This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Tremendously poor idea, general purpose chatbots have already led to suicides (example- https://amp.theguardian.com/technology/2024/oct/23/character-ai-chatbot-sewell-setzer-death).
Purpose built ones will have more safeguards but the problem remains that they are hard to control and can easily go off book.
Even if they work perfectly some of the incentives are poor - people may overuse the product and avoid actual socialization, leaning on fake people instead.
And that even if is doing a ton of work, good therapy is rare and extremely challenging, most people get bad therapy and assume that's all that is available.
Services like this can also be infinitely cheaper than real therapists which may cause a supply crisis.
I'm afraid at least this particular example is wrong, and popular media grossly misrepresented what happened:
https://www.lesswrong.com/posts/3AcK7Pcp9D2LPoyR2/ai-87-staying-in-character
(Note that one of links has rotted, but I recall viewing it myself and it supported Zvi's claims)
Anyway, I have a more cynical view of the benefits of therapy than you, seeing it rather well described as a Dodo Bird Verdict. Even relatively empirical/non-woo frameworks like CBT/DBT do rough as well as the insanity underpinning Internal Family Systems:
https://www.astralcodexten.com/p/book-review-the-others-within-us
Even I have to admit that Freudian nonsense grudgingly beats placebo.
You seem to agree that good therapists are few and far between, but I'd go as far as to say that I'm agnostic between therapy as practiced by a good LLM and the modal human therapist.
Oh hey!
When you get a chance I would love to hear how things are going for you!
On to the matter at hand -
Please update my understanding of that particular suicide if it's incorrect, but what I'd heard is that the person was substituting human contact with the chatbot and his parents didn't catch the worsening social withdrawal because he was telling them he was talking to someone. My fear is not that chatbots will encourage people to do things, but that they won't catch and report warning signs, and serve as an inferior substitute for actual social contact. Not sure what the media presentation is since I'm relying on professional translation.
Moving beyond that however, I think you underweight the value of therapy. DBT and CBT have excellent quality evidence at this point. The reason for those two specifically is likely two fold - they are "simpler" to perform, and because they are more standardized they are easier to research.
Also, good psychodynamics is not Freudian nonsense, it's mostly CBT with different language and some extra underlying terminology that is very helpful for managing less severe pathology. Again I tell you to read Nancy McWilliams haha.
At its absolute worse therapy is stuff like forcing social interaction, forcing introspection and so on. Some people can function well off of a manual, and some people can study medicine on their own. But nearly everyone does better with a tutor, and that's what therapy is.
A tutor is also more likely to catch warning signs because of (at this time) superior human heuristic generation and the ability to perform a physical and mental status exam.
I've been rather miserable since I've gotten here, for a multitude of reasons, which had notably dampened my appetite for chatting up my day job online. I'm slightly less miserable right now, which is why I'm back at it! I can elaborate in DMs if you'd like.
I raised objections against claims made exceedingly uncritically in the Guardian post you linked to (having assumed you endorsed it). For example-
I can cut a grieving mother some slack, but the facts don't bear out her beliefs, and the Guardian doesn't really do much journalism here, since it would otherwise suggest her suit is unfounded.
Your personal claims seem more subtle, but even then, I find it very hard to blame the chatbot for social withdrawal here. I'd point out you can make the same argument for anything from reading books to watching anime (a bullet that some may bite, of course). In other words, a potential refuge for the maladjusted, but also something that the majority of people would be loathe to ask others to consume less of or ban altogether, on the grounds that it's a net negative.
(I think the case for social media being far worse for teenage mental health is significantly more robust, and I still wouldn't advocate for it to be banned. In the case of chatbots, I haven't been nudged out of the null hypothesis.)
Imagine the chatbot was replaced by, idk, a Runescape girlfriend (do kids these days have those? Potentially substitute for someone grooming them on Discord), would you expect said person to be significantly more helpful, or at least worthy of blame? I wouldn't.
I'll have to see if it's relevant to the MRCPsych syllabus, God knows that having an unpleasant time with the subject makes most reading on it feel unpleasant :(
A fair point. But I contend that an AI therapist is capable of doing those things, in a limited but steadily improving fashion. You can have a natural language spoken conversation with ChatGPT, and it's very capable of picking up minor linguistic nuance and audio cues. Soon enough, there'll be plug and play digital avatars for it. But I think that therapy through the medium of text works better than doing nothing, and that's the standard I'm judging chatbots by. Not to mention that they're ~free for the end user
God knows what the standards for AGI are these days, with the goalpost having moved to being somewhere near a Lagrange point, but I would sincerely advocate the hot take that an LLM like Claude 3.5 Sonnet is smarter, more emotionally intelligent and a better conversationalist than the average human, and maybe the average licensed therapist.
It is, of course, hobbled by severe retrograde amnesia, and being stuck to text behind a screen, but those are solvable problems.
To run with your analogy, an AI therapist/teacher is far closer to a human therapist/teacher than they are to a manual or textbook! You can actually talk to them, and with Hlynka not being around, the accusations of stochastic parrotry in these parts has dropped precipitously.
What I'm really advocating for is not letting the perfect become the enemy of the good, though I'd certainly deny that human therapists are perfect. I still think that access to AI therapists is better than not, and I'm ambivalent when putting them up against the average human one.
Though I'd also caveat that Character AI probably cheaps out, using significantly dumber models than SOTA. But it's not the only option.
Will message you.
And yeah no doubt the media fucking sucks.
My fear is that people will engage in HER style stuff and this example is a bleeding edge version of that.
McWilliams is useful even if you are just skimming the personality disorder chapters because you will have colleagues with those. It's also interesting enough to make you go through it at pace haha.
I think things like your therapist looking at you like you are an idiot and you going "yeah I know" are underrated parts of therapy and the chatbot isn't going to do those things for now.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
Makes me wonder if you're the Scott Alexander alt because this is clearly a mental health practitioner's opinion. All LLMs go off the rails if you keep talking to them long enough, that's a technical problem to be solved in the next year or two, not a reason that human therapists should have jobs ten years from now. OpenAI has already made it a non-issue by just limiting ChatGPT's context window, you'll see this issue more on models that let you flood the context window until the output quality drops to nothing.
Just FYI, a lot of people would much rather spill their guts to an AI than to another human. Also, one of the most common kinds of stress people face is financial stress, and for these people paying for a therapist will cause more stress than it will ever resolve. Mental health professionals are much more useful to the people that need them most when they are free. Far more people will kill themselves due to not getting expensive human attention than will ever kill themselves because their cybertherapist told them to.
Haha I am a physician but I am not Scott and disagree with him on a large amount of his medical opinions.
I think you make a very fair point about access, and I don't have a good counterargument but it is worth noting that people excessively overweight their ability to manage their own health (including health care professionals who have lots of training in knowing better).
I guess the best argument I have is that these days a lot of mental health problems are caused by socialization adjacent issues and solving that with an advanced form of the problem is unlikely to be an elegant solution.
More options
Context Copy link
I just can’t get excited for AI therapy because honestly, unless you have literally nobody in your life to talk through things with, there’s no value to therapy. I just don’t see people with long-standing issues get better because they had therapy. In fact, some people have therapy for multiple years without ever getting to the point of not needing therapy anymore.
I’m very much of the Stoic/CBT/Jordan Peterson school of therapy. Over focus on feelings and overthinking problems not only does not work, but quite often makes your original issues much worse. The key to getting better (barring something organically wrong with your brain — and that’s fairly rare) is to get out of your own head and get into taking productive actions to make your life better. Feeling bad about yourself is much better treated by becoming a better person than by sitting around trying to convince yourself that just because you haven’t ever done anything useful doesn’t mean that you’re useless. Get out there and start building, fixing or cleaning things. You’ll get over feeling worthless because you’ll know you did something useful.
Uh, isn't the evidence that therapy- or at least forms of therapy- is genuinely helpful to people with actual mental health issues- or at least some subset thereof, eg PTSD- pretty ironclad?
Thankfully I do have my effortpost/AAQC on the topic handy:
https://www.themotte.org/post/983/culture-war-roundup-for-the-week/209218?context=8#context
(In short, yes)
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link