Mentalizing and machines: Imagining the future of psychotherapy

by Debbie Quackenbush, PhD on January 10, 2012 · 0 comments

in therapy

Can the future of psychotherapy be found in an iPad?

As I read Dr. Allen’s recent blog post “What’s Next? Psychotherapy by iPad?,” I had a few thoughts. I was reminded of the seemingly natural gradiosity that we humans possess in believing that there are certain behaviors that only we can do, or that we do best. I recall reading When Elephants Weep: The Emotional Lives of Animals and having that same thought: Is it not grandiose to believe that, as a species, we have the corner on the market of complex emotional worlds? As an avowed middle-aged geek, I was also reminded of Data from Star Trek: The Next Generation and his quest to be human. In one episode, the wise Captain Picard mused that perhaps humans ought to aspire to be more like Data.

Attachment and machines

In all seriousness, I think one question that begs to be answered is whether or not computers can simulate mentalization. I have a pleasant memory of the old computer program ELIZA that was created in the 1960s and programmed to give Rogerian-type responses to “clients” who chatted with it. Many people found ELIZA to “feel” strikingly human and some reported feeling helped by “her.” A more modern version of ELIZA can be found in MindMentor, a computer-programmed “chat therapy” developed by a pair of Dutch psychologists. According to one survey, 47 percent of individuals who used the program reported that they had been helped by it. Did they feel heard? Did the program mentalize them? Is it possible to attach to a computer in the same way that persons attach to other non humans such as family pets?

Though I realize I am straying away from the topic of mentalization and attachment, as Dr. Allen alluded to in his post, there are other, non-human modes of treating people out there. There are CBT sites, for example, that purport to help people with depression and OCD. Also, as he mentioned, thousands (millions?) of self-help books exists that presumably have helped individuals in their recovery. Did the individuals reading these books feel “heard” or “understood” when they turned the pages? Did the books “speak” to them?

In the future

The most recent Monitor on Psychology, a publication of the American Psychological Association, just arrive in my inbox, and on the front page, it says “Beyond one-on-one psychotherapy.” In Dr Allen’s post, he rightfully mentioned recent thinking by psychologists that we need to try to reach more clients. We ought to be able to provide services in many modalities, and to people who are geographically, financially and mobility challenged. It seems to me that ongoing debate and study regarding alternative delivery methods is inevitable. It’s conceivable to me that, in the future, I might pull out my smartphone and utilize an “app” that helps me think about an interpersonal problem I might be having. Will I feel “attached” to my smartphone? Well, I already am. :) (Just a little textual cue so that you might better mentalize me and the playful spirit with which this post was submitted.)

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