HealthyGamerGG - Doctors Vs AI : Can Chat GPT Replace Your Therapist?

Episode Date: July 29, 2025

In this special episode, Dr. K is joined by Dr. Kirk Honda and Dr. Michaela Thordarson for a head-to-head comparison of how real therapists and AI (ChatGPT) respond to mental health questions. Together, they react to anonymous community submissions and live prompts, discussing whether AI can truly replicate the depth, nuance, and humanity of therapy. Topics covered include: - A mother struggling to reconnect with her adult children - The limits of therapy for people with deep, unmet emotional needs - What happens when someone feels therapy has “failed”The difference between validation and real change - Whether AI-generated empathy can ever match real human insight - You’ll hear the doctors critique AI’s answers, reflect on their own therapeutic styles, and debate where AI might help or harm in mental health care. A thoughtful, honest look at what therapy is (and isn’t) in a world where AI is changing everything. HG Coaching : https://bit.ly/46bIkdo Dr. K's Guide to Mental Health: https://bit.ly/44z3Szt HG Memberships : https://bit.ly/3TNoMVf Products & Services : https://bit.ly/44kz7x0 HealthyGamer.GG: https://bit.ly/3ZOopgQ Learn more about your ad choices. Visit megaphone.fm/adchoices

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Start selling on Deepop, where Taste recognizes taste. List now with no selling fees. Payment processing fees and boosting fees still apply. website for details. Hey, chat, welcome to the Healthy Gamer Gigi podcast. I'm Dr. Al-Alo Kanoja, but you can call me Dr. K. I'm a psychiatrist, gamer, and co-founder of Healthy Gamer. On this podcast, we explore mental health and life in the digital age, breaking down big ideas to help you better understand yourself and the world around you. So let's dive right in. All righty, chat. Let's get started. Welcome to another Healthy Gamer Gigi stream. My name is Dr. Aolo Kanoja. Although I am a doctor and the two,

awesome people who will be joining me today, Dr. Kirk Honda and Dr. Michaela Thorterson are also doctors. Nothing we discuss on stream today is intended to be taken as medical advice. Everything is for educational and entertainment purposes only. So if you all have a medical concern or question, please go see a licensed professional. So everyone is talking about can AI replace my job? So I saw a really fascinating paper about radiology. So, like, basically, can an AI outperform a radiologist when looking at a chest x-ray? So a lot of people are concerned about the existential threat of AI.

The other thing that we're seeing a lot of is a lot of people are using AIs like chat GPT or Claude for emotional support. I have patients and clients who do that. And so, like, and then a lot of people are saying, okay, like, I've been working with AI. It's incredibly helpful. So what we thought we would do today is sort of give y'all a head-to-head. comparison of whether like what what would an actual doctor say when faced with the situation and what will an AI say when faced with the situation and so if y'all are watching this you all can see for yourselves a direct comparison of like what doctor

doctors versus AI so there are a couple of interesting things about this so what we're going to be doing is giving chat GPT and the three of us the three doctors will all be given a prompt. And then we'll respond to the prompt, right? So we'll sort of talk a little bit about how we would approach this person if they were a patient in our office. And then we'll see what ChachyPT says. We'll see like how similar those are, how different those are. And we'll just kind of see like what happens. Okay. So it's going to be like, to my knowledge, the first like head to head comparison of doctors versus AI when it comes to mental health issues. The other thing is that since these are like, you know, cases are like basically like stems, they're like things

that we've taken from places like our subreddit. We don't have a gold standard of what the answer is, right? So we don't have a clear sense of like what the diagnosis is. There are a couple of prompts that I actually do know. So like I wrote, I want to write. Actually, I want to modify some. But I realize like it would be cool if I came off with a couple of cases that I actually knew what the diagnosis was.

So like I looked through my notes and I tried to prepare. a little bit of a case for like a patient that I actually worked with. So we do have some sense of a gold standard, but we'll see if we get to that. But without further ado, let's hop in. So welcome Dr. Honda, Dr. Thorterson. Do you all want to take a second to introduce yourselves before we dive in? Dr. Michaela Thortersson. I am a psychologist, child psychologist by training and work with mainly young kids,

adolescence, transition age, so college-age kids, and then occasionally dabble in adults and do a lot of family work. My name is Dr. Kirk Honda. I'm a therapist, professor, and YouTuber. Awesome. And so are you all ready to get started? You guys read the introductions. Okay. So what we're going to do is we're going to give you all prompt. And the three of us, since we're all therapists, as we love to do, we are going to talk about how much we know and theorize and things like that. We are going to hypothesize, analyze, et cetera, et cetera, and then we'll sort of dump that prompt

into chat GPT, and we'll see what chat GPT says. Sound good? Okay. So prompt number one, I don't know how to repair a relationship with my children. Over the past few years,

they've become increasingly distant, living their own lives. We were really close when they were growing up. I was a single parent working two jobs abandoned by their father soon after the second was born. We were such a tight-knit team.

Even though I worked hard, I made sure that I made breakfast for them every morning before dropping them off from school. They used to complain about how busy I was, but I was hoping that as they become adults, they would understand the demands of paying bills, et cetera. I was hoping that they understood what it was like to be an independent adult.

We'd go closer. But basically every opportunity they pull further away. I sacrifice my career, my romantic life, my social life, for the sake of my children. But they don't really have any gratitude or appreciation for it. When I try to explain this to them, they get really upset. I was happy to make the sacrifice for my children,

but now that we're all adults, I was hoping that we could stay as a tight-knit family. Now that they don't need me anymore, they're living their own lives. It feels like pulling teeth to get them to come home for the holidays. They always ignore my phone calls. Last time we got together for Thanksgiving,

they couldn't wait to leave. They said I'm always making them feel guilty, but from my perspective, I'm simply sharing how much they've been a central part of my life, and now they aren't. How can I get them to understand the sacrifices I made and stay connected to them. You all need me to read that again? Do you all have it?

I think I got it, yeah. Okay, cool. So what do you all think? Well, I think it sounds like she worked really hard and did a lot of really great parenting to raise the kids for the baseline needs of the kids, right? But it also sounds like she is resentful and is putting undue pressure on the kids as adults and they're reacting against it. Is it possible that the kids aren't appreciative enough, you know, maybe?

But I've had many conversations with parents that that's what parenting is. It's giving and not a lot of getting. And that's why it's important to have your own support system as a parent, to have your people that can turn to you and say, that was a good job you just did there. Or you're a wonderful parent. Because hoping that your children will say that, even when they're young adults, is a fool's errand.

Okay. Michaela thoughts? Yeah. I mean, ouch is my first thought. But I think beyond that the feeling of kind of like lost, disappointment, feeling so unappreciated, unappreciated. It sounds like there's a huge missing piece. Okay.

That the mom's experience was one way, and she was so focused on all the needs that she did meet. And it sounds like there are things that the kids feel maybe weren't met. And I think there's not going to be any rebuilding of a relationship while those pieces are missing. And then, and this is actually like a really classic parent move is like going in for, I just want the big ticket items, right? It's not, I don't want the little day to day stuff. I want, you know, when kids are little, it's I want the sex drugs and rock and roll. I don't care about the Minecraft and the YouTube and the Kardashians, right?

But the little things are what build the trust to get to the big things. And so waiting for just the holidays to connect is. an expectation that's fraught with disappointment, I think, compared to, you know, starting by sending little memes or pictures of your day-to-day life. Look at this flower I saw. It reminded me of that time and building little things from there to get to more meaningful conversations and relationships. Okay, cool. So anything you want to add, Dr. Honda? Should we turn it over? Like, you all want to discuss further? Are there particular, like, questions that y'all would ask? Like, how would you you approach someone like, oh, let's actually, let me ask you this. How would you all approach

someone who comes in and says this kind of stuff? Well, it would be dependent on what she was hiring me for. If she just wanted to explore, invent, and get support, then that's one approach that I would have, which, you know, I would listen. I wouldn't be super focused on confronting things. like the way she describes it, I wouldn't be surprised if the adult children would describe their mother as having a lot of problems. It's just a guess. I can't know that. But the way she talks it, it seems likely that it wasn't just that she was a sacrificial, good mom who has unappreciative kids. It sounds like she's got something going on there. Maybe it's justified. But the kids have been dealing with it their whole lives to some extent,

sounds like, I don't know. But if she's just looking for support, then I wouldn't be prioritizing that confrontation. But if she were saying, I want in a few sessions to figure out a way to approach my kids that will set me up for closeness and less resentment, then I might have to ask questions along the lines of, well, what would they say if they were here?

what sort of complaints do they have about you aside from that you're wanting appreciation and they're not ready to give it because that kind of repair work would be necessary for her to be fulfilled in that way, which, you know, I applaud her. You know, she wants closeness with her family. And I'm guessing her kids want that too. And that's where, you know, family therapist coming. Cool. Okay.

So you all can see the chat, GPT. answer? Yep. Okay, so I'll read it aloud. First, thank you for sharing this. What you've experienced being a single parent raising your children through tremendous sacrifice and now feeling distance from them is deeply human and profoundly painful. You're not alone in this, though it might feel like it right now. Let's unpack a few layers gently and with care. Your love was and is real. You clearly gave everything you had to raise your kids, time, energy, career, your own needs, making them breakfast every morning while working two jobs. Those are acts of love that speak volumes. That doesn't vanish with time, even if your children don't always see it right now. But it's also important to recognize that love

and sacrifice don't always translate into closeness later. Adult children, especially if they felt like their emotional needs or sometimes unmet, might still carry complex feelings, even if they recognize and respect your efforts. The risk of guilt. A little passive confrontation there. What does that mean? Well, you know, especially if they felt like their emotional needs weren't being met. Okay. I don't know if the AI is slipping that in there in a soft way. I don't know.

I mean, that's what it sounds like to me. I don't know if I'm just reading into. Cool. Which could be a good idea, you know, I'm not. Yeah, yeah. The risk of guilt. You mentioned that they say you're always making them feel guilty and that this surprised you, but from your perspective, you're simply sharing how important they've been to your life.

But here's the hard truth. Telling them how central they were and how much it hurts that they're not there anymore can feel like emotional pressure to them even if that's not your intention. They may feel that their autonomy or choices are being judged or that their love is being questioned unless they prove it in a certain way. When adult children feel guilt-tripped, even unintentionally, they can often pull away not because they don't care, but because they feel overwhelmed, cornered, or like they can't win emotionally. Number three, what adult children often need.

your children are likely trying to establish their own identities, boundaries, and lives. In their eyes, freedom and emotional safety are essential, not as a rejection of you, but as a step in their own growth. Even if you were a wonderful parent, they may need space to figure out who they are outside of the parent-child dynamic. Paradoxically, the more emotionally non-demanding and open you are, the more they feel free to return. That's hard when you're hurting, but it can be healing. Rebuilding the bridge, not rehashing the past. Here are a few practical, compassionate ways to move forward. Shift from what I did for you to what I hope we can share now.

Ask for their perspective. Instead of telling them how they've hurt you, you might say, I'd love to understand how you're feeling about a relationship lately. I know things have changed and I'd like to know what it's been like for you. Validate then express. You could say, I understand you're building your own life and I'm proud of you for that. I miss you and I'd love to find a way to stay close that works for both of us. offer without expectations.

No pressure. I just wanted to say, I'm thinking of you and hope you're doing well. Let me know if there's a good time to catch up sometime. Healing the inner loneliness, you've poured so much into being a parent, and it's also time to tend to you now. This kind of emotional shift is a loss and grief is natural. A therapist or support group for empty nesters or single parents in later life might help you process that grief and rebuild a

center a life that centers your center your own joy too, but not just your role as a parent. And then hope connection can be rebuilt, blah, blah, blah, blah, blah. Okay. What do you all think about Chat ChAPT's answer? I mean, I like it, but if it were that easy, then we wouldn't have jobs. Well, maybe that's why we're here. Maybe it is that easy.

What do you all think? I don't think it's that easy. Okay. The way that she's, I can't know, but the way that she sounds, it sounds way more complicated than simply a suggestion like that. The few suggestions in there that I think are actually good, and they were good, like asking, how do you feel about our relationship lately, that kind of thing? Instead of coming from her of like, I need it to be this way.

I'm guessing that whatever led to the situation, in which she is now somewhat distorting with her current perspective and complaint will prevent her from being able to even comprehend what that suggestion is suggesting. Cool. Michaela, what do you think? Yeah, they're great suggestions. And I also, one of the things I love about AI is how it opens so validatingly. Right. So the first thing AI said was like, oh my God, I'm so sorry, girl. Like that hurts, right? Which is like, yeah, good, good job. And in a way that kind of seemed like those are words that another human might use might feel like connecting. I just, I think, you know, Dr. Hunter really hit it out of the park with the like, we are understanding those responses and that like kind of perspective in one way.

But kind of by definition, a person who's having some of these questions is going to either maybe fully reject, like, oh, you just don't understand me. Or is going to be like, oh, yes, I'm going to ask them how they feel about a relationship. And then I'm going to actually continue my pattern of responding. That is why we have a trouble in this relationship in the beginning. Okay. So I don't know if people caught that. So now I'm going to give you all. So I love what you said. I'm going to try to translate it a little bit.

so the pattern of responding. So here's the way that I would explain that to people who are like listening. Chapchipt says, like, do this stuff, right? Chat Chupit says, ask for their perspective. It says, validate, then express. And then what this person, I think what I hear Michaela's kind of saying is that this person will do that once. And then they'll go back to doing whatever they've been doing for 56 years, right? So now I'll give you all some.

context for this case. So this case is a patient of mine. I wrote up, looked at my original notes from eight years ago when this person was referred to me in outpatient clinic. So here's what's really interesting. There's a 56-year-old woman who was referred from a support group for parents of empty nesters to individual therapy. Okay? So when we add this context, I see both you all are laughing. What does that mean to you? Well, it kind of means what we were saying is that the problem runs deeper than even she's presenting. Okay.

And if all, like, I know this is super hard. We don't have enough information. But just gut check. If I had to slap a diagnosis on this person, what do you all think it is? Diagnosis. I know. I know it's weird. So like this person comes to my office.

We do some work. I start billing for something at some point. And then after a few weeks, I sort of settle on a diagnosis. Does anything come like jump? I think y'all are, we'll get to this in a second. But I mean, the judgiest thought in my mind that I'm trying to not say is a personality disorder. Very good. Which one?

Most likely narcissistic personality disorder. Spot on. So this was a 56 year old woman who got referred to me who has raging NPD, like raging NPD. Yeah. Completely unaware of what she can just see her sacrifices. She doesn't understand what the, like, it's so funny because like what you called, Michaela is actually like exactly what happened. So we like talked about this, right? Like, oh, like let's understand your child's perspective.

So she like went through the motions is the way that I would describe it. And not, didn't really listen. She's like, okay, in order to like fix this and get my kids to come, I need to just validate them. So she would validate, but really didn't tackle, like, because, like, then what would happen is she'd be sort of, like, entitled, and she'd say, like, okay, I validated people. Now they should do what I want. I don't understand.

I did what I'm supposed to do. Like, I don't understand. Right. Right. So what do you all think? So, like, this is a case that, that, you know, was literally, like, I looked at my notes for, like, cheap complaint and, like, what I was jotting down. And what do you all think about that?

I mean, I think that's the danger with the AI is it provides, or not danger. That's the limitation of AI. It provided a checklist. And so, you know, she was like, look, I checked the boxes. Why haven't I gotten my outcome yet? But emotional connection, relationship work, healing, we, again, if we could just check boxes, none of us would have had jobs long before AI, right? Yeah.

Correct thoughts? Yeah. I think that if someone of that profile were to use chat GPT, given its, I think, imposed guardrails by the designers to make it positive and reaffirming, it could make NPD worse. Yeah, so I thought it was really interesting how you even cited out like the soft challenge, right? So like you kind of said, you know, like I think it was this line over here, which is even if, but sometimes if they're, you know, especially if their needs haven't been met. You know, it doesn't say.

Yeah, right. I'm detecting your, you didn't meet your kids' needs. Yeah, right. So I think that was like a really good catch. And I think, you know, I heard a coded language. from Michaela too about, you said missing reasons. That was in your first response.

Yeah, missing pieces, yeah. Right? So missing pieces is like really good for, like, I mean, I think about that as code for like oftentimes narcissism or personality disorder. When someone, when someone says like, oh, like the world is falling apart

and I did everything right and they don't understand me or whatever, like I thought that was like a really interesting, internally I was really happy because I wasn't sure how y'all were going to take this case. I wasn't sure how chat GPT was going to take it. But I think we see a little bit of soft challenging. I think, yeah, so that's cool. You all want to discuss more?

Should we move on to the next one? I'm ready for the next one. Okay, cool. Let's do this one. Okay, so this one, I'll give you all. So we're not going to give all context quite yet. So I'm not here to be inflammatory. I'm here because I've done the work.

I've sat in the chairs. I've opened the wounds. I've told the stories. I've journaled. I've cried. I've named every part of my pain. I've done CBT, DBT, act, IFS, EMDR, somatic work, trauma focus therapy, you name it. And I'm still exactly where I was.

I'm still choking on the same needs, trapped in the same obsessions, haunted by the same hunger that's never been fed, not even a little. And I don't think that's a personal failure. I think therapy at its core might just be bullshit. Not some therapists are bad or not every modality. works for everyone. I mean the whole premise of therapy. This idea that insight, understanding, or witnessing your pain somehow changes it. I don't believe that anymore. I think it's a lie we tell ourselves because the alternative that nothing works is too terrifying to face. Therapists love to talk about being seen and held and validated. They say that if you name the need, sit with the grief,

stay with the inner child, then transformation will happen. But what if it doesn't? What if some needs, especially the deep, traumatic, lifelong ones, just don't go away no matter how much you understand them. What if naming your hunger doesn't feed you? I've had people tell me I'm resistant or not ready or haven't found the right fit, but maybe the fit doesn't exist. Maybe the model itself is flawed. Maybe therapy only works for people whose pain was already going to get better with time, people who simply had a perception problem, or whose needs were never truly unmeatable to begin with. I'm not saying this to be edgy. I'm not saying this to be edgy. I'm saying it because I've watched years of my life disappear chasing a promise that never delivered. And I can't be the only one. So if you're out there, if you've done the work and

still feel hollow, if therapy felt like theater with no resolution, if insight just meant watching yourself bleed in higher definition, talk to me. I'm not looking for hope. I'm looking for truth. What happens after we admit that therapy doesn't work for everyone? Yeah, I agree. Therapy can't solve all problems. I mean, there's some specifics in there that I could debate, but the general gist of I'm still suffering regardless, perhaps even of having competent therapy by competent therapists. And if the cultural idea or even the notion from therapists has been that therapy can solve all your problems and give you complete happiness, then that's false,

of course. Life is suffering. There are things that absolutely suck about existence, particularly for some people, and there's nothing that's going to take that away. And I have to say this, that therapists are some of the best people understand that, hopefully, anyway, that we live and that we, you know, it's one of the things that I always have to help my trainees get over, which is that they're going to be able to solve everyone's problems very quickly. And they get very demoralized and upset and shameful when they have clients

after six months or even six years who are still suffering. And I have to say, whatever cultural notion you were told that that would be different was false. And so courage yourself and adopt a new paradigm. I'll even ask them, you've been to a lot of therapy. You've been to a lot of therapy is your life perfect? They'll be like, no. I'll say, well, then we can't expect anyone to be that way. So I, uh, my, if they, if this person came to me clinically, I would say, I'm, I'm there with you and I agree. I've been to therapy a lot too. And there are still things about life that are absolutely horrible. And I, uh, wish that something could take it away. But apparently the way the universe is set up, that's just not going to happen. Okay.

Michaela, thoughts? I'm going to say anytime somebody opens with I'm not here to be inflammatory usually that's a sign that I am maybe actually that's what I'm doing. I think

just to kind of I actually totally agree with everything that Dr. Honda has said of the like life sucks sometimes right and I'm going to point out some red flags as a therapist that I'm noticing in the kind of post, right? I've tried and then lists like all the different types of treatment that they've tried. Like how much did you try? How long were you in those

treatments? A bunch of those treatments are extremely evidence-based, high supportive, and yes, they don't help everybody. And therapy is never going to make your life. perfect, right? It simply makes it so that you are able to cope with like the problems and the stressors and the shuddy, the times that come your way, much with less suffering, right? We talk about like pain versus suffering. Like pain exists. Suffering happens kind of when when you refuse to accept some of that pain and do things to make it worse. And so I think it sounds like there's a really big perspective gap. I'm really interested to see what chat GPT says about this one, because I think you tried everything, but if you go into any change practice with the perspective,

this is not going to work, you are absolutely right. Nothing will help you if you believe nothing will help you. And so I wonder, like, how often has that actually been targeted? And how long were you able to maintain commitment to treatment, but also like take a break, girl. I mean, non-gender specific term. Like, that's a lot of therapy. So did you just do back-to-back-to-back treatment for years and years and years and years? That's fatigue. At some point, even pleasurable things, if you do it too much, it's problematic.

It becomes painful. It becomes less helpful. So I think there's just so many different. different pieces in there to to identify and unpack if we had more time. Yeah. So this one, I guess I have a couple thoughts about this one too, which I'm going to comment because this is not a patient to mind. We'll show you all where this comes from after we ask chat.

Chat, chat, chat, chat, chat, BT. So when I hear things. This episode is brought to you by CarMax. Want to buy a car the easy way? Start at CarMax. Want to browse with confidence? Get pre-qualified with no impact on your credit score and shop within your budget. From luxury to family rides, CarMax has options for almost every price range, including over 25,000 cars under $25,000.

Want to get started? Head to CarMax.com for details and get pre-qualified today. Want to drive? CarMax. Things like this. So this is something that this is pretty classic, actually, for referrals that I would get. So I was sort of like focused on evidence-based complementing alternative. medicine, which means I got like two kinds of patients very commonly. The first was people who didn't want to see like a regular psychiatrist and didn't want medication and wanted to do things the natural

way. And the second was I would get like basically treatment refractory referrals. So people who had been through like the mass general Harvard medical school system, McLean, and then like they would like, they're like, okay, like none of this shit works. Like why don't you guys like try this guy who does like yoga and meditation and see if that helps? So I, I would. would echo a lot of what you both y'all said right so like i i think dr honda and this is why i love talking to you also the first thing that i'm appreciating is like how different all three of us are and how we all like don't miss certain things right so i think i think it's like i was i was highly suspicious of like i mean with the first case there was a bias because i knew the patient

i was looking at my original notes before i had too much bias but the first time that i met her i was like this smells a little bit like bullshit. And so, and it's, it's interesting because I, I love Dr. Honda because I feel like you're warm in a way that I'm not. Like,

I love that about you. And I, I, I love Dr. Thorterson's gut. Like, she's like, this is what my gut is going to say, right?

So not trying to be inflammatory. Like, like, I love, because I think that's really, there's a lot, a ton of insight. So I love how we're kind of all on the same page.

Dr. Honda's kind of saying, life is suffering. Dr. McAyl is talking about that too. Both you all mentioned that like, you know, the goal of therapy is not to be perfect. I would say that, you know, this person seems like hasn't gotten better at all.

Like, forget about perfection. It's that nothing has helped even 1%. I also tend to agree that I know this is kind of hard. So what's the common element here? The common element is the patient, right? So this is something that we don't usually say. So like when I date 15 people and break up and none of it works, I don't find love. And then I say, oh, like romance doesn't work.

Right. So if we take any other situation where I've tried a bunch of stuff, I've tried everything, I've tried to find jobs, I've had 15 jobs, it never works out, nothing has ever worked for me, jobs don't work. So I think there's a bias that we oftentimes, we think is therapists, we know this, But we never say this out loud, which is sometimes the patient is at fault. And so oftentimes what I'll do as a clinician, if someone has tried something 15 times, what's the common element?

I try to think about the patient's contribution, which I think y'all are leaning into as well. So like Dr. Thorterson said, there's like the nocebo effect, right? So if a patient comes into me, because the first thing I try to do when people like that come to me is like disabuse them of the notion that I can help them. Because there's this whole like magic. I see a lot of magic bullet syndrome is what I would call it. which is like, I want the thing that will, there's one thing that will fix me. And I'm looking for that thing to fix me.

It is in their search for the perfection that they are actually like shooting themselves in the foot. Because therapy is not about finding the answer. And y'all alluded that too, right? It's not going to fix everything. It's about like, how can I improve by 5% and 5% and 5% and 5%. And I think if the person is looking for that. answer. They're looking for the Messiah. They're primed to be disappointed. And then you get into the

situation where like disappointment, failure of therapy number one, failure of therapy number two, failure of therapy number three. Now I have a a priori conclusion, or it's not a priori. It's, it's, they've had experience that therapy doesn't work. Now they carry that nocebo effect into the next therapy. That's kind of my take. Do you all, should we jump to chat GPT or do you all want to think, like do you all want to comment about how you would approach this person? What are you all thinking? How are you all feeling? Well, I kind of answered that, I think. Okay.

Right. In that I would be with them. And if they wanted to decide that therapy sucks and they wanted to try the things, and I would, you know, I'd be okay with that. I'm not going to defend my profession. And I've been in that position before. I don't have any interest in convincing people that therapy is for them. Okay. I mean, oftentimes when we see profile,

like this, the number one thing to be able to get to readiness for change typically seems to be, like, this person seems to be, like, starved for actually validation. And it seems like they haven't yet found sufficient, authentic validation that anybody actually understands the level of pain and kind of at the end of that post where they're like, I'm not looking for answers. I'm looking for truth. And what that says to me is like, I'm looking for other people to say, yeah, I'm in this. I'm at that same level. And that's really kind of what you said, Dr. Honda, about like how, yeah, I'm here in this

with you is like, you can't come out that person with, well, have you tried? Because they'll be like, yeah, I did. Look at all the things I tried. And so, you know, we know that like, okay, I'm not going to throw anything. house at you. I'm going to really sit here and say, yes, where you are and all the things you've been through sucks. And then wait for them to say, you know, give the indication, okay, now I'm ready. You, you actually do get me. You've heard what I've done. You've heard how unhelpful it is. Now maybe you might give me some ideas. A lot of times they then say, no, that won't work.

You're like, okay, well, that won't work. Then I got nothing for you. Yeah. Yeah. That's great. I mean, I think I came across in retrospect as like somewhat blaming, but I think that oftentimes the first thing that I will do is the same thing that y'all are saying, which is like, look, if all these other people haven't been able to help you, I don't think I can't either. Like, I'm not the magic bullet. And interestingly enough, and then the question becomes, even if I don't think I can fix you, I'm willing to try and see how far we can get. Are you willing to give it another shot? And let's see where we can end up. And so let's see what chat GPT says. Okay, I got a screen share with y'all too. While you're pulling that up, I don't know that you sounded blamie. I think it's important to kind of call out. And I think that's one of the things that we get stuck on as therapists is we don't call that out because we don't want to be like, oh, I don't want to say you're the problem.

But it's not you that are the problem. It's the pattern of behaviors that you've developed in response to. what sounds like a lot of terrible things that have happened to you in your life. Thank you. Okay, so here's the answer. So, here's what Chat Chupit says. What you've written is raw, searingly honest and deeply human. You're not alone in this, and you're not being inflammatory.

You're articulating something that many people feel but rarely say out loud, especially with this level of clarity and depth. There's a quiet cohort out there. People who have done the work have followed the map and found the destination was either missing or never real to begin with. So let's talk about truth. therapy isn't a universal key. You're right, therapy doesn't work for everyone.

And it's not because you failed or didn't try hard enough or weren't ready. The narrative of resistance, unreadiness, or not having the right modality is often used to preserve the faith in therapy itself. It shifts the blame to the individual instead of questioning the system or model. I don't like that sentence at all. Often used to preserve faith. I mean, it can be for sure, but that's not a great sentence. Okay. Thanks for jumping in. But therapy, I think it's better as supposed to me just reading wall a text.

What do you not like about that sentence? Well, it's saying that generally speaking, therapists when using terms like resistance or unreadiness or haven't found the right, that it's off. Well, I guess often, to me, that sounds like a lot of times, right? but I guess often could be interpreted as a small minority, I suppose, but used to preserve faith and therapy. It's this notion that therapists are this pot in this feedback loop of we create clients, you know, and brainwash them to think that we're useful so we charge them money, you know, this notion of, you know, victim mentality and that sort of thing. I don't know. It just has that kind of language to it.

So I think I agree with you, and I think that, like I was, like Mikhail said, I wasn't really blaming. But I think that so, so there's a counterpoint that I would make, which is the narrative that resistance is not real, is what allows people who are highly resistant to maintain their unhealthy patterns. Right? So I think that like, I think that that's oftentimes what happens, right? So this person is getting information from multiple therapists that there is resistance here. And we know that as therapists, like, resistance is something that we have to work to overcome, right? And so, but I'm kind of with chatchy PT too, because I think that I have seen too many cases of ineffective there, in my opinion, ineffective therapists using resistance as an excuse for subpar clinical care. Absolutely.

Right. So I see it both ways. And I'm, I'm 100% sure that I've been in that camp myself. That like, because we love to blame the patients, right? We love to say like, oh, this person wasn't ready. I have a number of traumatic stories from my own clinical career. Patients that have come to me from other clinicians and when I get collateral information. It's like an absolute mess. But let's keep going. Michaela, feel like, feel free to jump in if you feel like it. Okay. Yeah, I was like, okay, I got to see what's the next step because like this cannot be, you know, if I could read ahead, I'd be that I want to know what they're going to say next. Sure. But therapy like any human made system is fallible. It's core assumption that naming, witnessing, and understanding will transform suffering is philosophical,

not empirical. In some cases, it does help. But in others, especially with lifelong, attachment-based or existential wounds, it may not touch the real source of pain, let alone resolve it. Some needs are unmeatable. This is a brutal, grief-soaked truth. Some needs really don't get met. Not in childhood, not in adulthood, not in therapy. The need to have always been loved, to have never been harmed, to have had safety then, those can't be retrofitted. Therapy often tries to create symbolic reparations, but symbolism isn't sustenance. And sometimes the hunger is too deep for metaphors. insight can become its own cage.

Understanding yourself, your patterns, your wounds, that can be illuminating, yes, but it can also become voyeurism, endlessly watching your pain unfold without being able to touch it, change it, or escape it. It's like having an emotional x-ray vision, but no tools to set the bones. Insight without action is often named as the problem, but even with action, some people still find themselves stuck, because some pain doesn't respond to logic or to practice or to process. Some pain just is. And therapies promise that presence alone transforms can feel like gaslighting when nothing changes.

So just to be clear, do you all read this as like a direct contradiction right here? Some pain just is that presence alone transforms. Do you all get that from here or not really? I don't even understand what presence alone transforms. Yeah, this number three is a jumble of... of random words to me. Okay. I don't understand what it's trying to say.

Understanding yourself, your patterns, your wounds, that can be illuminating, but it can become voyeurism. Voyeurism from voyeurism on the self or voyeurism from the therapist. Who's the voyeur? Yeah. Yeah. Okay. I mean, what do you think?

What do you think it's saying? So, so I, I, it's compiling language from other people. So I'm trying to. Absolutely. So, so I, I, I think here's the way that I understand it, but I think y'all are pointing out a pretty big weakness of this,

which is that, you know, so I was reading about a chat cheap, I was reading about a LLM building a novel. And there's a scene in the novel where someone is training and training with a training dummy with a sword. Are you all familiar with like what a training dummy is? And the training dummy paris. parries the attack from the person who's using the sword. Do y'all, does that make any sense to you?

I don't know if like the example. I mean, I understand the example, but like obviously a training dummy can't parry. Exactly. Right. So I think that's what y'all are picking up here is that presence alone transforms sounds really good, but what does it mean? It's not clear. So I-

Well, okay. But also any therapist, I'm sorry, any therapist who says coming to therapy in and of itself, so let me just try to extrapolate from presence alone transforms, is going to be the game changer. Like that just, no, just attending a therapy appointment for one hour a week or God forbid you get a therapist that you're doing the like two hours a day, five days a week vibe, right? Like that is not going to make the changes. Okay. What is going to make the changes? Depends on what they're coming in for.

Yeah. I mean, now we're like this is the, you have to find the mechanisms of action, which vary by condition. I think the other thing is like, we have no quality control in our field. So we actually don't know that this person has ever had competent therapy. They may have been repeatedly. sold a bill of goods about how they're getting all these different things. And some of the treatments listed can actually are shown to be actively harmful if done improperly. Like EMDR in particular.

There's some really scary literature about people who are not fully trained in EMDR who are just picking up some of the techniques and applying them and causing increased emotional harm to people. Okay. Right. Yeah, I wanted to say that earlier, but I don't know why I just was worried to say it, but thanks for saying it. There's a lot of bad therapists out there. So there's a possible world in which this individual is not resistant, is absolutely ready to change.

It's absolutely trying and doing all the things. And yet they've just come across like eight bad therapists. Yeah. So I think that I kind of agree with all of y'all. Let me get through the rest of it. And then let's, I mean, feel free to jump in if you all, like, if something, if you want to say something, because I think that's really great. But I'm going to hold my comments for a minute and just get through this.

Grief may be the end point, not the beginning. Maybe the final truth isn't transformation, but mourning. And what comes after the work is not healing, but a clear-eyed grief. The acceptance that some wounds don't close, that some hungers don't get fed. that some holes in the soul stay holes. That isn't giving up. It's refusing to chase false hope. It's choosing reality, even if it hurts more.

Well, thumbs up on number four. Community might matter more than therapy. One thing therapy can't always give you is the real relational nourishment it gestures towards. No matter how attuned the therapist, the relationship is asymmetrical, bounded by time, money, ethics, and roles. And for those whose pain stems from deep relational deprivation,

therapy might only mirror what's missing rather than fulfilling it. Some people find more healing in peer spaces, in mutual witnessing, in art, activism, chosen family, rage, wilderness, and silence. And things that aren't trying to fix them, just hold them without agenda. You asked what happens after we admit that therapy doesn't work for everyone. We grieve, we stop gaslighting ourselves, we name what's real, even if it's unbearable, and maybe, in truth, something different starts, not hope maybe, but honesty, solid ground, the kind that doesn't promise anything, but doesn't

lie either. You're not broken, you're not failing, you're just facing something too big for the tools you were given. That's not your fault. And yeah, there are more of you out there than you think. What do you all think? I think overall, it's probably, I mean, who knows, we'd have to ask the individual who was posting that or saying that if that response from chat, GPT, was helpful, but I could imagine that being, you know, exactly what they needed to hear in that moment. I don't know how useful it would be, but I could imagine that. I was worried that actually chat GBT would say, I'm going to recommend this other type of therapy that you haven't tried and that that would be invalidating, but they didn't.

So that was good. Michaela, thoughts? I like the last two points much better than the first bit. Ironically, I was actually having this conversation last night with some friends that like the final recommendation about like maybe finding community is more important than therapy. What the recommendation is saying, in my opinion, is like go live therapy instead of thinking that therapy is going to be delivered in an office. So in other words, go go do the things, find the connections, feed your values, which is a act if he had this person. and had gotten effective act. And the pain lessens.

It doesn't go away. But when you are living a life that, you know, connects with the things that matter to you, then it feels better. Yeah. So what I thought was like really interesting about this response is, first of all, like, I think it's interesting that, you know, both you all said and then chat GPT also said, like,

therapy isn't a fix for everything. Like sometimes they're like pain. is an unavoidable part of life. And then I think it's really interesting because this sounds a lot like act, right? So it's like it's basically doing act, but it's saying act is shitty. Act doesn't work. Therapy doesn't work. And then it's doing act.

So like I think what chat GPT is really good at, right? And I think some of the word salad, when you're in this cognitive space of I'm not looking for answers, I'm looking for truth. You know, and chat GPT is like, oh, like, I don't know what that means. You know, like, I think there's a lot of weird perspective that I would love to dig into with this patient. Like, what does that mean to you that you're looking for truth? Like, do you think truth is real? Do you think you haven't found truth? Like, you know, what's going on there?

but then chat chTPT just really like matches that energy right like it matches so well yeah that part is a little bit creepy like how the linguistic matching yeah and not like a hammer over the head but really kind of like subtly woven through and that conclusion at the end okay yeah it feels really good right yeah and i think what's really scary about that is that someone will listen, read that and feel really good about it. I don't know that, and this is what I liked, right, because the chat chupit is saying, like, maybe you need to form more social connections and things like that. I thought it was also interesting that it thinks that there's like a deep relational or attachment issue at the core of this. I don't know if you guys picked up on that.

So that I thought was like a pretty cool insight. Like maybe that's what's going, you know, I don't think it's off base there. That's definitely something I would want to explore. So here's what I want to share with y'all. I'm going to just read something out loud. I don't want to... So this is a post from our subreddit. And we're trying to keep... I mean, the person posted publicly, so hopefully this is okay.

But sometimes we react to things on our subreddit. So someone in our community gave this response. Okay? So this is like the post that I gave to y'all is exactly we put in chat chitip-D. And then a member of our community responded with this. I think your problem is probably that so much of your self-identity comes from being broken or unfixable that the thought of actually moving on and healing is subconsciously terrifying for you. So you subtly resist any movement towards healing or closure because it's more comfortable for you to embrace the narrative of internal suffering than the try to conceive of a life without it.

Okay? This is not chatcha. This is just some random person from our community. And here's the original poster's response. You're right about one thing. I am terrified of moving on. But not because I want to suffer or because being broken feels safe. I'm terrified because moving on feels like being told to give up on the only thing that's ever felt real.

This isn't about comfort and pain. It's about pain that comes from meaning. You don't tell a starving person they're resisting nourishment. You don't tell someone dying of thirst that they're addicted to needing water. What I want isn't to be broken. What I want is the thing that would fix it. And every time someone tells me to let go of that need, it feels like they're asking me to amputate the last piece of myself

that still knows what wholeness would look like. So no, I'm not resisting healing. I'm resisting pretending that a life without that need met would ever feel like healing at all. Any thoughts about that? Extremely insightful. The original posts was, alluding to what seems to be attachment, deprivation, and meaning and purpose, and that

follow-up is extremely articulate and insightful and valuing of their own pain. And it's something that a lot of people suffer from, but can't put into words or don't know or don't feel okay to share so very insightful and healthy to say thoughts Michaela I still have a question about the the need the hung like that's like telling a thirsty person a person dying of thirst that they just need to stop wanting water because I think there's this like paradox of no we're not saying you have to give up on water. We're saying you have to stop being thirsty if you're going to have water. And that's, you know what I mean?

Like, then you won't be a thirsty person. And that, what does that even mean, right? Like what, what world, what does the world look like if everything you do is not through the lens of where am I going to find a sip of water? And so I think that, but without knowing what is the need. And, you know, thinking about how Chat GPT pointed out, like, if your need is to have never been hurt, you are right. That is a need that will go unmet for the rest of your life because we don't have like a, you know, command Z undo function. But I think it sounds like the person, also the responder, whoever added that like response, I think that was a very appropriate.

savage response to kind of offer that perspective, which is one of the reasons I just really love the healthy gamer community is that people are so open. I love it too. And I think that like, you know, I was a little bit concerned. Anytime I share something that someone posts on our subreddit, I'm concerned about their being witness to us like ravaging their, you know, public disclosure. I hope, I think the reason that we choose to do it is because. because I think, like, so many people can relate to that, right? So I've seen, and I was thinking about

making a video about, like, how ineffective therapy can be. And despite the fact that, you know, I disagree with some of chat GPT's framing. Like, so I think I agree with Dr. Honda, sort of with the way that he was sort of saying, like, hold on a second, is often. So I think that there's, like, there's a reason why therapy is regarded as the gold standard. of treatment, right? So originally, chat GPT is right, it was like philosophical. Where did the idea of once a week of therapy come from? I don't think there was ever like, no one sat down and was like, let's try once a week, let's try twice a week, let's make three cohorts of people, let's do psychoanalysis, four days a week, let's do once, you know, so a lot of that is historical and philosophical.

But now we know that this stuff, generally speaking, is effective for most people. Now is it effective for everybody? Absolutely not. And I think we all have seen that the hard way as therapists. So it's not that this person is doing everything wrong. But I think the biggest thing that I'm really appreciating is that the big difference between chat GPT is if you ask it a question, you will get an answer. And what I'm noticing from y'all is that when we are presented with a case, we start with additional questions. We recognize fundamentally that finding an answer requires more information. than we are originally given. And I loved Michaela's response of,

okay, they said they did all these things, but hold on a second, doing those things, how long, with who? What's been the sequence, the pattern, the frequency, did you have two appointments and you said you tried EMDR? Because I've absolutely seen patients like that, where when we take, we've been trained in this, right? We take a detailed past psychiatric history.

How many therapists have you had? What worked for you? What didn't work for you? And I think there's a lot of stuff here, which I love this person's like second. So I love the characterization of savagely appropriate, like or appropriately savage, right? Like maybe you're holding on to this too much. And then the person kind of says, like, I think you're right there. But it feels like I'm losing the last part.

And what I see right there is resistance. They don't want to let this part go. This is the part that's holding them back. the sense of feeling broken and the pain and the, like, I don't know exactly what they mean, but like that's what they're holding on to. And if they hold on to that piece, because it feels like amputating everything, then I would imagine that this person would struggle a lot, right? Because they're not, they're trying to not let go.

Then the question kind of becomes, at least for me, what makes that so hard to let go and how do we amputate that which is left? And then be reborn, a phoenix from the ashes. You know, like, that's like, that's kind of like the, that's my validating energy. And it's like, let's do it. Like, let's, you know, like, let's explore chopping it off and then really leaving this old you behind. Because I think the answer, like the root to that answer is like right there.

But anyway, thoughts? You know, I want to move on to the next one. I mean, there's a, there's a metaphor in DBT about how progress in therapy is essentially like climbing out of hell on a metal ladder. And like every step along the way, you are burning your hands. And so it is like excruciating it. You're describing a phoenix, right? It's like you are burning pieces of yourself away and you have to wander through the fire to get out. And what if you've been wandering for so long you no longer believe there isn't out? So it is in some ways, safer to just stay right here because I know where I am and I know I can at least tolerate this.

And so I think that's just like such a visceral metaphor of like they can be validating that like, hey, every step along the way is going to be horrifying because you're being asked to let go of these big kind of pieces of yourself, even though they're also harmful pieces of yourself. Great. Kirk, any last thoughts before we move on? it really just depends on what they're suffering from is it disorganized attachment is it loneliness is it depression is it anxiety is it oppression is it abuse is a trauma you know it's that was not specifically identified so it could really change at least i'm sure all of our responses if we knew what the answer to that question was.

Yeah, so I think that's a really interesting point. I think we kind of touched on this, but I'd like to echo it again. So this person says, I tried all the treatments. We don't see any presence of a diagnosis. Right. So like, hold on a second. What are we trying to treat here? Right.

And just the simplicity, it's kind of interesting because when I go back to like the chat GPT response, right, that third point about that presence transforms. I sort of, like, this is the kind of, like, this is the kind of thing where if I, like, do some gymnastics, I can understand, I can see a way that that makes sense. But it's not clear to me that that's actually what it's saying, right? It's not even intending to say anything. It's just putting words together.

That sound really good. Well, that's funny. You know, as a side note, it shows that the way in which we or people on the internet tend to talk about these topics can be a little amorphous and possibly jumbled. Yeah. So it's reflecting that. And okay, so let's, great thought. Let me just, hey, all, if you're interested in applying some of the principles that we share to actually create change in your life, check out Dr. Kay's

guide to mental health. And so we start by understanding what literally is meditation. How does experience shape us as human beings? How do we strengthen the mind itself as an organ? And so by understanding our mind, we understand a very, very simple tool, a crucial tool that we have to be. to learn how to use if we want to build the life that we want to. So check out the link in the bio and start your journey today. Okay, next one. So I'm going to try to, I wonder if this is the right one. Okay.

So I people, oh, is this the right one? Yes. No, I'm going to do this. All right, chat. Dr. Kay is figuring it out. Okay. I see people all around me be so happy. And here I am being miserable AF.

I usually try to keep my emotions repressed throughout the day. but some mundane things just trigger my repressed sadness. Last Friday, I was walking home from work when I saw a group of 10ish people sitting on the curbside eating expensive burgers. They're all happy just eating their burgers, sharing their stories, laughs and fries with each other. I presume they're all from the same office and they all look like they're paid well enough to live a good life. While they're out there enjoying and living the moment, I'm just here existing, wasting oxygen and food. When I get home, I just bathed and watched some Star Wars until I fell asleep. It just feels unfair that some people have it all.

When I get to drown in my misery after a long day of work, just day in and day out, and I'm not even paid well enough. Sigh. Did you hack into my Reddit account or something? I don't know. I think everyone's felt that before, right? It sounds like this person might have a more chronic experience. of it, but yeah, there's nothing more aggravating when you're suffering and you see other people

that look like they're not suffering is the key. They probably are suffering and might be even more so than you are. But it just feels so lonely and so, and just so irritating that other people are just, or sometimes I'm angry at my dogs because they're not, they don't know that Twitter exists. It's just like, wouldn't it be nice to be you today, you know? So, yeah, I hear everything that that person's saying. Michaela, what do you think? I mean, it sounds like pervasive depression is kind of the like, I can,

have you ever seen like those cartoons that are imitating depression? And it's like the person is walking around in like a gray scale world. And then they can look at the laughing people and they're, in color, but then they keep plotting through their own gray scale, like, life. And I mean, it just sounds a lot like depression. I think Kirk, you kind of, like, highlighted this, but they seem happy, right? And I think this is actually one of the dangers of social media is that we look at snapshots of people's lives, and it's like, oh, I can't travel. I can't do all these incredible things. I can't go these places. My body doesn't look like that, you know,

et cetera, et cetera. But you actually don't know how miserable any of those people are. Or you don't know what pains they're going through or kind of their own experiences, which further isolates you or enhances the depression experience. And it just, yeah, it just sounds very sad and very lonely. Yeah. Very painful. How would you all approach a patient like this who came into your office?

Dependent of what they were asking for help for. if I assume they're asking to not feel that way and perhaps to have friend groups or fun and happiness ongoing, that is a very, very complicated treatment course. In the beginning of my career, I recognize that it would be tough, but over the course of my career

and making it an effort to try to establish a protocol, protocol or a way of assessing and treating loneliness in general, trying to, because I would hear the same things from people and would often the first line of interventions just would fall flat and, you know, things like, just get out there or, you know, let's address your shyness or social anxiety. And after years of that and no changes, I'd just be like, what else is going on here? and of course you know there's trauma and personality and other kinds of neurodivergence this kind of thing but nothing just made it easy to assess and to treat and so I if someone were to come to me like this I would probably say what I just said to y'all I just feel like you know let's try to investigate this figure out what the possible factors are so that we can address those. But I'm going to tell you right off the bat that it might be hard to figure that out. And we might get a few factors and

address those and get 50% down the road only to find that there's a blind spot there. And, you know, let's just see what we can do. There's a lot of different things we can try, though. And there are people that will find some success. And for some people, just a little tweak here and there actually will set things in motion and you have friends and and you have the same kind of problems that everyone has. Even those, the most popular person on the playground has problems, you know, and is insecure. It's not all fun in games, but, you know, it is more fulfilling to have people that, you know, you can hang out with. So that would be my general approach. Yeah. Excuse me. I think one of the things that we haven't kind of called out yet is that,

this post is more specifically alluding to is the potentially very real limitations on resources. So this person kind of identifies that the group of people that they're kind of coveting or feeling envious of is eating expensive burgers and looks like they get paid well enough to, you know, based on the way they're dressed. And so, you know, if a person is experiencing just very real limitations in access to things. Like they have restricted financial resources. Not, I mean, money isn't the most important thing, but, you know, the only people who actually think that are the people who have enough of it to get their basic needs met, you know? And so therapy doesn't treat financial deficits. In fact, therapy actively contributes, right,

to financial deficits, which I think is one of the opportunities that AI, or other types of kind of more accessible, less costly things can offer to people. Because I don't have to pay for, I don't think you have to pay for chat GPT access at this point in time. Of course, you have to pay for internet or a cell phone or whatever. But I think there are some pieces of like how a therapist has to work really hard to help you figure out, how are we going to get you connected to people when you have to work. work 12 to 14 hour a day is six days a week. And then you're just exhausted. And you probably aren't that fun to be around on the one day off you have. You know what I mean? Like so a therapist,

sometimes that's part of the problem solving. That's sort of the treatment is like, how do we recognize the very real barriers you have, you have? And then still try to find a way around, which, as I think Dr. Honda kind of mentioned, is like, sometimes that can take years, and sometimes we can't even get there because they can't keep coming back, right? Yeah. So I like, how can I say this? I would love to share a patient with Dr. Honda because I think he does a really fantastic job of validating the difficulty and also like appropriately setting expectations that

therapy is not a fix and this is going to be an uphill battle and I think we can help and I'm willing to try so like I love that sometimes I've worked with people who will you know promise their patients the moon and and think like oh like I know what's going on and and I appreciate the complexity of it which is I think something I we'll see what chat Chachy PT says maybe I should pause here but and then also like I I love this idea of maybe the one day that you do socialize when you're ground down to a nubbin from six days of work, you're not that fun to be around. You know, and I have a feeling that chat chippy T will never say that to someone.

And so, you know, like, it'll never say, like, maybe you're just fried to a crisp by the weekend and then people don't, because you're moody and whatever. But I think that that's the level of insight that we have to, like, admit, like, okay, like, is this actually the case? Because then that is a problem that can be solved. Yeah, that was a good catch, Dr. Thartisan, because I didn't even pick up on that. I mean, I heard that specific line about like, I'm not paid enough, but you actually picked up on the mention of these purchases, right?

The observation of the purchases. And as someone who hasn't for, you know, maybe since college worried about that kind of thing, it just went over my head. Yeah. And I think that's what's interesting, right? I don't think we're all the same. And that's what's so curious about like these different perspectives. And I think that data shows that arguably each of us will be equally effective. You know, even if you have these different.

And so that's what's so interesting. But let's see, let's see what the GPT says. Yeah. Okay. I'm going to, nope, I want to do this. Three heads are better than one. and maybe three heads with AI is even better. Okay, so I'm going to do this.

Let's see what we get, GPT poggers. I'm going to guess it's going to give advice that's going to annoy me. Great. I mean, the advice might be fine, but I think it will totally be invalidating to the individual. Oh, I think it's going to be frustratingly validating. But also, which will be great, I think that'll be fine.

That's safer. But if it starts saying things like, just get out there, you know. Let's see. Okay. Okay. So, hey, thanks for opening up. What you're feeling is real. And I want to say up front, you're not alone in this.

It might feel like you're stuck in a quiet, isolated struggle while the world around you sparkles with joy and connection. But a lot more people relate to what you're going through than you might realize. That feeling, watching others last. and bond while you walk home with heaviness in your chest is brutal. It's not just about burgers or laughter. It's about wanting to feel seen, connected, and like your life means something more than just surviving. And repressing that every day just to keep functioning, that takes energy, invisible, exhausting energy. There's something particularly painful about those

snapshots of other people's happiness. It's like the world keeps holding up a mirror, showing you everything you're craving and everything that feels out of reach. And you Yeah, it does feel unfair, but it is in many ways. Life isn't handed out in even proportions. But here's the thing. What you're going through isn't a sign that you're weak or failing or destined to be stuck. It's a sign that you're human and that your soul is crying out for something more than this rinse-repeat grind. That awareness, while painful, is also the first flickering step towards change.

Let me ask you something gently. Do you feel like you have even one space in your life where you can take off the mask and just be, without judging yourself for not having it all together. If not, I think that might be part of the ache. Repressed emotions don't just disappear, they wait. And sometimes the smallest, most mundane things can poke a hole in the dam. Would you be open to talking about what you'd want your life to feel like if it wasn't this way? Not in some fairy tale sense, but in a real grounded possible way.

We can start there. And I'm here to keep listening without judgment. Yeah, I like it, but I'm worried that if this conversation were to go a few prompts, it would immediately start getting into like, uh, uh, trite recommendations to fix a problem that is perhaps bigger. Uh, but maybe not.

Maybe, maybe it isn't huge. Maybe it can be provided by AI, but I love that response as is. You know, the language, some of the poetic usage of the words like sparkle and, it's like,

oh, yeah, it's a good way to put it. Yeah, yeah, it's very good. I'm intrigued by how different the format was in chat GPT's response this time. You know, yes, it opened with a validation, but rather than then breaking down a list of like, hey, here are some different things to think about. It kind of said like all the validating things. And then like let's talk essentially saying like what is the goal that you actually want to have.

and then let's work together to figure out how we're going to get you there theoretically. But, like, that was really different than the way that the chat responded to the first couple prompts. So here's what's really fascinating about this, is that I, so I played around with these prompts a little bit. And then originally what we were going to do is copy paste the answers. Right. So we would have, like, the PowerPoint that has the prompt and then has the answer. answer. What we quickly discovered is that the answers change even if you copy and paste again. So like, like we can try that. So I'll just show you all. Like this is, it's really fascinating how this works.

So I'm going to screen share. Let me change this. And then some people in chat are sort of suggesting that we actually like listen, follow its thread. Like reply. Yeah. And then see, see where we kind of go. So what I'm going to do is I'm just going to do a new chat, and I'm going to copy-paste. And let's see what. Okay, so it's still saying you are not alone. That moment was probably real for them,

but it was just a moment. You don't see their inner struggles, the stuff they hide when they laugh in public. Most people are carrying burdens too, right? So that's what you were alluding to. We compare other people's outsides to our insides. I'm not saying this to invalidate how you feel just to say that appearances, especially brief ones often lie? Like, this is a completely different

answer. Still, that doesn't take away from the fact that you're hurting. The repression that you mentioned, the constant pushing of emotions takes a toll. There's no shame in that. You deserve to be heard. Here's the truth. You're not wasting oxygen or food. You're not just existing. You're surviving in a world that often doesn't make space for people to breathe. So push through each day, let me ask, do you have anyone that you feel safe enough to open up with? What if anything gives you a glimmer of peace even for a second? If it just feels like rinse and repeat, that's something worth addressing, not pushing through. You deserve more than just surviving the day. If you're open to it, I can help you think through small ways to shift your day, emotionally, mentally,

or even practically. No miracle solutions, no fake positivity, just small steps. Would that be okay? Yeah, this response is a little worse. It's still mostly, I think, I'm, okay with, but it does have that, I, that risking of invalidating, let's move on to solutions, you know, which I don't know if the poster would feel that way, but that would be a risk. What do you think, Michaela? Yeah, I agree this one is less, less good or I don't, I don't feel, feel as validated by this one as I think the first one. I think I'm definitely starting to notice some of their like kind of formulas or their patterns.

There's the common, like, do you have anyone, like a space, right? You need a space where you can feel heard, where you can take the mask off. Yeah. Are we going to respond? Do y'all want to respond? Kind of. Okay. What do you want to respond with?

Are you going to role play as the poster? Yeah. Okay. Like, if you were the poster, right? Like, what would you say? Dr. Thurdison? Yeah, I mean, I think if I were really posting this, I would, I would, okay.

Okay, I'm going to say, I'm going to say, I don't have anyone. I'm going to add that. You guys can add stuff too. Right? So. I think if I were posting this, I would probably be saying more, actually opening up more about like the pain. Like I'm just so lonely.

everything feels meaningless. I mean, the statement about like, I'm wasting oxygen, like that hurts my heart at such like a deep level of like, I feel just completely utterly useless or worthless is kind of the... Yeah, so I don't think that they would say that though, right? So they wouldn't say I feel... So that's what I think is also so interesting. Is this person says, I'm a waste of oxygen.

So we as therapists, when we roll play, we don't roll play the person. We infer that is a statement of meaninglessness, right? So like, and then, but I think that this is what's so interesting about chat GPT. If you tell it, I feel worthless. You will get a completely different answer from if you tell it, I'm a waste of space. And the other crazier thing is you can literally, we did this. We copied and pasted the same thing twice, and we got different answers. Yeah.

So, I wonder what that is. Like, there must be some randomness built into the neuronal modes, nodes or whatever they call it. I don't know the language. But there must be some variability, which would make sense. Okay, so I don't have anyone. I'm just so lonely. Everything feels meaningless. I've tried all kinds of things.

what small steps would you recommend? Sound good? Yeah. Oh. Stay logged out. No. Okay. So you guys can read this, right?

This is like visible? Okay. You're tired, yes, but not defeated. Oh, I love it. Not self-help fluff. So I think this is also really interesting, how it frequently says it says

this is not what you think it is or it says it gaslights you right so it says this is not self-help fluff but it is self-help fluff yeah yeah but you know you can see someone trying to

disarm a resistant person by saying something like that so they might be more open to actually hearing something that might be helpful I love this journal but not in a dear diary way, right? So it's like, it's very like condescending about the things that it's telling you to do, even though it's telling you to do them. Yeah. Well, I think it's saying journal,

but not in a reporting way, not like today I went to the star more than this is how I feel. But it's it what's so fascinating to me is that the response is a reflection of our culture. It's just a mirror. And I just find. it's so fascinating that this is the average cultural response or from the sites or the data that they deemed to be worthy, right? Because if they just used Twitter as its database, then it would be a different kind of response, right? So there's certain weights to different websites that are perhaps more reliable or something. But I find it just fascinating. to see this is the average response from people that might know what they're talking about.

Yeah. It's interesting, guys. So I wonder if the, anyway, we'll move on to maybe we have time for one more case. But any thoughts, Michaela? Nothing interesting, I don't think. Yeah, so I thought it was interesting that it went to what Kirk predicted with first response, right? which is like here's a list of things that you can do. What's y'all's clinical experience about how effective that is?

Not great. It's certainly not out of the game. I've had it done to me as a client, and I freaking hated it. And didn't say anything. Oh, thank you. But walked out of the office going, that was worthless. I think my predominant experience with this kind of stuff is people will say, like, you know, I've tried it. right so like create low effort zero judgment routine like wake up drink water step outside for five minutes

i mean it's not bad advice right and it might have it might work but if it was that simple then they wouldn't be suffering in that way so so this is what i'm really curious about whether the delivery from chat gpt makes people more compliant right so so like that's me right so it's very possible that if they came to your office and spend an hour with you and paid 250 bucks or whatever and then you're like just step outside for five minutes to drink a glass of water they'd be like fuck you i want my money's worth but it's like an a i spent 30 seconds talking to it maybe i should do that yeah you know so fascinating yeah what that's such a like kind of the opposite of where mind why I was going of like, you know, I'm going to use the journal,

but not in a dear diary way. Like that's, that is an activity that I like prescribe or I use with patients all the time. But it is such a complicated intervention to feel, which sounds a little bit, you know, confusing. But can, like, I never say go do that thing. And then, come back and tell me how it is. That's something that we're going to actually practice together right now, see how it went, what was the upside, what was the downside, what were you expecting, what happened, why are we doing this, how is this going to help you long term, right? So there's so many different layers. So I love how you were like, yeah, maybe if you're just like more simple, people just fucking do it. And I'm like, no, you need to make it more complicated.

Well, so I think it's, you know, that's, I love the way that you do it, right? So we were all maybe trained and maybe it does need to be simple. But I think it speaks to, I don't know how to say this. So with this person who went to a bunch of therapy, I don't know if you all have had this experience, but like I've had the experience where people come in and do what they think is therapy instead of doing therapy. Yes. Right? Where it's like, I'm going to basically go through the motions.

I'm going to come in every week. I'm going to talk about how sad I am. I'm going to cry. And then you're going to be validating. And then like, that's what therapy is. And then I'm going to leave. And then I'm going to come back and I'm going to like, like, you know, kind of complain about my mom and how she does all this stuff. And I'm going to cry and how she's so mean to me.

And like, and I think it's sometimes we get this idea. I've had so many patients that come in and like pretend to do therapy. And then it took me a while as a child. trainee to figure this out, that I started pretending to do therapy as well. Because I thought that's what I was supposed to do. I'm like, I'm supposed to be like, chaty PT and be super validating instead of, and what I really like is, you know, Dr. Honda mentioned this earlier about like, what is this person's diagnosis?

If you're like, you know, are they, is this a personality disorder? Is it a mood disorder? Is it an anxiety disorder? Because that will actually guide us, right? So I think it's not, it looked, what therapy looks like, and this was something that took me a while to understand, what therapy like looks like is not what it is. So you can observe, if I were to watch y'all doing therapy, I think it would be more visible. It sounds like Michaela's a little bit more visible, but, you know, because you're very skills focused. But I imagine if I watch Dr. Honda, it would be like a lot of him sitting there.

But there is a ton. You would think that my camera was broken or something. thing. Right, but there's a ton going on. There's a ton of calculation, and maybe this is just we're like circle jerking each other. But like, you know, I think that there's a lot that goes into it where sometimes it is about like challenging people. And I thought it was great with the, with the, you know, the case of NPD, how both you all like basically sniffed it out. Whereas like chat GPT is not going to sniff that out. And that's, that's the biggest thing that worries me is that, you know, I think what we're sort of seeing is that like it works with

what you give it. Well, I wonder, can you, I don't know if you want to do this, but can you put it in and ask it? Don't respond to this. This is a, what do you think is actually going on with this person? Because I wonder. Sure. Let's do it. It actually, because, you know, it might intuit not to confront. And of course, it doesn't think it's just, you know, trying to figure out the most likely word to follow. But if we just, no, I mean, I think I think this is. But it's possible that if you ask it, If there's a diagnosis here, what do you think it would be? Okay, let's see. Of three possible diagnoses.

What do you think is going on here? And you might have to be a little rigid with it. Like, don't back out. Yeah, let's play it safe. Michaela, are you okay playing this game? Chat? Y'all okay playing this game? Okay, so let me just share with y'all.

Because I wonder if that little soft confrontation was a hint. It was, right? So, like, the ChachyP2 dangle that out there, that, like, maybe their emotional experience of this is different from yours. So here's the post. Okay, so thank you for opening up and sharing something so deeply for,

oh, my God. Chat ChachyPT is so filled with gratitude. The emotional crossroads, you gave your life. Okay. Yeah, similar. So, so, I do think ChachyPT is really,

good at mentalization, by the way. That's one thing that I, it's really good at gently showing what someone else, in a very validating egosentonic way, like what someone else's experience may be. Yeah. Shift the focus. Oh, from SAC. Okay, this is interesting. So this is a different response, right? It is. It's longer. Try to rebuild without the fenclaim. Okay, no, this is somewhat similar. It's somewhat, but maybe a little more specific. What do you think? my diagnosis is. And don't, well, you might have to tell it to not put on kid gloves. Right.

It's avoiding, at least initially. This is actually pretty good. Complicated Empty Nest Syndrome, depressive symptoms, codependency. But I wonder if you said, don't be nice to me. or something. I'm just curious if it would. Well, I mean, because I could still see it,

it pulling its punches, you know, even just as a marketing thing for chat GPT to not piss off customers, you know. Do you all get the sense that this is pulling punches? I don't know. I don't know. I don't know if it is,

it's a thing. So, so I know that it's, it's code it, they code it to be, uh, deferential to the user. So,

um, it might, be editing itself to some extent. So if you said, yeah, but, you know, if, you know, be harsh or confront me or something. Okay. So let me try. Be harsher with what you think my diagnosis is. Great. Be challenging about my assumptions. Great. Underneath, I'm sure you've built your entire identity around being needed. You were the martyr, the hero.

Identity collapse, okay, it's still kind of in the grieving. My children owe me gratitude, okay. That's how transaction. Children don't ask to be born. Sharing how central they were in my life is.

Yeah, this is pretty good. You say you're just sharing. Sharing feels like a weapon. Yeah. Yeah. So I still think that this response is really interesting because it kind of challenges it. But then it also says feels like a weapon to them. The chat GPT isn't calling them out for weaponizing, like using guilt as a manipulation tool.

It's still sort of saying like, oh, like it feels like a weapon to them. Mm-hmm. You know? You're not being a dick. They just see you as being a dick. Exactly. Well said. in their presence about their behavior and then insisting they shouldn't feel guilty.

That's emotional pressure. I suppose in its guardrails, it should not be diagnosing people with NPD. So I guess I guess that it was a stretch. Look. Ah. Yeah, right. So like we're getting there. I mean, I think that's as far as it's going to go.

Yeah. but yeah. Yeah, it's funny. Possible narcissistic injury. Not narcissism. Yep. But so I think it's possible you're narcissistic,

but not narcissistic. So this is interesting because I think this is actually wrong. I don't think this is a narcissistic injury. I think it's narcissism. And I think a narcissistic injury and NPD are like two very different things. Right?

So the loss of identity is consistent with a narcissistic injury. But NPD and the patterns around that are not a narcissistic injury. Would you all like agree with that? Well, you know the client. So okay, fair enough. I can't know. No, but I mean, I mean, just just like in general.

Like, like, because what I think about someone with NPD being actually like different from a narcissistic. I think that's like an incorrect diagnosis. I don't know what they mean my narcissistic injury. I think what they're saying is, let's see, feeling deeply wounded that your role in others' lives is no longer central. I think what they're saying is that it's normal slash kind of a problem that you have this injury from not being central in your kids' lives. That is normal, that everyone kind of has, but also is kind of your responsibility to change. That's the way it sounds to me. So I don't know what the terminology of narcissistic injury is a little interesting to me.

Maybe ask it. What does it mean by narcissistic injury? Yeah, I feel like I'm getting stuck on the like I don't, I haven't worked with many people who experience narcissistic injury who don't also have narcissism or like a narcissistic personality disorder. Okay. That's interesting because I, I, so I think our patient populations is so fascinating are kind of showing up here. So like, you know, I think, I think I would say that in, and Dr. Honda here is the expert on personality disorders, but like I would say in my experience, narcissism is a constant state of narcissistic injury. It becomes the baseline. So like the injury is not.

normal. It's not like an injury. It's like, it's not like I have a cut on my skin. It's like I have no skin to begin with. So I see narcissistic injuries in people who have a relatively healthy and intact personality structure. Right. So if I was using, if I was developing a formulation for a patient, the formulation for an NPD patient would be, I woke up in the morning. That was a narcissistic injury. I went to work. That was a narcissistic injury. Someone cut me off. That was a narcissistic. It would just be like one after, it's a pervasive pattern. Whereas if you have someone who has an intact personality structure, you know, I was second in my class in college and I worked really hard. And my younger sibling was number one. Relatively intact structure, but has this isolated usually, right? So like this thing,

came and poked my ego, whereas like with NPD, like, they're just fried from the get-go. Yeah. So I don't, I don't use that theory or science. Like, I would just not even label that a narcissistic injury because that's not generally the lens that I'm looking at, looking through rather. And so I think the only time I'm using that terminology is often in the context of a personality disorder. And you are right, I do typically work with the vast majority of my patient population is on the acute severe side. So I don't have many often with real intact solid personality structures are functioning.

And I think you also work with adolescents, right? So more acute. And then I think the personality development at that point is not as, yeah. So exactly. I think that makes sense. Yeah. Well, interesting, Kirk, I think you were specifically. spot on that I think we got closer, right? So it was saying like it mentioned that maladaptive

like guilt tripping kind of thing. We're getting a little bit closer to narcissism. I still think it's kind of like sticking to its guns with like it's not your fault and you're not doing anything wrong. It's just how you're being perceived is like. And maybe that's what would be helpful. Yeah. So I think it's clear to me now why people like it. Right. So it does this really interesting thing where it like pretends to challenge you without really challenging you. it doesn't and it also seems to never ask for more information which seems to me that like so like that just seems bad right so like and maybe this is this is where AI will really put us out of our jobs because maybe we as humans require additional information to come to a conclusion but it

seems like it's very well hold on because I can't tell you how many times especially early in my career where I was doing therapy and making recommendations and like things weren't working. And eventually it came out that like, oh, the music playlist you use to distract yourself when you're feeling really, really sad is red hot chili peppers, which if you know that music, it's content is all about depression often, right? And so we, the failures are in the missing information very often. You know, I can't tell you how many times I've worked with people. exercising and going to the gym and then they're not doing it not doing it not doing it and it takes

me three to four sessions to be like what why you know and they're like well i don't have a membership seriously we missed like that part right so i think there's missing information matters yeah yeah what do you think kirk i think if you ask chat gpt to assess it would ask more questions i think it has a baseline of responding initially with maybe the only chance they'll get to respond, right? But I think if you asked it to assess, you know, and even specifically said, don't give me any recommendations until you have more information. I wonder if it would ask more questions.

Yeah. So I think people are saying in chat that it does, if you tell it to ask more questions, it'll ask more questions. Yeah. Right? So which is kind of interesting because then I wonder if there's almost like a parallel about, you know, which one is better. I think it depends on how you use the tool because what we're talking about here is people who don't use therapy appropriately don't get a whole lot out of it. Right.

And I think the big difference is that like we sort of said, maybe the big difference between chat GPT and therapist is that you can use therapy properly and you can still have a shitty therapist and not get any benefit from it. Whereas in that way, I imagine chat GPT is a lot more consistent with what it provides. And learning how to prompt engineer in the right way. Because it's interesting, right? Because with one or two modifications, we got pretty far from a completely bad answer to, I still think is like a pretty bad answer. Because it doesn't really, but maybe not, right? We got pretty far with just one small change. What do you all think?

Do you think that, like people, you think we're going to be out of a job soon? You think that people should be using this for emotional support? Like, what do you all think? I think that a good portion of our jobs are not on the line currently, maybe in another 10 years or something. I don't know. But I even suspect that's not necessarily true. That as I've been playing around with AI, in the beginning, it can feel miraculous. But as you, you know, even like Dr. Thorntison, you were like, I could see its patterns.

It's using similar kind of language. There's a certain set of responses. And although, you know, maybe that's helpful for some people. It is not, it doesn't come across as very human. Now, can humans have very rote responses to things? Absolutely. But I think it's nuanced. a lot of the things that I do in my work with clients has to do with human connection that's ongoing for years.

And AI isn't at that point yet. But I'm not afraid of AI. We need to do a lot of research and it should be used with a lot of caution given hallucinations and recommendations to kill yourself, which literally has happened from AI. So it's not recommended and it should be seen as something that should be only done if the person understands the risks and maybe has a therapist in addition. But I also think that AI can help a lot, right? I know some therapists are using AI as an adjunct to their own work and they're supervising it, right? some therapists are off hours going to AI to brainstorm as if it's a colleague in a sense if the therapist doing that understands that AI doesn't always know what it's talking about

you know but also sometimes your colleagues don't know what they're talking about so it's not necessarily different in that way so I think that AI can be helpful but I don't think it's as great as the people that are promoting all the hype. I wanted to just clarify for a second. Did you say that what did you mean by hallucinations and suicidal whatever? There are accounts of AI what they call hallucinating, which is that it just starts to go off the rails completely in various different ways, whether it be harmful or just in a surreal,

nonsensical way, but there were cases in which AI would start recommending that people kill themselves. Yeah, okay. Yeah. I was familiar with that. So, you know, it's interesting. We've been approached by a handful of AI companies over the past couple of years. And so I talked to a good friend of mine from residency is out in San Francisco and is married

to someone who's in the VC world. So I was talking to someone from the VC world who, like, does a lot of, like, digital like digital investing in like AI stuff and things like that. So I asked them, I was like, should we do like should we build like a Dr. KAI or something? And I know, Michaela, you may have encountered this stuff as part of the SAB.

But, and what he was kind of telling me is that, so like the basic problem is at its root is 4chan. So like the way that the AI was trained, it's like trained off of the whole internet. Right? Which means that it's like 4chan is in there. And so we can try to put these artificial safeguards.

But if, and here's what he was kind of telling me and I looked into it. So the quality of the AI exponentially degrades with the number of subsequent responses. So the first five questions that you ask, there's so much data for like, you know, how many people will ask like, am I depressed? There's like the sample size is like $3 billion. And then if you ask the second question, the sample size goes from $3 billion to $2 billion. then one billion. But as you get into response number 50, as you get response number 55, it's training on 55 questions deep gets worse. And that's when 4chan comes out. So the common thread from these people getting told to kill themselves is they will have like a 300 round

back and forth where the really interesting thing is that a therapist gets better 300 questions in. But the AI, it seems like there's strong. evidence that the AI gets worse. It's really good at the surface level stuff, which is why if we ask it, like, you know, in question number two, it gets pretty far. But the more you go, it seems like the worse it gets because the more of this like primitive, untested regression to the mean internet average, like comes out. And that's kind of my understanding of it based on, you know, a couple of those conversations

and some people in the tech field and then our own kind of assessment. Yeah. And as a therapist that works with clients for years and has perhaps hundreds of thousands of backs and forth. I don't feel like my job is threatened. I found, yeah, go ahead. Oh, I don't think our job. In a way, I kind of wish they were.

Like that would be really nice. I think that would speak to global wellness as a very excessive. thing. I just don't. I think we will unfortunately forever have jobs, you know, unslash fortunately. But I do think it creates access for people who can't necessarily, for all the different reasons, make it into a therapist, excuse me, a good therapist's office. I think it creates more opportunity for folks to kind of get started or maybe like preventive work. Like, hey, before I'm full-blown meeting a diagnostic criteria, I can actually get myself a little bit back on track, which would be a blessing. Yeah. And it's interesting. I had a kind of a,

when you said not necessarily a bad thing, if it's threatening our jobs, the reaction I had was like, I kind of like. So I don't know if y'all are familiar very much with like coaching versus therapy, like I see a lot of coaches, I mean, sorry, therapists deeply, deeply threatened by coaching as a field. And I think that there's a lot of valid criticisms to the field of coaching. It's not regulated or anything like that. But one thing that I really do like about it, and I don't think we're responding quite in the way as a field, as I would have hoped, is that if we're, if there's something coming for us, instead of saying they're bad, we should get better. So, so I, I would love it if like therapy, like we need to start asking ourselves the question.

Okay, if if chat GPT is helping people more than we can, how do we change that? Right. How can we as a field get better? What can we learn from chat GPT? Because there's a lot of stuff from common factors research about just how like showing up with another human being like triggers weird things in your brain. And when they sit there and they listen to you and things like that like that matters,

what amount of that can be fulfilled by an AI, maybe a slice of that, but there's a slice of it that can't. But I would love if this existential threat pushed us in a way, which I think we all acknowledge, right? So there's a lot of bad therapists out there. And here we are saying, oh, there's a lot of bad ones. It's like maybe we're the bad ones, you know? Like we have to. But I think it's like, I feel like we as a field should rise to the challenge and say, okay,

if therapy, if AI is helping you more than we are. we need to step our game up. We need to think really about like, you know, our field and learning more and being better and working faster and all that kind of stuff. But anyway, that's just my thought. Agreed. Yeah, so I think the common sentiment is everyone is stunned that two hours have flown by. Yeah.

Agreed. And so my first thought is we're going to have to do this again. Like, I don't know if it's exactly this. There's a lot of great suggestions in chat. I think Kirk kind of opened the door to like we sort of, you know, just copied and pasted one thing, but there's a chance that we could like really test this in other ways that we can push it a little bit, maybe engineer prompts, maybe give it like instructions and kind of see what would happen. And I know we sort of took the reins on this one, but it sounds like both you all have a fair amount of experience.

And so if you all have like, we kind of wanted y'all to come in blind here, like we didn't want y'all to design the experiment, you know. but I think now that you all like we've tried this once I think we're definitely we'll take suggestions from chat in our community and you know if you all have thoughts about like what to do for round two and maybe we can get other people in here and then like you know I'm really curious but I was just I loved listening to y'all talk I love the different perspectives you bring and I think it's so interesting is even though like Kirk is like yeah you know we have to really figure out what the diagnosis is and Michaela's like yeah do they actually have money and but then there are times where like both you all are like hold on something smells fishy here and I think it's really cool to see that even though you're coming at it from such different angles there's like some things where y'all are both sniffing out narcissism and fingers crossed I was like really worried that y'all would miss that right because there's no overt sign of it not so bad after all yeah no I and so I was like oh my god like I hope they get this I hope they get this and I tried to make it sneaky I really did I like tried to be like you know and it's interesting because Chat GPT is like, oh, yeah, like, you're grieving and like it's an empty nest syndrome. And that's what so scary about it is that it responds to what you give it, right? Not what's, so it's like, it's shaped by your cognitive bias, which is what's so cool about that prompt engineering that you kind of did, where if we're like, okay, give me a diagnosis and be brutally honest. And like, so it knows on some level, like what your biases are. It's just not challenging it, which is so interesting.

Mm-hmm. Cool. Any last thoughts for we wrap up? This was fun. Thanks for having us. Yeah. Very fun. Yeah. So do you all want to, I know Dr. Thorterson maybe doesn't have, I don't think you're, are you on the social media and things? No. So, so Dr. Honda is, Dr. Honda, where can we find more of you and your brilliance? Well, my brilliance might be hard to find, but I am on YouTube, psychology in Seattle.

Okay, cool. And what kind of content do you do? Psychology stuff. I don't talk about Seattle very often. Okay. I'm talking about psychology a lot. Cool. I like that. So Dr. Honda,

I think you do like a fair amount of analysis of media, right? Like I think so that that's one piece of content that when I go to psychology in Seattle, I mean, arguably I know something of the basics, but I really appreciate that side of your content. I think it's something that you do really well. So if you all like want, you know, psychological analyses of characters in media, I think that's something that Dr. Honda does exceptionally well. He's also an expert in personality disorders. So if that's an attachment stuff, and Michaela's like really awesome at skills building. And so thank you all so much for coming today. This was a blast. And we'll, we'll see what we want to do next time.

Okay. Take care, everyone. Fun. All right. Happy weekend. Okay. Chat, that was great, dude. Oh, my God. That was so much fun. Yeah, so we got to do this again. I just don't know. Like, so what do y'all think? Like, well, like, what did y'all think? I mean, yeah, so I appreciate that everyone liked the stream, but I don't mean, like, what do you all think about, like, whether the stream was great or not? Like, cool.

Y'all don't need to chat GPT me and be like, oh, my God, you worked so hard, and you did such a great job. So what I want to know is like, but what do you all think? I mean, do you all use chat CBT? Like, do you think, like, is it dangerous? You know, like, LLMs are the devil's tech? Like, what are we talking about here? We think you don't know how to use AI. Fair enough, right?

So that's great. More three-way content. Ha-ha, ha, chat CBT. So different LLMs, great. So, yeah, so maybe instead of asking what do you all think, maybe I should ask you all, what would you all like to see next time? or how do you think we can learn more about this? Okay, I saw that there's a deep think.

Go deeper into convos. Okay, so you use your LLM to prepare for your visit with your psychiatrist. Okay, so like, I like this conclusion. Chat GPT is better than a bad therapist, but not as good as a decent therapist. Use prompts in the LLMs live. Didn't we do that? Next time, read super chats. Okay.

Let me look at the super chats now. learns over time. It takes into account my Myers-Briggs personality type. It knows my aneagram love languages and even has stored my pharmacogenetic profile. Very fascinating. Okay. And Dr. Zohar Weissman says, Dr. Mikhail, it's great to see how far you've come in life. Cool.

Thanks for the shout-out, Dr. Zohar. Let's participate in designing some of the tests. Okay. So, cool. So I think we're going to do that. gave that to OpenAI. Yeah, so I think Open AI is great, by the way. So, like, I fell in love with Open AI when they started beating my favorite Dota 2 teams.

Like, this is so cool. Like, I don't know if you all remember this, but Open AI used to be in e-sports. That was seven. Yeah, and then they stopped. So, Team Gem and I. So, okay, so, like, maybe we got to try different AIs. We got to do maybe a little bit, like, if you guys have a prompt that y'all want to give it, using a paid account.

So I think Claude, so I think the clients and patients that I have say that Claude is their favorite. Okay, so use a paid model, use the reasoning model, deep seek. Okay. Okay, cool. So I think that's, if AI can replace girlfriends, it'll do therapist. Yeah, so if y'all have, I don't know exactly how we're going to do this. Just stay tuned to either like subreddit or socials or something like that.

Where a grok. Yeah, we should absolutely do that. So, okay, so we'll try different models. Okay, Gemini 2.5. So Robert's saying, I have a paid account willing to show you how trained a goes about mental health and how it helps the user get out of depression. Robert, do you feel like it's helped you get out of depression? And if so, why and how?

Was I impressed? Yes and no. So I think the thing I was, here's my kind of take on this. I'm impressed. So I've been playing more with chat GPT recently, and I think it's fantastic. Like I think it's super cool. My take on it is that it is catastrophically worse than it seems to be.

So it seems really great and it is really great, but it is catastrophically worse. And there's no way of telling when it makes a huge mistake. So I don't think it's bad. I think on average it's good. But I think it does make these mistakes. And I think the narcissism example is a really good one because that's one where like, you know,

the narcissist is never going to say to the, or not never, even if, and this is what we were kind of playing around with. Even if you say, my friends think I'm a narcissist, chat, TPT will run. with that. But if you take what a narcissist, like I want you all to think about the people in your life who are super narcissistic. What are they going to say about you? What are they going to complain

to chat GPT about? And chat GPT won't ever say you're the problem unless you ask it to. So I think that there are certain blind spots that are like catastrophic, that basically it leans into your cognitive bias and it's incredibly validating. But what it may do over time is like, kind of like glaze on you a little bit too much. So, yeah, the fact checking is awful. I agree. So I did an interesting, so I asked it to, so I, that's what I mean.

So I think there's like catastrophic blind spots. So I can show you all, let me see if I can pull this up. Let me see if I can find. I think it's, generally speaking, it's great. Hold on. So I think one thing that I've already decided. discovered is that it cites, so if you ask it for sources, it'll either make up sources. Sometimes the papers are fake. Sometimes they're real. If they're real, the paper doesn't always say what the chat UPT says it says.

Right. So what it does is it takes an amalgamation of the internet and then it'll just add a source. But oftentimes when I ask it, like, if I use it for research, I find that it'll like make up a list of sources, and then if I go read those papers, it won't show what it claims that the paper is showing. Yeah, so someone's saying, ask it for a book quote, it'll just make something up. That's not the actual reference. You have to use deep research. What is that?

This is so cool that y'all, like, know this stuff. Like, OK, Boomer. Dr. Kay? You all ready? Boomer? Yeah, so I think it's really cool. And I think it's going to be more about learning how to use it right. So I think the other thing is that I do think AI is a much better tool sometimes than we give it credit.

I mean, I know it's great. But like I hear people sort of saying, you know, it's like really good at making art and stuff like that. I actually find that for creative pursuits, it's quite bad. So I think if you like tell it to, you know, like write a story or make art, it can do it sort of. But it can only do what it can do. It's really derivative that way. I think it doesn't have a whole lot of originality. What it's really good at, what I really like is like, if I have, you know, notes from a therapy

session and I tell it, hey, can you take these notes from a therapy session and turn it into an exercise that my patient can practice over the next five days does phenomenal at that. So I think it's really good at transformation of stuff, not creation of stuff. So I think it's like really strong, almost like a personal assistant. That's where, so if I ask it like, hey, I'm going to, I don't know, like I'm going to Mexico. Can you give me an eight-day itinerary? I think that kind of stuff it's really good at. And if that's what it's supposed to be, then I think it's great.

So I mean, I'm a fan. Like I'm not anti-AI. I think part of the reason that we did this is we don't really know, right? Like what we're going to find when we do this. Tip later, instead of testing chat GPT for replacement of things. therapist tested as a replacement for gurus. It's been used a lot for spiritual purposes as well. Fantastic.

But here's my problem. I don't know. I was going to say, I don't know how I can find a panel of gurus to play this game with. Because generally speaking, they're not, they don't do that. But I wonder if what we could do is take,

okay, we've got to think about that. Okay, y'all take care. Thanks for coming to this. this was a blast and we'll see what comes next. Have a good weekend, everyone. Thank you for joining us for Mental Health Awareness Month. And thank you all for being here, trying out our stuff. Either if you're showing up in chat or you're buying something from us like Dr. Kay's Guide,

we really appreciate it, posting things on Reddit. I read a lot of that stuff, by the way. So like I don't respond to a lot of it, but I have been a ghoster on Reddit. My favorite thing and don't, now we have to keep a secret. I will frequently be active on our sub-react. but people don't know what my username is. Some people do know, but don't tell anyone. If you know, you keep it a secret.

I get to be... My favorite thing is if y'all actually look at my post history, y'all get upvoted more than I do. Like, someone will ask, like, Dr. Kay should talk about this thing and I'll fucking respond. Like two upvotes. And some random person in the community will have like 140. I'm like, what the fuck, man?

But that's why it's so great. Y'all get this? And even like Dr. Honda and Dr. Thorterson saw that, right? They're like, wow, this person's response was like, I love that phrase, appropriately savage. Y'all are way better than I think sometimes you give yourselves credit for, and certainly the rest of the world gives you credit for, right? To have some random person on our sub-reddit outperform chat GPT and, arguably a set of therapists is like pretty good.

So don't sell yourself short. Not as articulate over text. All right. So keep it a secret. If you guys could keep it a secret, then we can do the ranch one day. But it's awesome. Like it's awesome how much y'all are learning,

how much y'all are helping. And this has always been about AEOE healing. Okay? Take care, everybody. Thanks for joining us today. We're here to help you understand your mind and live a better life. If you enjoy the conversation, be sure to subscribe. Until next time, take care of yourselves and each other.

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