This paper critically examines the use of therapeutic chatbots based on artificial intelligence from a psychoanalytic perspective. Drawing on current literature, it questions the legitimacy of labeling these tools as “therapeutic,” arguing that they lack essential elements such as subjectivity, transference, symbolization, and the capacity for psychic transformation. A case example illustrates how the relationship users establish with chatbots is narcissistic remaining in the “as if” register in the absence of a real other to enable intersubjectivity. Ethical, epistemological, and clinical implications are discussed, especially in relation to vulnerable populations. The paper highlights the urgency for ethical reflection, regulation, and long-term research as these technologies advance in the field of mental health.
Culture wars in Western society have entered the academy and are affecting the integrity of mental health professions by introducing identity politics in education, training, and public policy in the name of social justice. What seems like a righteous, ethical endeavor is in fact a harmful and destabilizing movement that aims to displace established psychological and psychotherapeutic paradigms that have their origins in psychoanalysis. Such political divisiveness introduces a real threat to humanitarian egalitarian principles that have traditionally informed psychoanalytic praxis based on apolitical commitments of care to all peoples regardless of their personal and cultural identities or past collective suffering. A return to professional civility, prudence, and therapeutic integrity requires an apolitical philosophy that stays focused on our universal humanistic obligations.
This paper begins from two ideas, separated by roughly a decade, that raise very different but not exclusive priorities regarding the analyst’s technique and how an analysis proceeds. Where the first focuses on the analyst and his or her professional attitude, the second draws attention to the setting. Both derive from the foundations of Donald Winnicott’s work in his attention to being. I approach this apparent shift through a discussion of two patients from the case histories gathered in Playing and Reality (1971a) and argue that this late work emphasizes the individual complexity that can only emerge through analytic work. It highlights the need for the analyst to meet the patient on their own terms and be prepared to wait for them to arrive at a quality of psychic life through the continuing presence of the analyst. Playing originates in and depends on the patient’s capacity to be, and to live from that being, most especially with oneself and only then with others.
