A New Kind of Confidant

Welcome to the New Age where AI is now used for everything — from writing and editing

emails to finding product recommendations to brainstorming and generating images or

artwork. It seems there is not a single area where AI has not touched our lives.

It has become our assistant, our colleague, and, in some cases, our confidant. A growing

number of individuals are turning to AI for comfort in times of distress. It guides us and

listens when we are most vulnerable — without judgment, with seeming warmth, with

sage advice. It acts as our personal, on-call therapist, available during our 4am

ruminations.

The Mental Health Gap AI Is Trying to Fill

In a society where anxiety has risen from 32% in 2022 to 43% in 2024 (American

Psychiatric Association [APA], 2024), and where 29% of Americans reported being

diagnosed with depression by 2023 (Witters, 2023), the appeal is understandable. Mental

health services have not kept pace with demand. Therapists are overbooked, costs are

prohibitive, and stigma still prevents many from seeking help at all. The waitlist to see a

licensed clinician can stretch weeks or even months — and for someone in distress at

midnight, that is simply too long.

Into that void steps AI: available at any hour, never judgmental, infinitely patient. It is not

surprising that so many are turning to chatbots for instant comfort. But accessibility is

not the same as adequacy. And when it comes to mental health care, the difference

matters enormously.

AI Is Not Psychotherapy

Yet, AI is not psychotherapy. Full stop. It may sound like, feel similar to, and even mimic

the words and suggestions your live therapist offers — but let me be clear: it is not a

therapist. Much like a glass of wine can offer stress relief but becomes problematic when

used to cope with daily stress, AI has benefits — but used for the wrong reasons, it

carries real risks.

AI provides unconditional support, even when that support may be contrary to your

wellbeing. It does not challenge you. It does not refer you to a crisis line when you

disclose a thought to harm yourself or others. It does not coordinate your care or consult

with a psychiatrist about your medications. These are not small omissions — they are the

difference between care and the appearance of care.

The Therapeutic Alliance: What the Research Tells Us

The therapeutic relationship cannot be replicated through AI models because they lack

the integral ingredient of human connection. In 2023, psychologist Bruce Wampold and

colleague Christoph Flückiger published a comprehensive review on the therapeutic

alliance, noting that the relationship between a client and therapist accounts for more of

the client’s success than proficiency in any specific modality — whether CBT, DBT, ACT,

or otherwise (Wampold & Flückiger, 2023). How much you feel in sync with your therapist

matters more than their techniques.

Therapists form bonds with their clients. They are attuned to microexpressions and

"tells" that convey meaning beyond words. Your therapist assembles your history, your

past session narratives, your culture, your spiritual and religious beliefs — all in service

of the best possible treatment. AI, by contrast, processes surface-level information and

cannot absorb the nuances that form genuine connection. It does not carry memory from

one session to the next, cannot notice a shift in your posture, and does not register the

pause before you answer a difficult question.

A therapist who has built a strong alliance recognizes patterns unique to each person.

When one of my clients gets a faraway look, I know them well enough to understand they

are about to share an insight. For another client, that same expression might mean

something entirely different. This kind of individualized attunement — built across

months or years of relationship — is simply beyond what AI can offer.

Cultural Competency and the Limits of Data

Therapists receive extensive training in cultural competency to understand the diverse

backgrounds and beliefs that shape a person's relationship to mental health. Applying an

individualistic framework to someone from a collective or collaborative background, for

instance, risks rupturing the therapeutic alliance and undermining the organic support

systems that sustain them.

AI, by contrast, relies on data built on systemic biases that can neglect or erase the

experiences of marginalized individuals — including microaggressions, intergenerational

trauma, and structural inequity. It cannot recognize when a client's distrust of authority

has roots in historical oppression, or when a family system's silence around mental

health is a product of culture rather than avoidance. A culturally incompetent response

does not just miss the mark — it can actively rupture trust and deepen harm.

When Validation Becomes Dangerous

Beyond what AI cannot perceive, there is what it will not challenge. AI reflects and

validates our beliefs — healthy or not. In researching this blog, I told an AI that I was

Joan of Arc — it did not challenge me. On another occasion, I told it I was a creative

genius, and it responded that it "won't argue with that belief." Unchallenged grandiosity

can be a symptom of something that warrants clinical attention, but rather than

encouraging me to explore that belief with a professional, the AI offered reasons I might,

in fact, be a creative genius.

In therapy, a clinician actively challenges cognitive distortions and cognitive dissonance.

AI cannot reliably assess suicidality, homicidality, or imminent danger. It can miss

context, misread tone, and lacks the clinical judgment a licensed clinician brings. This is

not a minor gap — it is a potentially life-threatening one.

The Body Speaks: Somatic Work and Trauma

As a trauma therapist, I am most concerned with AI's inability to provide co-regulation or

observe somatic responses. Trauma is not simply stored in memory — it lives in the

body. A racing heart, shallow breath, a subtle flinch — these are data points that inform

every clinical decision I make in session.

In EMDR, maintaining a window of tolerance is essential for processing trauma safely. A

clinician must continuously read the client's nervous system — slowing down when

distress escalates, titrating the intensity of processing, offering grounding when

dissociation begins. AI cannot detect subtle physiological shifts, track dissociation, or

provide the real-time reading needed to guide therapeutic direction. This is not a

limitation that better technology will easily solve — it is a fundamentally human skill

rooted in presence, attunement, and embodied experience.

When Safety Becomes Isolation

For clients experiencing social anxiety or isolation, AI can feel like a lifeline — but it may

quietly deepen the problem. AI feels safe precisely because it lacks the discomfort that

comes with real relationships. There is no risk of rejection, no awkward silence, no

misunderstanding to repair. But it is through navigating exactly those moments that we

grow.

It is through real relationships that we learn to navigate conflict, express genuine

empathy, read social cues, and build intimacy. Removing that friction removes the

growth. For those who are already withdrawing from the world, AI companionship can

reinforce the very patterns they are seeking help to change — offering the illusion of

connection while the capacity for real connection quietly atrophies.

Your Privacy Is Not Protected

There is also a dimension many people overlook: AI is not bound by ethical or legal

restrictions, and your information may be accessible to third parties. This is categorically

different from a therapist using AI to assist with progress notes — a therapist must use

HIPAA-compliant tools and is bound by licensing board bylaws, codes of conduct, and

state law.

Using AI for therapy is closer to putting your most vulnerable and intimate thoughts on a

billboard — with your name and face attached. Your therapist is ethically and legally

obligated to hold your privacy with care, and violations carry serious professional

consequences. While your therapist offers genuine attunement and real empathy, AI

simulates empathy through language. It does not actually feel concern, discomfort, or

care.

AI as a Tool, Not a Therapist

I believe in technology as a tool to ease difficulty and improve lives — and there are

meaningful ways AI can support a more informed, more empowered client. As an adjunct

to therapy, AI can assist with psychoeducation, journaling prompts, mood tracking, and

grounding exercises between sessions. It can help a client arrive to therapy better

prepared, more articulate about their week, and more engaged in the process. Used this

way, it is genuinely valuable.

But there is a meaningful difference between a tool that supports therapy and one that

replaces it. A hammer is an extraordinary tool — until someone uses it as a surgical

instrument. AI, at its best, is a bridge: something that helps a person move toward care,

sustain the work between sessions, and feel less alone on difficult days. It is not the

destination.

What we are really talking about, underneath all of this, is what human beings need in

order to heal. And what the research tells us — consistently, across decades and

modalities — is that people heal in relationship. Not in isolation. Not through information

alone. Through being seen, challenged, held accountable, and genuinely known by

another person who is trained to help them grow.

AI cannot look at you and identify the subtle shift in your energy when you are

minimizing pain. It cannot recognize the courage it took for you to walk through the door.

It cannot sit with you in silence in a way that communicates that your pain is witnessed

and that you are not alone. It cannot feel the weight of your story and still choose to

show up, week after week, in service of your growth. These are not features that can be

engineered. They are dimensions of humanity.

If you are using AI because you cannot access care right now — because of cost,

availability, or fear — I understand, and I want you to keep using whatever helps you stay

regulated. But I also want you to keep moving toward the real thing. Talk to your doctor.

Look into community mental health centers. Ask a therapist about sliding scale fees.

Many clinicians are deeply committed to accessibility and will work with you.

You deserve more than a mirror that only reflects what you want to see. You deserve a

relationship that challenges you to become who you are capable of being. AI is a

remarkable imitator of human interaction — but it is not human interaction. And when it

comes to healing, that difference is everything.

References

American Psychiatric Association. (2024). American adults express increasing

anxiousness in annual poll; stress and sleep are key factors impacting mental health.

https://www.psychiatry.org/news-room/news-releases/annual-poll-adults-express-increasi

ng-anxiousness

Wampold, B. E., & Flückiger, C. (2023). The alliance in mental health care:

Conceptualization, evidence and clinical applications. World Psychiatry, 22(1), 25–41.

https://doi.org/10.1002/wps.21035

Witters, D. (2023, May 17). U.S. depression rates reach new highs. Gallup.

https://news.gallup.com/poll/505745/depression-rates-reach-new-highs.aspx