ERP Therapy Sucks
18 comments
·September 13, 2025codeduck
irjustin
We were on another thread where the study was saying LLMs being used as psychiatrists is bad.
Then another hnuser chimed that he ran a support forum for people. Said, these aren't the real problem. The real problem is the that are "AI girlfriends". They go off the rails completely and tell people to unhinged things. Apparently his forum already lost a few members to who knows what because of these things.
That surprised me a lot.
spacechild1
I'm currently working on an art installation where visitors can replay dialogs I made with AI chatbots that I created on character.ai. I'm showing how quickly these bots can go off the rails, sometimes leading you into very dark territories. The fact that these apps are used by milions of people on a regular basis, supplementing or even replacing real human interactions, is frightening.
tasoeur
That sounds pretty neat! Are you able to share more about it?
ykonstant
That feeling when you have filtered out Hackernews LLM articles via UBlock Origin, and you still get clickbaited into reading a content-free article suggesting LLMs for therapy. Shit sucks.
electroglyph
have you considered doing ERP via an ERP model to overcome your irrational fear?
krtab
If you're interested in this topic, I very warmly recommend the book You're not a rock by Mark Freeman. There are also episodes of podcasts around with interesting interventions from him.
The way I usually pitch the book is that Mark is not an MD, or a scientific expert on the topic, but he is a patient who's been through it, is very interested, and explains to you how it worked for him, and what he knows about the topic like a friend would. There are some mistakes, some things are a bit awkwardly explain, but the book is overall a tremendous read for anyone interested in anything dealing with anxiety, ocd, or more generally a mind too keen on spinning in a wheel.
baq
There’s a coaching diagram which goes like this:
- I want to do a thing.
- Do the thing.
- but I’m scared
- Do it scared.
taberiand
Courage is a core virtue for a reason
null
forgetfreeman
Author shoots the article in the head instantly with the suggestion that LLMs have a part to play.
lmm
I thought this was going to be a biting satire about using an ERP tool for therapy, but sadly no.
reify
ai, I bet its got a conscious mind too!!!!!!
CBT/ERP, medicalised Skinner pavlovian model, cheap, short term relief of symptoms, no long lasting effect.
CBT = there is no unconscious!
CBT is based on a theory that it is not events in themselves that upset us, but the meanings we give them. However, CBT believes that this meaning is conscious, can be accessed, and is not ambiguous.
If someone says that they feel sorry for a person, they do feel sorry and it is possible that their problem is that they should not; the therapist then tries to help the patient to see that they are thinking about something in the ‘wrong way’. By using brain washing techniques.
The concept of the unconscious, a central Freudian discovery, renders the picture instantly more complex: if you say you are sorry for someone it might indeed mean that you are sorry, but could also mean that you can’t face your own aggressiveness and the fact that you are delighted at what happened to the other.
The question of the existence of the unconscious is crucial, because if CBT starts to take into account the possibility of unconscious meanings and logic, then it would become another branch of psychoanalysis.
willvarfar
I was with it right down to near the bottom where the author suggests people try it out using an LLM. Hmm, LLMs fall for cargo cults and I'm not sure they are to be trusted with even the most trivial self-help.
wulfstan
Yes I'm really not sure obsessive patterns of behaviour will be helped by an unqualified stochastic parrot giving you advice. Unfortunately, when treatment for conditions in some countries costs you an arm and a leg people will resort to quackery. But even in countries where it doesn't, the waiting list for therapy can be so long that you could be waiting years if your case isn't somehow life threatening or profoundly limiting you won't be a high priority.
jrflowers
I like how the author says that they only started a few weeks ago and find it good, actually, but has already amassed the requisite expertise to advise other people not to seek out therapy from human beings if they don’t get the result they want from a chat bot.
It is literally “My Mental Health is Improving Through Human Contact: Human Contact Might Not Be For You. The Only Way To Know Is By Asking The Computer”
It is kind of like “I started exercising with a trainer and I feel better and I’m losing weight, because of this I suggest you take up smoking and based on that decide whether or not you want to exercise”. Like the advice is simultaneously almost completely unrelated to their experience and also the exact opposite of their experience.
I cannot wait to hear more well-thought-out advice from the author of “God created men; Sam Altman made them equal”
> Luckily, LLMs significantly reduce the effort/cost of therapy experiments.
The day just started and I'm already done with it.