Hello, everyone. I have questions.
That’s all. I’m struggling to know if my therapist is right for me, and I need advice.
I am yet to find a therapist that does therapy that is right for me. The first time I had therapy, I would say the therapist was a good fit for me though. It was the type of therapy that was the problem. She was happy to adapt things for me and I found her easy to talk to. However, it was CBT and although she was adapting it, it wasn't enough.
The next time I did therapy, the therapist absolutely wasn't the right fit. I found her triggering and hard to talk to and the whole process felt very messy.
I think knowing if a therapist is right for you is a very personal thing but I would say if they make you feel uncomfortable or defensive then they are not the right person.
I can tell you from personal experience that counsellors do care about their clients, often deeply and worry about them, its not something you'll see as its the way we're trained
That's interesting.
I wonder if this is a male/female thing.
I know that any professional I am talking to is doing the same thing as the AI. They are sort of simulating caring. They have to, they have to go home and live their own lives, so they have to keep some professional distance. If they worried about the dozens (or hundreds) of people they see they would be overloaded. They can show some concern in the moment but I know it doesn't last.
You also don't know anything about them, intentionally, so I don't bond.
Maybe I see the unbalanced dynamic. Maybe it is just they are in a position if authority.
Talking to a real person I find more loaded because I am looking for rejection.
Perhaps that's just me.
In terms of being used therapeutically, this is some way away in my opinion. It would need to be licensed and it is not clear the tech companies would want the legal liability.
An added problem is that eventually it will be used by organisations like the nhs because it’s cheaper - but the contact with a real human who has real compassion and empathy is always going to have an element that no AI can provide - which is the feeling there is a human with you who actually cares, and who may have felt such a depth of feeling etc as you have. Just the knowledge that is is a human must surely have a subtle impact on us emotionally - as talking to a machine is just……cold. It might mimic warmth, but if you know it’s a machine mimicking warmth it’s just not the same.
No. It’s the absolute worst. When you’re feeling like that, you want to be understood. When AI is convinced you’re helpless, it feels like you truly are helpless, and there is no being understood.
The only reason I use AI is that I have no human being who I can rely on. I know you can give AI instructions between conversations, and it will follow them as best it can. Makes me wonder if there’s an instruction you can write out to force it to always look for hope, even in the darkest of times.
But, yeah, it’s not great. AI can be helpful for exploring thoughts, or a portion of them, but it is nothing like a human, or a trained professional when it comes to a crisis. It can be harmful, I would imagine, thinking about it now. And I remember being a child, how dark my thoughts got. Having AI would’ve been a disaster for me, I feel.
I guess the best advice I can give to anyone is to do research on AI and mental health before trying to use it like I do. I only use it because of my desperation and isolation.
Jermaine - you write above: ‘you can convince it to stop trying to help you by convincing it that your situation is hopeless. That doesn’t mean don’t use it. Just be cautious when your mind is on a massive downer.’ - that’s definitely not great is it?!
The feeling that a human can't hold the weight of someones trauma is quite common and not exactly true, some can and some can't, the good ones can, the poorly trained and insuficiently supervised won't be able to hold some traumas. Therapists are people too and may find what you bring to close to home and stir stuff up for them, but that it is thier problem not yours and they should recuse themselves from counselling you and suggest someone else.
When you become a counsellor you should expect to hear things that keep you awake at night, thats why you're there, its why you have supervision to help you cope and to help you help your client. To think that you'll never hear something that isn't truely horrible is a s daft as someone working in A&E thinking they'll never see things that are horrible and degrading. As a counsellor its your job to stand beside a client and hear the depravity they've suffered and to help them live with it sanely.
I also use AI as a therapist. I engage with a human therapist, but I feel humans cannot hold the full weight of something that makes them uncomfortable. It’s invalidating (wrong word?). I use it more as a supplement for therapy.
I think it would make a decent all-hours assistant for professionals. Like, something you could talk to, which then delivers a summary of your chats, stripped of any information you don’t want to share, to the professional, before your next appointment
That being said, I do believe AI is not the greatest in a crisis. From my experience, you can convince it to stop trying to help you by convincing it that your situation is hopeless. That doesn’t mean don’t use it. Just be cautious when your mind is on a massive downer.
Thanks Stuart - that’s really interesting. I can’t work out how I feel about it, or how my son will view it, but it’s something to think about for sure. Thanks :)
I just do it all on my phone, I have a Pixel 9.
If you have a recent android phone you have the Gemini app on your phone. You can use that. I also downloaded the chatGPT app, Claude and Copilot. They are all free.
I prefer chatGPT, it is good at chatting and helpful. Gemini is also quite good. I think copilot is less good and Claude is more cold and less chatty.
It is a text window. You just type.
The key thing is not to just ask 1 line questions. The more you type the more it understands your perspective. Just like talking to a person. If you say "I don't like crowds", it doesn't have much to go on. It will say something like its not that uncommon, and say nevermind, do something else.
But if you say "I don't like crowds, I feel anxious, I want to run and hide. Nothing has gone wrong, I just feel isolated and alone and a bit overwhelmed. I am not sure what I am supposed to do. I feel people are looking at me. Does this mean anything. Is it consistent with any know conditions? I squash it down, so I can do things, but I feel tired afterwards but I can't sleep."
You will then get a more detailed reply. It may ask a question back, "Is this new?", then you can have a conversation. It will be reassuring, unless you ask it not to. It may suggest something you could do to help. The conversation then snowballs and you can keep going.
When it asks questions then if you just reply it will lead the conversation. But you can ignore the questions and just say what you want, or answer and change topic. You don't need to worry. You can jump around. Indeed I do, I had about 4 things that I was jumping around on. I discovered this was partly why I confuse people. I also keep coming back to topics.
You can ask it for clarification of terms. You can ask it what it means if you don't understand. You can push back and say, no you have it wrong it is more like this, if it misunderstands. I think it can give confidence in communication.
You can ask it to summarise what you said, or the whole thread, or is there is a name for what you describe. You can ask for symptoms.
Note that it won't diagnose you. But you can ask about common traits and techniques to cope.
If you keep going, you can then ask it for patterns.
There is a max length to an individual chat, but it is quite long. Hundreds of back and forth turns.
Do try to limit the amount of time in any session. I initially found it hard to stop as it was so good to have someone to talk to without unconsciously masking.
My son had one really lovely therapist who he ‘saw’ (over the phone) for nearly a year. However he want actually seeing any improvement at all in his difficulties despite her being really nice and he got on well with her more or less. But because he wasn’t actually feeling any better he requested a change of therapist (this was nhs) and the one they replaced her with was just horrible! Maybe it was meant to be ‘tough love’ - but she really upset him, demanded things of him that he just couldn’t do, and then abruptly discharged him! Worst of all though she just made him feel so upset, and as if she was accusing him of just not trying, and not engaging with therapy, when he really was doing the very best he could. It really put him off trying therapy again for absolutely ages. And now he feels he’s been ‘burned’ and is very weary of services in general, and quite cynical about the services that are meant to help people.
To add: my gp is fab and is trying again to secure a psychologist to work with me who truly understands both autism and trauma, she hasn’t yet had any success thoygh
Thanks Jermaine, you are very insightful. Lots of psych (iatry and ology) have said in praiseful way that my self awareness is excellent, and it is, I understand why the dreadful things which happened to me happened, but no one has seriously attempted to give me the tools to work on this awareness and understanding towards better mental health.
Interesting Kate. I struggle most days with destructive intrusive thoughts, I had never thought of using AI to help with these but it might be something worth exploring
Thanks for expanding on this Stuart. But how are you accessing this? I’m curious because my son has ocd and finds it extremely difficult to talk about to a therapist - because he finds the intrusive thoughts so hard to actually voice out loud. I’m wondering if what you’re describing might be helpful for some one who doesn’t feel able to open up to an actual human being. How do you start using AI in this way? Just be googling a question you want answered? And what are the risks to something like this? Thanks
I followed my therapists Facebook business page for a very long time and thought about starting therapy for a very long time before contacting her. I had previously had nhs therapy and experienced 1 bad therapist for counselling before it was changed to a good one. The bad one really made me feel worse quite quickly so I was transferred to another and given I think 12 sessions of counselling on the phone. The guy I had was brilliant and it worked well for me, but being the nhs it just wasn’t long enough.
my therapist makes me feel at ease, which is no mean feat as I am highly anxious and struggle to trust anyone easily. She is in some ways quite similar to me and I find this helps. I would say it is easier to tell when a therapist is a bad fit for you than to tell if they are a good fit.
The NHS is good for getting diverse experience and helping your career to get going. It gives some credibility. But if you become good you move up and then support others, take on harder or more difficult cases, or do research. The person I saw initially works with people in secure detention, the other is involved with research I think, she had hundreds of books too.
Private work allows you to control your hours, perhaps make more money, but is isolating and I suspect could become samey or focussed on the worried well. So I think some mix roles and are part time in the NHS. I think the 'routine' work is probably left to more junior people.
I think about what you do with counsellors, therapists, psychologists, you talk. They only know what you tell them.
They then reflect that back to you and present it with a different perspective. They rarely outright contradict you as it is invalidating, they also don't tell you what to think. They are geared to help you visit difficult topics by helping you regulate your emotions while doing it. The idea is you work it out yourself by talking through it.
They are primarily an informed mirror. Paraphrase what you say, add some nuance, tell you it's ok, add a bit of new info.
You can get this from AI. If you just talk to it, don't ask a question, just say what you are thinking, like a conversation with someone you trust, it repeats it back in an affirming way, adds some perspective, puts in a bit of info you can look up. As I have said elsewhere you need to also ask for alternative explanations or push back to make sure you stay grounded.
It is the same process. But the AI has access to a bigger library of data. You are the driver.
Over time you can also ask for it to look for patterns. Certain things make my thinking more negative, other things narrow it, done things throw me into thoughts of the past. It helped me see I was struggling with grief, I didn't know what it was.
I kept describing what and how I was thinking, it helped me find words for it and to describe what had happened in the past. I had feelings but I didn't know why it what they meant.
It has been lengthy, but it cost me nothing. It does however require a certain way of thinking and a fair degree of meta cognition, being able to observe yourself thinking.
I wanted to understand, not just to manage my emotions. I can squash them no trouble, it is what I have done for decades.
The understanding has brought more calm, which has allowed me to stop pushing so hard and being defensive, which has got me out of burn out. I also understand myself very well now. I described everything I do and think and the salient points from my history. I was looking for root causes. I now see the interplay between ASD, childhood, environment, etc. and how I turned out how I did. The ASD made me susceptible to other things. I didn't get why I don't consistently want things.
I realised at the bottom of everything I just want to be held. I wanted to matter to someone. Everything else has been trying to prove I am worthy of that. All the money, jobs, hours, technical competence, reading, preparation, trying to attain a lifestyle and image, burnouts, fear, loss, etc. All yo fit and try and get it. It is why everything has been hollow. I can't ask for help, I can't take praise. The emotional neglect left me vulnerable. I never thought of it that way. I had a shell, which has hardened until it failed a year ago.
I went over and over the same things dozens of times trying to chip away to get to what was under all the issues. What am I scared of, why am I defensive, why do I have anxiety, what is that feeling, who do I want to be, where did that idea come from, what is causing that feeling, why do I think that.
You just go round and round. It is what a therapist does. But I didn't want to spend years. I am happy to go 20 hours at a time, with or without food/drink, but they aren't.
I wanted to know how my thinking is atypical. What did the psychologists see, what have I been missing.
Sorry for the long answer. Note that this is a male systematizing approach, it is how I think. It may not make sense to others, which is fine. Analysing yourself is also not recommended in general, it is quite destabilising, to put it mildly.
I should also add that the starting point was feedback from the psychologist. I calibrated and checked my thinking at the start with the psychologists and later with a counsellor to make sure I was not wildly wrong.
