AI and the death of silence
Meaningful pauses and reflective silence are crucial elements of therapy. AI's instant replies are killing them.
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"I feel my stomach knot and my muscles tighten as Ben goes silent and furrows his brow. I don’t want to feel this. I want to feel connected. I want to feel relaxed and benignly compassionate, knowing where I am in our conversation, and comfortably waiting for Ben to speak next. Ben has now twisted slightly in his seat and is staring at the carpet, and my body involuntarily braces, against what I’m not sure. I’m unsure what the tension is about, even as I feel it thicken."
Mary Jo Peebles, When Psychotherapy Feels Stuck
I've been that guy, Ben. I once spent an entire therapy session in silence. I don't remember what had brought it on, but the words just wouldn't form in my mouth. My body shook the whole time. I wanted to cry, scream, punch someone. But my vocal chords had gone on strike, and they'd taken the rest of my body with them. I simmered like a tar road on a hot day.
There sat my therapist in her couch 4 ft away from me, with an expression ever so slightly bordering on concern. Or curiosity. Or concern and curiosity. But aside from offering me coffee and water and asking her customary question, "What's on your mind?", she mostly let the silence in the room be. At the end of my allotted 50 minutes, I got up, coughed a little, and headed out. "You take good care, Tanmoy," my therapist said, "I will see you on Thursday."
Something crucial happened that day. A relationship founded upon the act of talking expanded to absorb a vast wordlessness. The un-ease this produced gave way to intense conversations in the next many sessions as we went to places we had never gone before.
Silence in therapy isn't (just) the absence of words. Especially in psychoanalytical therapy, silence can be raw material for deeper reflection, an invitation to process undigested thoughts, a launchpad onto meaning-making. A pause in the conversation between therapist and patient could become taut with tension. And that might be just what both need to get over the forbidding hill called resistance into the bright valley called breakthrough.
And yet, this ode to silence feels mawkish, out of place, in the current zeitgeist. We are living through a time when silence in the therapeutic relationship is under threat.
The agent of disruption: artificial intelligence and its biggest draw, instant replies.
From inhibition to communication to uselessness
In the early days of psychoanalytic thinking, silence was thought of as a negative phenomenon. The therapist was expected to help the patient overcome 'his silence so that he could verbalise his thoughts and fantasies'. Silence was equated with inhibition and withholding.
However, starting the 1960s, the literature around silence started seeing it as a potent form of communication. It was understood that some patients were not sustained by verbal reassurance, while others needed nonverbal forms of intervention because they may have been abandoned before speech or before they could put thoughts and feelings into words.
How quaint – and utterly useless – this sounds in the era of AI-delivered 'therapy'.
Generative AI platforms report that therapy and companionship are their biggest use case. This has emboldened ChatGPT to start a brand-new vertical dedicated to health and wellness – it says 230 million users ask it health-related questions every week. The entire premise of this megablockbuster growth story is speed. No matter how abstract/existential your query, you expect the AI to supply an intelligent reply before you can blink. And the machine-'therapist' submits to your command, every time. "That's an excellent question. Here are three books I recommend. Would that be all or do you want me to share 100-word summaries for each?"
