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Our Gradually Lowering Standards for Human Interaction

Posted on 10 Oct | 0 comments
This is your therapist ... without a therapist
This is your therapist ... without a therapist

Computers have never passed the Turing Test, but plucky start-ups say software is ready to replace therapists anyway.

That’s according to a recent article in The Atlantic highlighting “The Digital Future of Mental Health” -  which doesn’t sound like an overhyped tech-trends piece by a documentarian pushing a movie at all.

The article envisions a day (in 2018) when people will subscribe to online mental health services – the largest component of which will be software programmed to read patients’ vital signs through their phone (or other devices) and put them through screen-based cognitive behavioral exercises to make them feel better.

In this scenario … I’m not making this up … the time a digital therapist spends listening to a patient is referred to as a “cathartic warm up,” and is only allowed to go on for as long as the patient’s heart rate and blood pressure are elevated.  This marks a significant change from the previous generation of software therapists, which at least let you talk.

Absurd as this is, there are already firms trying to create just such services, and the National Institutes of Health has offered its first grant for the development of “neuropsychiatric interventions” “delivered through computers and/or gaming platforms.”  

This, of course, runs right into the not inconsiderable research suggesting (though not yet proving) that spending more time on computers actually make people depressed (or worse).  If that’s true a virtual therapist could be like an open bar at Alcoholics Anonymous.  But never mind.  There's plenty of time to argue about that on Twitter.

In fact, let’s put a host of issues aside:  let’s put aside the fact that only one kind of therapy, Cognitive Behavioral, could ever be offered this way – and that while it’s a good form of therapy in many cases, it’s hardly a universal panacea.  Let’s put aside the not inconsiderable risk that getting a virtual therapist could cause people with more serious issues to put off seeing a much needed mental health expert.  For the moment … for purposes of this post … let’s put aside all these objections on the feasibility of the project.  Let’s say, for now, hypothetically, that’s it’s feasible.

What are we left with?

First we’re left with a system that is, by design, less effective.  The research is overwhelming that the single most important element in successful therapy is the strength of the bond between therapist and patient – precisely what a virtual therapist can’t offer.

Beyond that, we’re left with a system that, in some cases, for some people, will surely be more helpful than nothing – but that represents a huge decline in standards for us all.

MIT sociologist Sherry Turkle summarized this well when she noted that some nursing homes are experimenting with cuddly robot animals and dolls to keep otherwise lonely seniors company.  It is certainly true, in specific cases, that a lonely person will respond to a robot animal and that it’s better than nothing.  But the basic assumption then becomes that people shouldn’t have an expectation of being listened to or cared for by other human beings.  And that, therefore, we don’t have to do it if it’s not cost-effective.

A subscription to a virtual mental health service carries with it the same message:  your humanity does not need to be acknowledged.

Worse:  being with other people is both a need and a skill.  The less chances we have to practice it, the worse we get at it.  Perversely, the same technology that makes our desperately needed interactions with other people less frequent also makes us less able to take advantage of those view opportunities we do get.

We’ve been moving in this direction for a long time:  Behaviorism in all its forms was an attempt to deal with people without acknowledging their humanity – and CBT is simply the most refined version.  Psychopharmacology was the next step:  if it’s all in your brain, than your humanity doesn’t need to be acknowledged. 

All of these approaches have done wonders for individual people.  And yet, despite all these “advances,” despite all their miraculous promises, our society is more depressed than ever.  I don’t think that’s a coincidence.  I think depression and unhappiness keep rising because it keeps getting harder to find someone to authentically listen and acknowledge our humanity. 

I have no doubt that virtual mental health services will happen, and that they’ll be very good for certain people at certain times – and that they’ll make it even harder to find an authentic therapist to listen to you … and that we’ll collectively all feel even more lonely and isolated and depressed. 

The technology is new, but we’ve seen all this before.

-- Benjamin Wachs

Read more posts by Benjamin Wachs

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