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Comment by agnosticmantis | Hacker News Reader

I haven't done it yet due to privacy concerns, but I would totally do it with a private local model that's as intelligent as current frontier models and is not sycophantic and perhaps is finetuned on the psychology literature.

My reasoning is that, if therapy is a well-understood science, then I trust a big finetuned LLM more than a run-of-the-mill human therapist. I will not be able to afford a Harvard trained psychologist.

If therapy is more of an art and needs the human touch and mojo, then again, then again I'm not going to be able to afford Sigmund Freud or Carl Jung.

The few times I've tried human therapists, my impression was that the questions and answers were fairly standardized, which I think LLMs can excel at. Not to mention I'm more at ease talking to silicon- than carbon-based creatures.

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My experience with therapy has been that it's more of an art than a science. It's hard to say what good therapy even is - different people need different things. I would not want Freud or Jung to be my therapist.

I think your ideal AI therapist doesn't exist and may never exist. Given current models, I have a hard boundary where I will not rely on AIs for therapy or companionship. There are just too many stories of AI psychosis, and it's too easy to see myself becoming dependent on them.

LLMs don’t notice the frown or smile as you talk about sad memories or incidents. They don’t notice the underlying emotions that aren’t explicitly expressed through words. They don’t have the timing of when to ask questions that deepen your experience. They also don’t provide the regulated nervous system when you’re feeling dysregulated.

LLMs are basically glorified CBT machines, but they don’t have the Rogerian presence and therapeutic alliance that good therapists are able to provide, and are more important than the modalities that are used in sessions.

The problem is that all the frontier models tend to be more sycophantic when confronted with emotional support issues.

I believe sycophancy is a side effect of RLHF and whatever reward function it explicitly and implicitly optimizes.

> then again I'm not going to be able to afford Sigmund Freud or Carl Jung.

Just spin in place chanting “it was my mother’s fault” and you’ll get 99% of the effect.

It's a little both funny and awkward to see all these jokes about Freud while in my particular case "patient was traumatized by dysfunctional family, also patient has incestuous desires" is 100% correct.

Also, I suspect that in 5 to 10 years these ideas will go back to mainstream, especially considering the current fad of calling everyone "daddy" - that word is slowly moving from underground gay fetish into mainstream, and I assume that it didn't appear out of the blue.

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> the current fad of calling everyone "daddy" - that word is slowly moving from underground gay fetish into mainstream, and I assume that it didn't appear out of the blue.

That's been in mainstream straight porn for at least twenty years.

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