Why AI “therapy” between sessions may feel helpful - but is quietly undermining real psychotherapy and change. 🧵. I am seeing more and more articles about how AI can be used to support patients between sessions. This is why this is a bad idea:.

'If you want to be loved and liked, don't go into psychotherapy. Because you have to put up with people hating you, because they have not been able to express that hatred to the real people who didn't take care of them, didn't welcome them, ignored them.' - Estela Welldon.

Psychological change on a structural level is the goal. But only through the experience of deep relational contact. That is why therapy matters. Not as advice. Not as cheerleading. But as another mind.

Eventually, the therapeutic task is internalisation. The therapist becomes an inner object—a good other who is kept inside. This is how the patient grows the capacity to be alone: through the experience of having been together.

Patients often want to “do the work” on their own. But just like the baby cannot self-regulate without the mother, a patient cannot reorganise the psyche in isolation. Therapy is not introspection or insight, it is a relationship.

There is no such thing as a patient, there is always a patient and a psychotherapist. The process of therapy is not something the patient does in isolation. They must use the therapist. This is not metaphor, it is the essence of depth psychotherapy.

Just as the mother’s attuned responses give shape to the infant’s inner world, the therapist’s capacity to hold, reflect and survive is what allows the patient’s fragmented internal world to be reintegrated.

In the consulting room, the psychotherapist is not a technician applying a treatment. Not if they are any good. They are a person-to-person presence. The patient uses the therapist’s mind to think, feel, symbolise, and ultimately, to become.

The infant is not born with a self. It is the mother’s presence, her mind, that creates the space for the baby’s mind to form. Psychotherapy takes this idea seriously: it doesn’t treat the patient as a sealed-off unit, but as a person formed and reformed in relation to another.

🧵There’s no such thing as a patient (alone). Winnicott famously said: “There is no such thing as a baby… there is a baby and someone.”.He meant that human beings only exist in relationship. A mind emerges with & through another mind. This has radical implications for therapy.👇.

Jung is on the money: modern man - scientific man - has lost the ability to think symbolically and understand the unconscious. We take everything on face value and social media is simply accelerating this. Most of our individual and thus collective behaviours are not quite what.

Depth therapy doesn’t work because the psychotherapist is always available to the patient, it works because we are not. It’s in the waiting, the frustration, the rupture and repair, that the internal world begins to shift.

Holding the therapist in mind between sessions is often painful. But it’s how object constancy is earned. Enduring the absence allows the internal object to become stable and real. No chatbot can substitute for this.

Good therapy teaches patients how to tolerate feelings - not escape them. Seeking AI reassurance mirrors early defensive structures: clinging, splitting, omnipotent control. These are not signs of growth but regression.

The therapeutic relationship depends on transference. If a patient turns to AI in moments of distress, they avoid using the therapist as the object. The AI becomes a decoy - diluting the relational intensity and its transformative potential.

Prematurely filling the gap with AI interactions may feel like a balm, but it denies the patient the chance to metabolise longing, frustration, and absence. These are the very conditions where internalisation occurs.

In object relations theory, the capacity to hold the therapist in mind - to internalise them - between sessions is central to psychic development. This is the work of object constancy. Using AI for artificial soothing interrupts this.

Depth therapy is not about symptom management between sessions. It’s about developing a new capacity to be alone in the presence of the other. The space between sessions is not a void—it’s a vital part of the work.

On tolerating difficult emotions with a capacity to be curious about their meaning versus 'soothing' them away. And the modern world provides an endless source of ways to distract ourselves from discomfort including fancy hairbrushes. .

More of my musings? .