Your AI Therapist Doesn't Think About You

More and more, people are turning to artificial intelligence (AI) and large language models (LLMs) for psychological support. The appeal is obvious: AI is always available, and seems nonjudgmental and empathic enough. Even paid versions cost significantly less than therapy, with no waiting lists. We hear horror stories about how it has driven people to psychologically dangerous places, with suicide being one of the outcomes. But there is also the argument that for many, especially those who cannot afford therapy or live in places where mental health support is scarce, it feels like a lifeline. Without dismissing their utility, this discussion focuses on one irreplaceable aspect of human therapeutic connection and what AI cannot do.

The Need to Exist in Another's Mind

At the core of therapeutic healing lies something deceptively simple yet psychologically fundamental: the deep sense of knowing that another human being holds you in their mind. This "holding" is not just rational awareness that someone knows your name and background. It represents a bone-deep, visceral knowledge that you exist not just in a vacuum but within someone else's mind and heart—that they know you as an organic, evolving being, that your story is real, valid, and believable, and that you exist.

The feeling that you exist in someone else's heart and mind holds weight much deeper than knowing you are in some database, in a single chat thread that can be erased with the click of a button. When we share our inner world with a fellow human being, we are placing our narrative into the consciousness of another person who will carry it with them beyond the session.

The Psychology of Mirroring

Consider the process of mirroring, a fundamental concept in developmental psychology. Mirroring is an essential, mostly nonverbal process that first occurs between caregiver and child when the child sees their own reflection in their caregiver's eyes and expressions. In childhood, psychological development would literally halt without the caregiver's mind serving as a container for experiences. Through facial expressions, attention, and responses, children learn they exist in their caregiver's awareness. Without mirroring, a coherent sense of self cannot develop.

But our need for mirroring does not end there. As adults, we still want and need to have presence as a living, dynamic agent in another’s consciousness. When your therapist or coach offers mirroring in a session, the verbal content of your conversation is only a small part of it; the majority of it occurs on an unconscious, right-brain-to-right-brain level. Your therapist or coach continues to think about you between sessions. You become part of their internal world, just as they become part of yours. And just like how you developed a sense of self as a child through your mother’s eyes, through being held in your therapist’s consciousness, you develop the ability to hold yourself, to think about your own thinking, to observe your own emotional states with the same compassionate attention you have received.

To assume your therapist or coach is a mere "blank screen" that receives everything you say would be a mistake, as demonstrated in recent years in literature on relational psychoanalysis. The reality is that inevitably, the therapist is changed by holding you in mind, and you are changed by being held. The real dialogue is what goes on between sessions; it is always there: active, dynamic, and reciprocal. Your narrative evolves in your therapist’s consciousness as they reflect on it, connect it to other experiences, and feel it resonate with their own life. Their understanding of you deepens and shifts even when you are not together.

The Fear of Annihilation

Perhaps most importantly, when it comes to healing, the psychological impact of knowing we exist in another’s mind addresses one of our most primitive anxieties: the fear of annihilation. This is the nameless dread many of us try to suppress but is very much present at all times — the existential terror of existing without being known, of having experiences that are not witnessed or contained by another. When we know our therapist carries us in their mind, we are anchored in a human relationship, and therefore in the world.

An AI bot, no matter how sophisticated its memory systems or how "human" its responses, cannot offer you the bone-deep sense of being known and held. It may do so temporarily, when you simply need a bit of "back-and-forth," some reassurance of what you already know, but you would likely struggle to convince yourself that you are held, with tenderness and warmth, in another human’s heart. AI does not "carry us" with it because there is no consciousness to do the carrying. There is no mind in which we can exist between conversations. When you log off, it is "off"; the AI does not hold lingering emotions left by your conversations; it does not wonder about you, worry for you, or feel delighted for you; and it does not come back to you with spontaneous insights.

The initial appeal is understandable—AI is always there and always responsive. In some ways, it seems to have traits of a responsive, attuned parent. However, after investing relational energy and vulnerability into this artificial connection, after coming to trust it, the recognition of its limits can be traumatizing (or retraumatizing). When people hit the ceiling of AI's relational capacity, it may evoke the very existential fear they sought to avoid: the terror of existing in a vacuum, of realizing how fundamentally alone they are in their pain. Without the containing function of another mind, experiences feel unreal, disconnected, and meaningless. This disconnection can escalate into nihilism—a slippery slope particularly dangerous for those already struggling with mental health challenges.

The Irreplaceable Power of Human Connection

Ultimately, there remains something about the warmth and continuity of human-to-human interaction that holds power AI cannot replicate. A human relationship is by no means perfect, but that may be precisely what makes it meaningful. The knowledge that another flawed human chooses to show up, to hold your story despite their own struggles, provides validation no algorithm can match.

This is the first part of a longer piece I’m developing about what AI cannot provide in therapeutic and coaching relationships. Some other aspects that feel equally important  might be  the necessity of genuine boundaries, how the always-available nature of AI might paradoxically hinder rather than help our growth, and the fundamental differences between AI creativity and the kind of spontaneous, intuitive breakthroughs that happen in human healing work. As I am still thinking through these points, I welcome your thoughts and experiences.

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