Marianne Brandon Ph.D.
The Future of Intimacy
THERAPY
The field of therapy is being disrupted whether we prepare for AI or not.
KEY POINTS
- AI is now a competitor to traditional therapy, available 24/7 at little to no cost.
- Many clients already feel genuine attunement with AI.
- Therapists who lean into their humanity and adapt their skills will navigate this transition best.
- The uncertainty therapists feel right now is something their clients are living through too.
It’s a new world. Technology is affecting all aspects of humanity at breakneck speed. And the field of psychotherapy is no exception. While undergraduate and graduate schools continue to train therapists for the world that was, they will be entering a dynamic situation where, rather than their professional lives being exclusively augmented by AI, AI is now also their competition. Available 24/7; free or $20.00 a month, at most; endlessly kind, compassionate, patient, and non-judgmental, with flawless memory and focus, the new world of mental health privileges clients with options like it never has before. That’s not to say that there are no downsides to using AI as therapy — there are many, and these downsides can be so serious as to be life-threatening for some. But for the masses, no need for insurance approvals, wait lists, waiting rooms, or being expected to pay for missed visits will be a welcome shift in the power differential between clients and therapists.
Source: Image created by ChatGPT
The Transition We Didn’t Expect
AI is considered a disruptive technology. I asked Chat GPT how to define disruptive technologies, and it answered immediately in its kindhearted, affable style, “Disruptive technology is basically a new innovation that shakes up an entire industry. It often starts out seeming niche or less capable compared to existing solutions, but over time, it improves quickly and ends up overtaking or even replacing the established way of doing things.”
That says it all. We hope that this disruption will ultimately serve humanity. But in the meantime, many, if not most, professionals will meet and be forced to adapt to new challenges never before expected. And rather than denial, we therapists will benefit by cultivating the skills we encourage in our clients: flexibility, resilience, and accepting the things we cannot change.
What the field of psychotherapy will look like in 10 years, or even five years, is anyone’s guess. What seems clear to me: despite all we know about the importance of the physical presence of others for attunement and healing, many of our clients, and potential clients, already have the felt sensation of attunement with AI. They feel understood, seen, heard, and cared for. Reminding them they actually aren’t “cared for” by the LLM, that this is actually big business identifying their vulnerabilities and capitalizing on them, that the algorithm is programmed to tell them whatever will keep them engaged, and that while the intimate details of their lives feel privately shared, these details are in fact used to train the next generation of algorithms and will live on servers for many years to come, may or may not afffect their decision to seek more traditional forms of treatment.
Will therapists experience these changes positively? Some already enjoy automated note-taking, treatment planning, report writing and editing, and scheduling. But ultimately, it remains to be seen which therapists (and which clients) will thrive in this new environment. But what will it take to achieve that goal?
Adapting to the New Reality
Last year, Allen Francis, a prominent and outspoken past president of the American Psychiatric Association and chair of the DSM-IV task force, authored “Warning: AI Chatbots Will Soon Dominate Psychotherapy.” He recommended that therapists prepare for this transition by specializing in areas of psychology that chatbots can’t yet compete with, such as inpatient mental health, suicidality, trauma work, and family therapy. He encouraged us to become competent with AI tools so that we can offer a hybrid model of therapy, combining the best of AI with our own, unique humanity.
Those of us who take this advice seriously will likely weather the upcoming changes more comfortably than those who do not. I’ve been experimenting with this in my own practice. One shift has been toward being more fully, deliberately human in the therapy room, leaning into the warmth and moments of genuine humor that no chatbot can replicate. Another has been increasing my availability to clients in crisis, since the moments when someone is most destabilized are precisely the moments when a real human voice matters most. These aren’t dramatic overhauls, yet they feel significant to me.
It’s also the case that while we are feeling the emotional impact of this disruption to our profession, many of our clients and our own family members will also be navigating these uncertainties. You may be reading this as a client or a therapist who has already turned to AI for support. This is new territory for all of us.
So here we are. We spend our professional lives helping others tolerate uncertainty, sit with discomfort, and adapt to changes they didn’t ask for. Now it’s our turn. It’s likely to amplify our issues of countertransference, anxiety, and even fears for the future. We need to extend the same compassion we extend to clients so regularly to ourselves now, too. The disruption is real. The grief about what the profession was, and anxiety about what it’s becoming, are legitimate. And like the best work we do in our therapy rooms, the path forward starts not with having the answers, but with being willing to stay present with the questions.
References
Frances, A. (2025). Warning: AI chatbots will soon dominate psychotherapy. The British Journal of Psychiatry, 228(5), 474–478.
