third in the field of psychotherapy. The introduction of an artificial third marks a critical juncture, prompting us to ask the following important core questions that address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships? (2) How does it reshape our perception of ourselves and our interpersonal dynamics? and (3) What remains of the irreplaceable human elements at the core of therapy? Given the ethical implications that arise from these questions, this paper proposes that the artificial third can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy.

Using GenAI to train mental health professionals in suicide risk assessment: Preliminary findings

“…Since then, numerous studies have demonstrated the significant potential of this technology in various domains, including education, medicine, law, art, programming, and psychology. [11][12][13][14] LLMs are a cornerstone technology within the broader GenAI field, designed to understand, generate, and manipulate human-like texts based on vast amounts of training data. While GenAI encompasses various AI systems capable of creating new content (including images, audio, and code), LLMs specifically focus on language tasks, serving as the foundation for advanced natural language processing applications and driving significant improvements in AI's ability to interact with humans in more natural and contextually appropriate ways.…”

“…These include data privacy, algorithmic opacity, threats to patient autonomy, risks of anthropomorphism, technology access disparities, corporate concentration, deep fakes, fake news, reduced reliance on professionals, and amplification of biases. 12,21,28,29 At a more philosophical level, questions arise regarding GenAI-human relationships, the prospect of generating intimacy, and how this may affect human-to-human relationships. 12,18,30 One promising domain in which GenAI has the potential to make a significant contribution to mental health is a global endeavor to prevent suicide.…”

“…12,21,28,29 At a more philosophical level, questions arise regarding GenAI-human relationships, the prospect of generating intimacy, and how this may affect human-to-human relationships. 12,18,30 One promising domain in which GenAI has the potential to make a significant contribution to mental health is a global endeavor to prevent suicide. 22,24,[31][32][33][34][35]…”

Harnessing Large Language Models for Identification and Treatment of Obsessive-Compulsive Disorder

“…Studies in the field of mental health indicate that AI models can optimize assistance and diagnostic processes, shorten the time required for administrative tasks, improve patient availability, and reduce stigma [5][6][7][8]. Despite these advantages, issues concerning ethics, privacy, and cultural bias still present difficulties [9][10][11]. Moreover, the results of these studies are inconsistent, often because of differing methodologies [12].…”