Making an AI dynamic therapist

Currently, therapy apps featuring a nonhuman “therapist” aim fairly low at best, and at worst willfully mislead the public.  However, the advent of large language models (LLMs) such as ChatGPT-4 brings exciting potential for genuine depth psychotherapy delivered by AI — and many challenges and potential pitfalls as well. 

Since “therapy” has no precise […]

Hiring the one-armed surgeon

Two of the most commented posts on my blog are about charging patients for missed sessions and how psychotherapies end. As there is no single correct approach to either of these, there’s plenty of room for practices legitimately to vary, and plenty of room for patients, i.e., most of my commenters, to express their likes […]

My goal as a therapist: to make myself obsolete

Traditional psychodynamic therapy is often caricatured as endless, with a complacent therapist silently growing cobwebs, listening to a patient who never plans to leave. This isn’t completely unfounded: there are therapeutic advantages to losing track of time, “swimming in the material,” and letting one’s therapeutic focus be broad. The patient’s chief complaint, i.e., the […]

Psychotherapy branding and marketing

I just read a mildly disturbing article in the New York Times called “What Brand Is Your Therapist?” The author Lori Gottlieb was a full-time journalist who took six years to retrain as a psychotherapist — her website, but not the article, says she has a master’s degree in clinical psychology. Yet she found herself […]

Therapy for therapists

Tara Parker-Pope of the New York Times blog Well featured my prior post, on the feelings some patients have as they imagine whether their psychotherapists have been in therapy themselves. My post was about patients’ fantasies, not the reality of therapy for therapists. Nonetheless, many of the comments argued for the great value of such […]

Should therapists accept holiday gifts?

December brings the annual pleasures and challenges of holiday gifts and how to deal with them in dynamic psychotherapy. Although it is relatively easy to follow a simple rule about this, ideally a good deal of thought goes into a therapist’s decision about whether to accept a patient’s holiday gift. Below I will give a […]

Is your therapist biased by money?

Earlier this year, blog commenter TK wrote:

“Isn’t this the greatest countertransference, in this age of fee-for-service psychotherapy as opposed to psychotherapist-on-salary: How do I work around my own economic motivation in deciding whether to continue with a patient or terminate?

“In other words, how does one reconcile the consistent economic incentive to keep a […]