Every year, we’re finding new ways to use technology to combat mental illness. Apps like Calm and Headspace help to address chronic anxiety with guided meditations and progressive scheduling. Anger Management offers hypnosis treatments for short tempers. Social anxiety apps are just hitting their stride now too, including AI-Therapy, which markets itself as the “AI” cure for the affliction.
“AI-Therapy” was started by Dr. Fjola Dogg Helgadottir and her former professor, Dr. Ross G. Menzies. Helgadottir specializes in cognitive behavioral therapy, which includes exposure therapy, a technique for reducing your anxiety through visualization and controlled exposure. She has translated those best practices into lessons with audio and video components. The cost, depending on how long you have access to the program, is about the same as one in-house visit with Dr. Helgadottir herself.
CBT is a scientifically-validated treatment for phobias, anxieties, and mental illnesses, and it doesn’t have any of the same complications as SSRIs or Benzodiazepines. The fact that it’s available in an easily accessible and affordable online treatment program is good news. The “AI” aspect on the other hand—which I’ll admit, got me reading about this research in the first place—is a bit of a letdown.
What Do Companies Mean When They Use the Term AI?
Perhaps you’ve noticed the trend of using “AI” to broadly refer to intelligent data analysis and application of any kind. The Obama administration, for instance, is currently using “AI” to help reduce the unjust distribution of arrests in predominantly black communities. But that doesn’t mean SmarterChild or Watson are donning a badge and a gun; it just means the computer program they’re using to crunch data is “learning” as it goes.
When I think of AI, I think of the disembodied voice from “2001: A Space Odyssey.” So naturally, I imagined AI-Therapy as a chat-bot or Second Life avatar that could engage in small talk while I stumbled my way to competency. That’s the sort of thing cognitive behavioral therapists would advocate for in a controlled clinical setting: exposing yourself to the fear of rejection, or crowds, or domineering authorities, as many times as you can so that you eventually understand intuitively that you can survive those encounters.
Instead, the AI in AI-Therapy just customizes your lessons to your unique user data. If your social anxiety has less to do with “fear of authority” and more to do with “fear of being yourself around strangers,” the machine will learn that and walk you through personalized scenarios that treat your unique brand of crazy. It’s an AI implementation that feels a little light on the “intelligence,” but if we’re getting technical, this is the definition of AI:
The theory and development of computer systems able to perform tasks that normally require human intelligence.
Not a particularly high bar. AI-Therapy isn’t exaclty Rosie from the Jetson’s tucking you in at night, but it is something. Something pushing a novel and potentially game-changing approach to adapting to people: eliminating people. People, however, in the right artificial form, could be the real cure. If we’re really looking to leverage this kind of technology, we need to look beyond curated artificial guidance.
Joyable is another app we’ve covered that’s working with social anxiety. They allow users to speak directly to trained coaches through text, email, or phone for $25 per week. Like AI-Therapy, Joyable uses CBT to inform the advice that coaches give. Well-meaning but under-performing coaches could do more harm than good, while trained doctors like Helgadottir, emulated by machine learning, would likely fare better. The human touch is a nice one though. It just doesn’t seem to hit the mark either.
Criticism aside, I’m genuinely excited about both prospects. If my social anxiety were really severe, I would foot the bill for each. But what about leveraging the technology to facilitate “real” AI treatment for social anxiety? Like Scarlett Johansson in “Her,” only with an entire virtual world of Hers and Hims for me to practice my boring anecdotes on? That’s something I could get down with. Let’s just imagine that I have unlimited resources, access to brilliant developers, and a lifetime of experience creating virtual reality games. Here’s the AI-Therapy I would make:
I Call It “Sim Anxiety”
You put on a virtual reality headset and tune into the “House Party” level. You have three “lives” and an anxiety score. If your anxiety goes above a certain level, voices start to compound and get louder, it gets harder to see, and you have to start over.
You open your virtual eyes in a crowded living room and walk over to a group of three near the door and wait for what feels like 20 minutes on the periphery. No one acknowledges you but they’re clearly aware of your arrival.
“Sorry I’m just standing here…” you joke in a small voice, trying to make light of the situation.
They laugh helpfully, but look slightly annoyed. Panic sets in, and the last thing you said starts to replay in your earphones. Two members of the circle gently break off to get another drink. The last person remaining asks you if she can get you something.
“I don’t drink.”
“Maybe you should,” she says, laughing.
What does that mean? Is it that obvious that I am completely BLOWING this right now? Should I explain why I don’t drink?
“I’m an alcoholic.”
“Oh…damn. I’m sorry, I didn’t know.”
“No, it’s not your fault! I’m just saying…”
“Ok, I’m gonna go get one for me, if that’s ok?”
You just lost a life, press enter to start over.
After watching a brief video about determining when and how to approach a group of people, you walk back into the same party. A new, randomly-generated group of people congregates near the door, but the radio is playing too loud to hear. How did you not realize that last time? You move to the back to see if there’s a bathroom you can hide in while you collect your thoughts. On the way, you see a couple engaged in conversation in the kitchen. One of them mentions the show Family Matters.
“Family Matters was my childhood!” you shout out without really thinking.
“Mind if I join this conversation?”
“You just did. Who do you know here?”
“No one actually, my friend invited me but he hasn’t shown.”
“Good for you! I would never come to one of these alone. We’re all nice though. Want something to drink?”
“I don’t drink, but I’ll take a water or something if they have it.”
Achievement unlocked: smoke weed with the host of the party and get invited back!
Am I the only one who wants to play this game right now? It’s like the Sims, but informed more by CBT than Jungian psychology. It might sound sort of pathetic to someone with supreme confidence. After all, you can always just, you know, go to a party to practice these social skills. But like a lot of fear-driven people, I would love the opportunity to practice for the practice. All it would require is some sort of response-generating software that comes close to passing a Turing Test—if even that.
A product like AI-Therapy signals that we’re not far from the verge of this sort of application within the therapy sphere. We’re heading towards a world where you don’t actually have to interact with people to be less afraid of people (some would say that gaming has gotten us part of the way already). AI-Therapy might not be quite there yet—it’s more of an education tool than an exposure method.
If AI-Therapy can use machine learning and specialized lessons to actually get people out of the house, where they can truly experience and overcome their fear, we’ll have exploited technology in the most classical sense; getting the benefits of historically human services, in this case CBT, for a fraction of the cost. Technology can take us much further though. If, like me, people are looking for real live practice without the pressure of real life, they’ll have to wait for Sim: Anxiety. Because in the absence of an uncanny artificial person to who you can fake talk, and in front of whom you can get legitimately fake embarrassed, experiencing social anxiety is still probably the best tool we have for “curing” social anxiety.
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Ralph Johnson says
I am not sure there is any cure, without a lot of doctor time, but this could be one way to lessen the impact of an anxiety that is felt for those that have it.
Shawn Osborne says
Having lived with a person with social anxiety, I can truly see this working to a limit. As always, there is a limit, plus you have to understand that, for them, virtually seeing people and REALLY seeing them around is different.
Hi, this is a great article. It is pretty spot on.
I’m not sure if you have seen it, but I’ve actually addressed a similar point in one of my blogs (https://www.psychologytoday.com/blog/man-talks-machine/201404/artificial-intelligence-and-the-future-therapy). The term “AI” comes with all sorts of connotations, and people often think of intelligent robots. However, real-life AI is different. It’s algorithms that are behind the scenes and we use them every day. e.g. the Netflix recommendation engine. When they are working you don’t even notice them (they are more obvious when they fail!).
As I say in the article, the future of AI for therapy “will be in the form of increasingly sophisticated computerized therapy systems, not increasingly sophisticated computerized therapists.” Thanks for taking a look at the program and sharing your thoughts!
Devin Greene says
Dr. Helgadottir, thank you so much for chiming in! I did read your Psychology Today article, and I found it interesting that both of us seemed captivated by the movie “Her” and how an AI like that could help people overcome their fear with virtual exposure therapy. I also found that some people who were writing or commenting on your research were incorrectly imagining this kind of chat-bot, so I wanted to clarify the term AI. Once I understood your use of AI though, I still wanted to write the article and give you credit for making CBT therapy available without a physical therapist. That’s incredible! I look forward to trying CBT myself, probably with one of the methods I wrote about, since my insurance is “in limbo,” shall we say. Thank you for your work, and for your comment! But like you, I couldn’t help but imagine what’s coming next.