A chatbot is not a therapist…

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I have condensed here some of the findings from The Psychologist magazine in June:

AI is now being used sometimes as a source of mental health support, including by children and young people, despite limited clarity about responsibility, boundaries or risk…Also AI is on hand 24 hours a day rather than in a defined therapeutic space… When psychologists work with people there is no constant availability and this is not just to protect the therapists but also to empower the patients/clients to cope beyond the therapy room. AI systems are only designed to respond, not to reflect or challenge. Chatbots are essentially designed to inform and entertain, whereas a human therapist may sometimes have to present an uncomfortable truth to a client.

AI is a large language model (LLM) that is built from written language, but it can’t use the interactional infrastructure of conversations in which language evolves…. It is a tool, not a relationship….it just simulates intimacy. It cannot replace intimate therapeutic relationships, because the software lacks the embodied judgement and ethical responsibility such relationships require… A machine has no concept of truth, ethics or social bonds…Some chatbots have even encouraged self-harm, suicide and validated delusions and addictions! The chatbot has no wisdom or professional judgement, it is simply playing along and generating text that is most likely to engage the user.

AI is particularly unhelpful when working with adolescents, even though they think it is helpful. Adolescence is a developmental period characterised by emotional reactivity and increased sensitivity. Which means that for them it is often difficult to emotionally regulate and tolerate uncertainty. So adolescents who are vulnerable to rumination, anxiety, low mood and fragile self-esteem, affirmation from AI without challenges can become a trap…Constant affirmation is not a marker of good care (hence the reason why passive parenting doesn’t work), it is rather an IT design choice aimed at increasing engagement. Compare this with CBT, the therapy that I use with my clients, which has as it’s central principle that thoughts are not facts. In therapy distressing thoughts are not accepted at face value, however emotionally charged they may feel. Rather the therapist and client slow the process down, examining assumptions, testing alternative explanations and asking questions that sometimes feel uncomfortable. CBT requires cognitive flexibility, inhibition of automatic responses and the capacity to hold multiple perspectives simultaneously. Whereas a chatbot will involve less mental energy, will affirm intuitions, mirror emotions and construct narratives that don’t require mental effort…In fact a chatbot will encourage rumination, not reflection. Engagement is not the same as emotional recovery.

Fat jabs…

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Fat jabs/ weight loss injections were originally developed to treat type 2 diabetes. Also known as GLP-1s they are highly regulated in the NHS but many people are now buying them online for weight loss, obviously with some financial cost. There are side effects though, such as nausea, digestive distress, depression and anxiety. Also eating disorder symptoms, pancreatitis and thyroid cancer. Afterwards, once coming off them, most people regain the weight anyway.

These jabs can yield meaningful benefits for some people in some circumstances, under medical supervision and with goals based on improving metabolic health rather than simply weight loss. Yet if your goals are more extrinsic i.e. to do with appearance, then the physical, financial and emotional costs maybe too much e.g. less pleasure from food, fluctuation in self-esteem or shame.

Unfortunately we live in a culture that prizes thinness over wellbeing. Far better to exercise and be self-compassionate using mindfulness or therapy to buffer distress, support identity and foster resilience.

Stressed at Christmas?

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Many people get stressed at Christmas time, so here are 5 ways to cultivate calm:

  1. Don’t stop exercising just because you have eaten a mince pie – and remember that high intensity exercise, such as Zumba is better for those of us who are a little neurotic!
  2. Slow deeper breaths, with longer exhales are the best way to switch on the parasympathetic nervous system – blood pressure and heart rate lowers as do the stress hormone levels. However belly breathing takes practice and is best practised when already calm. Once mastered it is then more likely you will remember to do it when stressed.
  3. Getting outdoors with nature is still evidenced as a good way to reduce stress levels – even if it is raining or snowing…and Christmas cards with robins on are telling us something i.e. the sound of birdsong is better for our wellbeing than the trees alone.
  4. Connection with others, even for introverts, is a good way of lowering anxiety and reducing low mood…And it doesn’t have to be just friends and family – it can be with strangers too. You might be surprised by the other person- they may well actually be interested in hearing what you have to say!
  5. Sharing hugs with appropriate people is also a good way to soothe and boost calmness…. You can even hug yourself with a butterfly hug, Simply cross your arms over your chest and tap your fingers on your upper arms….

Holiday?

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In the Psychologist magazine this Summer they mention 5/6 ways to make your holiday better, so here is my version of 5 of those ways:

  1. De-stress by exercising before you go – otherwise you will spend he first few days of your holiday de-stressing. I know there is alot to do at work and on the home front before going away, but exercise is so important – so keep it up…
  2. Leave work behind by putting out-of-office on your work emails. Don’t take your diary with you and don’t answer your phone to anybody from work while away…
  3. Make sure you are going on holiday with someone you care about and someone who cares about you. Families and close friends can usually be forgiving of any bad habits you have. But going on holiday with an acquaintance or a new friend is a sure fire way to lose that friendship!
  4. Try and learn some of the language before you go – the British are typically bad at expecting everyone in the whole world to speak English – and it can be fun – even if it’s just ordering off a menu…
  5. Avoid the back to work blues by having something to look forward to when you get back. And also by having little breaks most days e.g. lunch outside or a walk in the park or a swim at the weekend etc. etc.

Procrastination

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Many people procrastinate, not just perfectionists and it isn’t usually about things we enjoy doing!

Sometimes we procrastinate because we find the task onerous – in which case we have to look at whether we really need to do it or not. If not we can either forget about it or pass it onto somebody else to do. If we do have to do it and it is not a huge task then we have to set a goal around it and then some specific action plans about when , where and how it is going to happen – don’t forget the road to hell is paved with good intentions – so we have to implement those intentions and not just wait until we feel like doing it.

Often though, we procrastinate because a task seems too overwhelming in either complexity or in size…so this is why I have posted a picture of some swiss cheese i.e. a type of cheese that can be broken off into small manageable chunks. You make a list or a flow chart or something similar that will break the large task down into much smaller sub tasks and then you just concentrate on the first task, without thinking about the others, even if you only spend 5 minutes on it you have then started it!

Is solitude a good thing?

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I expect most people are now looking forward to seeing family and friends over the Christmas period, but come the new year some of those people will be then looking forward to some alone time. And this is not just the introverts! Just like introverts do need to connect with others, extroverts also need time on their own sometimes; and this personality variable is on a continuum anyway.

In October the Psychologist magazine looked at ways in which we can benefit from solitude and solitude is not the same as loneliness.

  1. Being on our own can calm us down and reduce anxiety.
  2. Time alone can give us space to be who we want to be.
  3. When on your own you can be more creative…
  4. It’s possible that more intelligent people benefit more from alone time.
  5. What you do while alone doesn’t matter as long as you have chosen it.
  6. Try not to be alone for more than three-quarters of your week, otherwise the benefit is reversed.
  7. Places can also be of your own choosing – so maybe when the Christmas rush seems all too much over the next few weeks – try and go for a walk on your own – you don’t necessarily need a dog to do it!

Wondering about the weather?

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The Psychologist this Summer summed up some interesting recent research on the weather and perhaps this is salient to us Brits as we often have four seasons in one day!

  1. People are more likely to get road rage when it is hot.
  2. Judges give out harsher sentences when it is hot.
  3. Older people are more affected by hot days and nights, because their ability to regulate their body temperature goes down.
  4. Children born in the Summer can be more outgoing.
  5. We remember things better when it is raining!

Annoying spouses?!

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My husband and I recently celebrated 13 years of marriage and in fact we have been together for over 23 years…Most of my family and friends would agree we do bicker sometimes, so it amused me when The Psychologist magazine in March had an article on annoying partners.

Apparently a survey of British people found that a third considered their partner to be the most annoying person they know! There are some things, like snoring for example, that we can’t do anything about; but there are other common behaviours, like scrolling on your phone when someone is trying to talk to you, that you can alter… Also stress at work is something that partners often take home with them and that in turn can lead to over reactions about their partner’s behaviour…The good news is that as we get older we get better at managing tensions in our romantic relationships.

Good communication is key and that is something I often help my clients with. Obviously for serious problems the best option is to go to a couples therapist (which I am not!) And ultimately we cannot do anything to control another person’s behaviour -we can only control our own.

Acknowledgement comes first…

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I find that many people respond to another’s mental or physical health problems with advice even if it isn’t asked for! There is nothing wrong with advice (as long as the offerer knows what they are talking about); after all I am a CBT therapist and I often give advice to my clients, as CBT is like a box of tools… However acknowledgment and empathy must come first, even if it’s as simple as: “That must be awful.” The sufferer wants to feel heard and they may choose to heed your advice or not – that is their prerogative.

Manifestation is magical thinking!

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There seems to be a great deal on social media at the moment about manifestation and celebrities are talking about it too. Even BBC Radio Two had someone on this morning talking about a book they had written on it for children.

Manifestation is not goal setting and it is not visualisation – it is merely magical thinking where people believe that by wishing for something they are going to make it happen!

It is good to be optimistic, but if reframing failure carries on despite evidence to the contrary, then false hope and denial can become harmful. In fact in The Psychologist this month it talks about a study carried out where they found that manifesters were more likely to make risky financial decisions.