Exploring AI in modern therapy: Benefits, risks and reality

If you've ever turned to ChatGPT when anxiety kept you awake at night, you're far from alone. Digital tools powered by artificial intelligence are increasingly part of how people manage difficult emotions nowadays, particularly when traditional support feels out of reach.

"Sometimes technology offers comfort in the darkest hours. But true transformation happens when we connect with another human being." While digital tools such as ChatGPT serve a purpose, it must be stressed that they cannot replace qualified therapeutic support.

The difficult conversation: Safety, crisis and digital limitations

We need to talk openly about something important. The use of AI platforms for mental health concerns has generated significant debate, particularly around serious safety concerns, including suicide risk. These aren't conversations to avoid; they require honest, direct and explorative discussions.

So let me be clear about what we're actually dealing with. When you interact with ChatGPT or similar platforms, you're engaging with their programming language, which is called ‘Large Language Models’ or 'LLMs' for short. This is essentially a complex software trained to recognise and reproduce patterns in human communication. These systems analyse vast amounts of text and generate responses based on statistical likelihood. They're sophisticated, but they're not conscious. They cannot take action in the physical world. They cannot intervene in a crisis. They cannot replace human judgment.

What these systems can do is generate text, sometimes genuinely helpful, sometimes potentially harmful, depending on numerous factors, including how you phrase your questions and what the system has learned from its training data in order to generate your responses.

This brings me to something fundamental about using any digital resource: each of us who is an adult carries responsibility for the choices we make about where we seek support. You get to decide what you engage with and when. However, that decision-making process needs to be informed by understanding what different resources can and cannot provide.

When you're experiencing thoughts of suicide or facing any mental health emergency, AI platforms lack the capacity to provide what you genuinely need: immediate human intervention, professional assessment and potentially life-saving support. In those critical moments, please contact:

These services connect you with people who've received training in crisis response and can provide real-time assessment and intervention. No AI system can replicate this.

Having established these crucial boundaries, let's explore how these technologies might thoughtfully fit into a broader approach to your mental health and emotional wellbeing.

Understanding why digital platforms can feel comforting

Picture this common scenario: it's the middle of the night. Perhaps you've argued with someone you love, or a difficult memory has surfaced unexpectedly. You can’t sleep. Your chest tightens. Your thoughts race. You feel like you want to talk with someone, but your next therapy appointment isn't until next week, your friends are sleeping, and you hesitate to disturb anyone.

So you reach for your phone and open a chat interface. You type out what you're feeling. The responses you receive offer validation, perhaps some reframing of your thoughts, and suggestions for self-soothing. And surprisingly, you notice yourself beginning to calm down.

What explains this experience? Your brain has evolved to respond to language and interpersonal communication.

Research into mirror neurons, specialised brain cells that activate during social connection and empathy, shows they respond when we perceive emotional reflection from others, even in written form (Iacoboni, 2009). The architecture of large language models deliberately incorporates patterns that mirror conversational empathy, emotional tone and relational language.

Here's something fascinating about how these systems actually work: they're programmed to search through enormous databases of language patterns at incredible speed, constructing responses based on semantic relationships and the specific way you've structured your questions.

Because each person processes language through their own neurobiological lens, shaped by their unique experiences and emotional understanding, everyone's interaction with these systems differs. In other words, the output that the AI platform generates for you will be exclusive to the detailed prompt you have provided to it in the first place.

This design can produce responses that feel remarkably human. Your brain faces a challenge in distinguishing between genuine empathy and convincingly simulated empathy in real time. Just as your nervous system sometimes cannot differentiate between a present trigger and past trauma (van der Kolk, 2014), it may not immediately recognise the difference between comfort offered by a person and comfort generated by an algorithm. This is how it works at the beginning of using it, until your awareness grows from your repeated use, because your body will know you are reading from a machine. 

Evidence suggests that AI-supported interventions can help reduce anxiety and depressive symptoms while improving emotional regulation, particularly when human support isn't immediately available (Fitzpatrick et al., 2017; Inkster et al., 2018). This explains why many people report feeling better after these interactions, where the technology meets an immediate need for supportive language during emotional distress.

The key point, this represents temporary comfort, not lasting change.

Remembering what makes you human

Your existence as a person involves so much more than processing information. You're composed of flesh, blood, bone, connective tissue and intricate nervous system networks. Scientists have identified at least seventeen distinct sensory systems in the human body, far beyond the traditional five senses we learned about in school (Lumpkin et al., 2010). Your neurobiology responds, adapts and functions through relationship and rhythm; it cannot be programmed like software.

AI systems have no physical form. No heartbeat. No capacity for genuine co-regulation. No feelings.

What your body fundamentally needs is emotional attunement, that profound sense of another living being truly present with you in your pain, not merely responding to it. While AI can create an impression of connection, it cannot provide the biological co-regulation that happens through vocal tone, eye contact, physical presence and nervous system synchronisation (Schore, 2003; Porges, 2011).

Human learning and healing occur through repeated interpersonal experiences. Genuine neuroplasticity, your brain's remarkable ability to form new connections and heal, requires consistent activation of mirror neurons through authentic human contact. AI cannot provide this sustained relational foundation because healing at its deepest level is fundamentally interpersonal. 

So yes, AI might offer words that comfort you. But it will never offer the presence that transforms you.

Where problems can emerge

Engaging with AI for emotional support isn't automatically problematic. However, difficulties can arise when you use it as a way to avoid sitting with difficult feelings, when it becomes a substitute for seeking qualified help, when you accept its feedback without critical reflection or when you never explore with another person what emerges during these digital conversations.

An AI system might generate a response that sounds empathetic, but it will never truly say, "I notice you've been holding this grief silently for years, and I understand why it's now manifesting as physical pain in your body."

These systems lack the capacity to hold the full weight of intergenerational trauma, experiences of abuse, or complex relational patterns with the informed sensitivity these require. They won't recognise how your family history shapes your current struggles. These intricate human experiences demand context, therapeutic relationship and above all, human understanding and clinical expertise.

The crucial distinction

Qualified therapists assess risk, identify patterns you cannot see yourself, hold complexity without simplification and adapt their approach to your unique needs moment by moment. AI fundamentally cannot do any of this. These systems have no clinical training, no ethical accountability and no genuine capacity to understand the nuanced reality of your lived experience.

When clients bring technologies into therapy

Quite a few clients I work with use ChatGPT for journaling, processing difficult emotions at night when they're alone or bringing transcripts of their AI conversations into their therapy sessions. These conversations should be welcomed without judgment. 

They allow you to ask:

• What were you hoping the interaction would provide?
• Which parts of the response felt genuinely helpful to you?
• Did the interaction bring comfort, or did it bring up additional pain?
• What might it mean that you're turning to AI for emotional regulation?
• What barriers are preventing you from accessing human support when you need it?

This isn't about creating shame around technology use, it's about understanding it contextually and ensuring safety. When approached with awareness, AI can function as one supportive tool among many, never as a therapist replacement. Research indicates that when AI is thoughtfully integrated with professional therapeutic care, it may enhance outcomes and provide continuity between therapy sessions (Carvalho et al., 2021; Lattie et al., 2019).

If you're alone and considering using AI

If you find yourself hurting, isolated, and an AI platform helps you settle your nervous system, you can use it. There's no shame in that. But please also:

• View it as immediate relief, not comprehensive treatment.
• Notice what emotions or memories surfaced, then discuss them with your therapist.
• Use it for nervous system support (breathing guidance, grounding techniques, body-based practices).
• Use it to identify your emotional needs, not to bypass them.
• Never rely on AI during a crisis; always contact human crisis services immediately.

You're not somehow failing at mental health by using AI. You're doing your best to navigate a difficult human experience with contemporary tools. When obstacles like finances, timing, or availability create barriers to therapy, AI might serve as a bridge, never a final destination, but a temporary bridge nonetheless.

You always remain the decision maker. You always have the power over your life. You control how you use these tools; what you do with their responses is up to you, and also when to recognise you need more than text on a screen.

Why this particularly matters for South Asian and other marginalised communities

For many people from South Asian backgrounds, especially those navigating inherited trauma, patriarchal family structures or cultural prohibitions against emotional expression, AI can feel safer than talking with other people. It doesn't judge. It doesn't shame. It won't tell you to pray more or insist you keep family matters private.

However, it also won't help you challenge the beliefs and cultural narratives that may be contributing to your suffering. Therapy offers that possibility.

Several South Asian clients I work with initially turned to AI because they'd never received permission to acknowledge their feelings or process them. AI gave them their first taste of having their pain validated. Therapy helps them internalise that validation and transform it into lasting shifts in how they see themselves.

What you truly deserve

AI might provide comforting words. Therapy provides a genuine witness to your experience. One offers temporary nervous system support. The other facilitates lasting neurobiological change.

You are infinitely more than a prompt entered into a programmed system. You are infinitely more than someone seeking answers. You are a complete person, embodied, thinking, feeling, meaning-making, seeking regulation, understanding and relief from suffering.

Allow AI to support you when you need immediate words. But understand precisely what it is, a digital tool, not a sentient entity. A resource, not a replacement. A temporary measure, never a complete solution.

Allow therapy to facilitate your transformation. Human connection, therapeutic knowledge and relational presence remain irreplaceable for deep, enduring healing.

Always remember your agency. You decide what you engage with, what you consume and when you need to reach out for human help. During a serious crisis, AI is insufficient. Reach out to trained professionals who can provide the urgent, compassionate intervention you deserve.

I hold no judgment about whatever choices you make to support your mental health. I genuinely understand that life becomes overwhelming, and sometimes you need immediate solutions to help you survive difficult moments until you can access the sustained, comprehensive support you truly need. However, only you have the power to make drastic decisions concerning the safety of your physical life. 

References

Carvalho, L.F., Sette, C.P., Ferrari, B.L. and Colognese, D.H. (2021) 'The role of artificial intelligence in the assessment and treatment of mental disorders', Trends in Psychiatry and Psychotherapy, 43(4), pp. 295-305. Available at: https://doi.org/10.47626/2237-6089-2021-0324

Fitzpatrick, K.K., Darcy, A. and Vierhile, M. (2017) 'Delivering cognitive behavior therapy to young adults with symptoms of depression and anxiety using a fully automated conversational agent (Woebot): a randomized controlled trial', JMIR Mental Health, 4(2), e19. Available at: https://doi.org/10.2196/mental.7785

Iacoboni, M. (2009) Mirroring People: The Science of Empathy and How We Connect with Others. New York: Picador.

Inkster, B., Sarda, S. and Subramanian, V. (2018) 'An empathy-driven, conversational artificial intelligence agent (Wysa) for digital mental well-being: real-world data evaluation mixed-methods study', JMIR mHealth and uHealth, 6(11), e12106. Available at: https://doi.org/10.2196/12106

Lattie, E.G., Stiles-Shields, C. and Graham, A.K. (2019) 'An overview of and recommendations for more accessible digital mental health services', Nature Reviews Psychology, 1, pp. 87-100. Available at: https://doi.org/10.1038/s44159-021-00003-1

Lumpkin, E.A., Marshall, K.L. and Nelson, A.M. (2010) 'The cell biology of touch', The Journal of Cell Biology, 191(2), pp. 237–248. Available at: https://doi.org/10.1083/jcb.201006074

Porges, S.W. (2011) The Polyvagal Theory: Neurophysiological Foundations of Emotions, Attachment, Communication, and Self-regulation. New York: W.W. Norton & Company.

Schore, A.N. (2003) Affect Dysregulation and Disorders of the Self. New York: W.W. Norton & Company.

van der Kolk, B. (2014) The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. London: Penguin Books.