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I'm curious how the Motte sees using AI for therapy / life advice? Online I'm seeing a ton of people recommend Claude especially, but others are skeptical.
On the one hand I could see it being useful because of the fact that you have nigh-unfettered access to it, and can really dig into deep problems. Also, it's trained on all the therapy texts of course.
The other, more culture war issue, is that due to the way RLHF works, they will likely be pushing one ideological lens over another. Especially about deep topics like morality, relationships, casual sex, etc.
Overall I think it's a fascinating area of development, and I'm still optimistic that LLMs could help people much more than the average therapist. Mainly because I'm pretty bearish on the help people get from the average therapist.
Anyway, what do people think about therapy becoming AI?
Tremendously poor idea, general purpose chatbots have already led to suicides (example- https://amp.theguardian.com/technology/2024/oct/23/character-ai-chatbot-sewell-setzer-death).
Purpose built ones will have more safeguards but the problem remains that they are hard to control and can easily go off book.
Even if they work perfectly some of the incentives are poor - people may overuse the product and avoid actual socialization, leaning on fake people instead.
And that even if is doing a ton of work, good therapy is rare and extremely challenging, most people get bad therapy and assume that's all that is available.
Services like this can also be infinitely cheaper than real therapists which may cause a supply crisis.
Makes me wonder if you're the Scott Alexander alt because this is clearly a mental health practitioner's opinion. All LLMs go off the rails if you keep talking to them long enough, that's a technical problem to be solved in the next year or two, not a reason that human therapists should have jobs ten years from now. OpenAI has already made it a non-issue by just limiting ChatGPT's context window, you'll see this issue more on models that let you flood the context window until the output quality drops to nothing.
Just FYI, a lot of people would much rather spill their guts to an AI than to another human. Also, one of the most common kinds of stress people face is financial stress, and for these people paying for a therapist will cause more stress than it will ever resolve. Mental health professionals are much more useful to the people that need them most when they are free. Far more people will kill themselves due to not getting expensive human attention than will ever kill themselves because their cybertherapist told them to.
Haha I am a physician but I am not Scott and disagree with him on a large amount of his medical opinions.
I think you make a very fair point about access, and I don't have a good counterargument but it is worth noting that people excessively overweight their ability to manage their own health (including health care professionals who have lots of training in knowing better).
I guess the best argument I have is that these days a lot of mental health problems are caused by socialization adjacent issues and solving that with an advanced form of the problem is unlikely to be an elegant solution.
What do you disagree with him on?
The two things that stick out to me the most are his whole distaste for the FDA and his intense dislike of inpatient psychiatric stays.
The FDA does a lot of good and a lot of bad but the ratio is aligned with what we mostly value.
IP is important, I feel like he probably doesn't have enough ED experience and must have worked with shitty hospitals.
Granted the last time I looked at either of these opinions from him was in like 2017? So not sure if he has updated or I'm misremembering.
Also some boring Pharm stuff I remember reading back in the day but I'm guessing his views have changed a bunch and I haven't read much on the new site, dont want to hold that against him lol.
ED = eating disorder, in this context?
Emergency Department, that's often where the absolute worst psychiatric crisis happen - people who are high as fuck (and eventually calm down before they get to Psych) or incredibly decompensated (and get snowed with medication before they get to psych).
Outpatient Psych types in particular often forget just how bad things can get because the kind of patients who really need inpatient management end up being too disorganized to be seen outpatient and get disposed first to the ED, prison, or state level hospitals. .
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