Author: Sergio

Chatbots, authority, and the question of who calls the shots

This article builds on Clients Are Already Using AI. What Should Therapists Do? I want to look more closely at a different question: authority.

In many conversations, social, professional, and even in therapy, I often hear “ChatGPT told me…” or “With Claude’s help…” It is striking, if not scary, how quickly chatbots have become part of our everyday lives1.

The late Joanna Macy used to say that it took humanity 1,000 years to move from hunter-gatherers to agriculture, 100 years to move from there to industrialized society, and 10 years to move from there to the information age. Following that logic, it seems it took one year to move into the AI age.

The Oracle hath spoken

As a therapist writing about AI, I find it curious that AI has not only made its way into our lives but has also gained a level of authority in the process. Even with the warnings that “AI can make mistakes,” and even with all the media coverage and research about LLM hallucinations, I have heard, more than once, someone invoking the “authority” of ChatGPT to win an argument, implying that there was no use continuing to argue since the LLM oracle had spoken.

How could any puny human dare to question AI’s insight? Is anyone bold enough to assert higher intelligence than a chatbot “who” has been trained on almost unimaginable amounts of data? I must confess that sometimes, when a client brings it up in therapy, there is a part of me that feels intimidated, doubtful whether I can (or should) question the validity of Claude’s conclusions.

Who gets to choose? (hopefully not me)

This becomes particularly challenging since, often, when a client brings up ChatGPT, it has interesting and insightful recommendations. What is more, they are presented with a certainty and conviction that I rarely (if ever) use with my clients. While I try to keep the locus of authority within the client, LLMs have no qualms about claiming that authority.

This is dangerous. History has shown us that we humans tend to surrender autonomy rather quickly. There is something deep within us, stemming from our earliest childhood, when grownups knew the answers, that makes us susceptible to forfeiting self-determination. Politicians, dictators, preachers, corporations, and advertisers all recognize, and often take advantage of, this peculiar human inclination.

Good therapists are very aware of this predisposition. It is not uncommon for a client to say, “Just tell me what to do, and I’ll do it!” This is tempting (psychodynamic therapists would even say seductive). Feeding clients an answer seems to accomplish many things: we cut to the chase, we move forward, they get their answer, feel less anxious, get reassured that they have an amazing therapist, and, if that were not enough, the therapist gets to feel brilliant and caring. Everybody wins, right?

Wrong…

Therapy is about growing up

Therapy does not work that way. As tempting as it is, therapists should avoid taking on the client’s idealizing projection. Our job is to help clients find and claim their inner power, their capacity to believe in and act for themselves, find their own answers, and make their own mistakes.

LLMs are just one more in a long list of ways in which clients may relinquish their inner compass. Before them, we have had to deal with best friends, partners, parents, pastors, and even dealers telling clients what to think and do. Mind you, they may be right (just as Claude may be). That is not the problem. The problem starts when clients stop listening to themselves, stop exercising self-determination, and blindly accept someone (or something) else’s authority.

This may remind you of a question that was probably posed to you (certainly to me) at some stage of our lives: “If [fill in the blank] jumped off a cliff, would you jump too?” That was an invitation to use our own judgment. Growth is about learning to think for ourselves.

Not new, just upgraded

So, this is not a new problem. It has been with us for millennia2. The problem is that AI speaks authoritatively, even when hallucinating. Moreover, science fiction has led us to believe in infallible supercomputers or androids3. Combine this with the above-mentioned tendency to yield authority, and we have a potential perfect storm.

Therapists have feelings too

There is another dynamic worth naming. Therapists are also human beings (trust me on this one). We want to appear wise in our clients’ eyes. We like to feel useful. When a client chooses to trust Claude more than us, we may feel insecure, jealous, incompetent, or displaced. We may even feel tempted to prove that we “know our stuff.”

However, in those cases, good therapists need to contain all of this (saving it for our own therapy or supervision) and remain present for the client, helping them explore if, when, and how they may be forsaking their capacity to choose.

Let’s talk about it…

Our job as therapists should not be to compete against the other (the friend, the dealer, or ChatGPT…) and try to seize authority. That would be a disservice to the client. Our job is to help clients notice what may be going on.

Certainly, it is OK and even valuable to collect information from wherever it is available, ideally from reliable sources, and then exercise the power to decide for themselves.

What did the client ask the chatbot? Why did they ask it? What weight are they giving to the answer? Why did they not ask someone else (a human)? Do they agree with it? Are they taking it at face value, or are they willing or able to question it?4[4] Can we discuss it in session? It is all grist for the mill. AI itself becomes material for psychotherapy.

What about you us?

Even if you are not in therapy, it is a good idea to step back and consider the role AI plays in your life. Is it a tool to gain information, in the same way that an encyclopedia or Google (before Gemini) used to be? Are you letting it choose for you? Who writes your emails? Who answers your questions? Who makes your decisions? Are we, almost imperceptibly, giving away our discernment?

Let’s make sure we’re not trading our freedom to choose for the convenience of these amazing technologies. Let us keep thinking for ourselves and questioning our sources.

AI is already changing psychotherapy. If you’re concerned about how much authority you’re giving AI in your life, or want to explore AI and psychotherapy with your team, training program, or organization, let’s talk. I also offer speaking, training, and consultation.

Contact me…

  1. A 2026 APA survey found that 77% of psychologists reported that their patients discussed using AI, and 35% reported that their patients used AI as an additional mental health professional. ↩︎
  2. Among many, both Socrates and the Buddha encouraged their students to question everything, especially the authority of received so-called wisdom. ↩︎
  3. We’d need the nerve of a Han Solo to trust ourselves and not care for the odds. ↩︎
  4. Unfortunately, as several documented cases suggest, users do not always question AI recommendations or have a human being with whom to corroborate or challenge them. See: The rise of the AI gut check and The therapist in your pocket: Chatty, leaky — and AI-powered, ↩︎

Why powerful psychedelic experiences do not automatically become transformation

Psychedelic-Assisted Therapy Essentials | Part 4

Key takeaways

  • Powerful psychedelic experiences can be deeply meaningful without automatically producing lasting change.
  • Psychedelic integration helps translate insights and experiences into everyday life.
  • The psychedelic experience is only one part of a larger arc that includes preparation, integration, and aftercare.

An often-quoted Zen adage goes: After the Ecstasy, the Laundry. This applies beautifully to psychedelics.

Powerful, potentially life-transforming experiences

Psychedelic experiences have been described as ineffable, since it is impossible to fully put them into words. They often provide a profound sense of unity, insight into reality, transcendence of time and space, sacredness, acceptance of paradox, transience, and lasting positive changes1. People repeatedly refer to them as among the most important, if not THE most important, experiences of their lives2.

It is not uncommon to hear how an experience changed a person’s trajectory or even saved their life. We often hear that it is like three, five, or even ten years of therapy in one night. These are powerful, potentially life-transforming, meaning-making experiences3.

However, that is not always the case. In the same way that not all major crises (a near-death experience, an accident, the death of a loved one, a divorce, etc.) transform someone, not everybody who has a psychedelic experience returns a new person.

This begs the question: Why?

As beneficial as psychedelic experiences can be, they can also be challenging, confusing, and multilayered. Without adequate support and guidance, the same processes that may promote healing can instead cause harm. Getting lost is not hard. This territory can be as treacherous as it is alluring, and history has shown us how easy it is to get carried away and become overly enthusiastic or careless, believing that the psychedelic will take care of everything.

The importance of psychedelic integration

Integration helps people incorporate insights from their experiences into their lives. This includes short- and long-term strategies, continued support, and follow-up care intended to support lasting positive outcomes.

Just as preparation is fundamental to increasing the likelihood of having a healing experience, integration is key to making sure that whatever the person learned has a true transformational impact. As one of my teachers was fond of saying, for a change to be a change, it must make a change.

This is why it is misleading to say that psychedelics work faster than psychotherapy. The openness, catharsis, and realizations may feel dramatic, but transient and extraordinary psychedelic states need to be converted into enduring psychological traits. The seeds gathered in psychedelic sessions need structures in which they can take root. I simply cannot emphasize this enough.

Making it stick

Because these experiences are so powerful, it is easy to assume the insights will be permanent and our lives utterly transformed starting today. However, having facilitated hundreds of sessions, I know that this is not always the case. Becoming aware of unconscious patterns that keep us in repetitive dynamics can provide an opportunity to transform them, but awareness must be followed by diligent work to resolve them.

This is, in fact, one of the most difficult things to convey to clients after a journey. Unless you do the hard, ordinary, and unpretentious integration work, insights won’t “stick,” experiences will turn into memories, and the opportunity for growth may be lost. This is what psychedelic integration asks from us.

This is why, after the ecstasy, comes the laundry. In other words, what needs to be done to actualize this amazing experience in your life? After “meeting God” or “understanding the secrets of the cosmos,” can you become more patient with your partner? Can you apologize or forgive? Can you have compassion for yourself and others? Are you ready and willing to do the heavy lifting required to be a full human being?

Answering these questions, among other activities, ought to be part of the aftermath of a psychedelic experience. How is it going to change your life? How are you going to put this into practice? This is also the place where an experienced guide can really make a difference.

So, maybe psychedelics are not as powerful after all?

Quite the opposite. None of this diminishes the promise of psychedelic experiences. However, as with any good teacher, psychedelics are not going to do for you what you need to learn to do for yourself. Maybe that is why they are often called plant teachers.

Psychedelics and psychotherapy support each other so well because both can expand the richness and meaning of your existence. Psychedelics amplify; psychotherapy stabilizes. Together, they create a more complete path to transformation.

Psychedelic-assisted therapy is not only about what happens during the session. The full experience forms an arc: screening, preparation, the experience itself, integration, and aftercare. This reflects how nuanced, responsible, and complex this work really is. The experience may show us something extraordinary; integration helps what we have seen take root in our lives.

The joy of the work I do is witnessing people rediscover who they really are. Psychedelics are perhaps unmatched in teaching us what we need to learn, showing us what we need to see, and helping us let go of what no longer serves us. They may be the actual royal road to the unconscious, but the journey is more than a joyride; it demands commitment and a willingness to walk the walk.

Curious? Ready?

Next: Preparation Is Part of the Medicine. On why the journey begins long before the psychedelic experience itself.

If you are trying to make sense of a psychedelic or other expanded-state experience, reach out and let’s explore how to bring it into the world.

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  1. Pahnke & Richards, 1966.   ↩︎
  2. Depending on the study, participants consistently refer to their experiences as among the five most personally meaningful (58%; Griffiths et al., 2008), among the five most spiritually significant (83%), and even the single most spiritually significant experience of their lives (61%; Griffiths et al., 2011). ↩︎
  3. Of course, not all experiences are beautiful or healing.  Often enough, I also hear people talk about still not fully recuperating from a “bad trip”, even years later.  ↩︎

Don’t let convenience outrun clinical judgment

Believe it or not, there was a time before GPS (yes, I am that old). Back then, people needed to unfold one of those paper maps and figure out how to get from one place to another (and then how to fold the map back up). Nowadays, thanks to technology, I don’t even need to know where I am going. Google Maps knows, and that is enough for me. Likewise, in ancient history (before smartphones), I used to remember at least ten phone numbers: my home number, my grandparents’, and those of my best friends. Now I can hardly remember my wife’s.

Since the beginning of time, we have used technology to make our lives simpler. We could even argue that this is the purpose of technology. From the abacus and the calculator to Claude, we humans love to figure out how to make things easier and more efficient. This is often called cognitive offloading: using external tools to reduce the amount of mental processing required to do something. In the past, this might have meant mostly taking notes. Nowadays, it includes consulting Google or asking ChatGPT to summarize something, interpret information, or even write something for us (or as us).

The advent of LLMs and AI scribes

General-purpose AI systems powered by Large Language Models (LLMs), such as Claude or ChatGPT, have begun to revolutionize how we work. Months of research can be done in days; piles of books can be summarized in hours. They help us do things faster and often (but not always) better.

Just like clients, therapists and health care professionals are enthusiastically jumping on the AI bandwagon. The use of AI in health care, including AI scribes (note-takers), has grown rapidly1. It is undeniable that AI can reduce the administrative burden and make life easier for clinicians. As discussed in my last article, AI can also be useful for psychoeducation, providing additional resources, and as a tool for reflection.

As harmless as scribes may appear, they present important challenges for clinicians. Should clients give informed consent before an AI scribe is used? (probably yes2). Does sending client-identifiable information to a general-purpose LLM constitute a breach of confidentiality? (most likely yes, since information shared with an LLM is not confidential, at least not in the psychotherapy sense). Would it be a HIPAA violation3? (depending on the information, but potentially also yes). Things are even more delicate when considering that even purpose-built scribes can hallucinate, make inferences, or make mistakes4.

The deep end of the pool

However, note-taking is only the shallow end of the pool. Some AI scribes generate treatment language, conceptualizations, diagnoses, and suggested interventions, blurring the boundary between scribe and clinician. What is more, some therapists are using ChatGPT during sessions asking for insights or interventions5. Products are being marketed that listen during therapy sessions and provide therapists with real-time prompts, insights, and guidance.

When myth mirrors reality

In the Dialogues, Socrates tells Phaedrus a story about the Egyptian god Theuth. Theuth presents King Thamus with the gift of writing, claiming that it will make people wiser and improve their memories. The king is unimpressed. He argues that writing will produce forgetfulness because people will stop exercising their own memory and rely instead on external sources. They will think themselves intelligent because they have access to enormous amounts of information, while lacking real wisdom. It is uncanny how well this myth mirrors our current predicament.

What can go wrong?

As I have expressed, I am convinced that AI is an incredibly valuable tool when we know how to use it. However, outsourcing clinical thinking to LLMs presents potential risks that need to be acknowledged:

  • Relational disruption: Therapeutic success relies heavily on the relationship. Introducing AI into the equation changes the dyad, creating an artificial third: an opinionated, know-it-all chatbot.
  • Diluted presence: Real-time prompts, like an overactive inner critic, can get in the way of authentic presence. It may be difficult, if not impossible, to create a true bond when the therapist is simultaneously engaging with an LLM.
  • Automation bias and generic interventions: Because AI responses sound polished and authoritative, therapists may give them more weight than they deserve. Likewise, a chatbot may suggest elegant interventions that are technically plausible but misattuned or disconnected from the client’s reality. When that happens, besides potential risks6, the client may not feel understood, compromising the relationship.
  • Clinical deskilling: There is enough research to suggest that when we find a tool that makes something faster and easier, we are inclined to keep using it. As this process is repeated, we may stop practicing the underlying skill, become less competent, and rely even more on the tool (think of me and phone numbers). One study showed how by regularly using AI for diagnosis, specialists became less accurate when they did not have access to the tool7.

Offloading formulation, diagnosis, and treatment planning may gradually reduce clinicians’ skills. It may also prevent newer clinicians, who began practicing after the arrival of these tools, from developing those inner capacities in the first place. Therapists may slowly lose their clinical acumen.

The way forward

We have always used tools to extend our minds: dictionaries, calculators, GPS, Google… In some ways, AI is simply the latest iteration of this pattern, but it goes further because it can take over functions such as formulation, diagnosis, and treatment planning that have traditionally belonged to the clinician.

Psychotherapy has always been (and hopefully will continue to be) a profound encounter in which two human beings come together to work toward healing. This requires a human therapist who can create a safe environment and an authentic relationship where clients feel seen, understood, and safe enough to explore the deepest and darkest corners of their psyche.

Let’s use AI for what it is good at, but let’s not offload human connection. That is where true healing occurs.

AI can reduce administrative burden, but clinicians and organizations need thoughtful boundaries around privacy, consent, clinical judgment, and therapeutic presence. Reach out for lectures, professional trainings, and consultation on the responsible use of AI in psychotherapy.

Explore the AI series
  1. See https://www.ama-assn.org/practice-management/digital-health/more-80-physicians-use-ai-professionally-ama-survey and https://www.theguardian.com/australia-news/2026/mar/29/doctors-using-ai-for-notes-australia ↩︎
  2. https://www.nature.com/articles/s41591-026-04506-3 ↩︎
  3. HIPAA stands for the Health Insurance Portability and Accountability Act, is a federal law that aims to protect sensitive patient health information. It includes provisions for their confidentiality, privacy and security. ↩︎
  4. https://www.nature.com/articles/s41746-025-01895-6 ↩︎
  5. https://futurism.com/patients-furious-therapists-using-ai ↩︎
  6. https://spirals.stanford.edu/assets/pdf/moore_expressing_2025.pdf ↩︎
  7. https://www.thelancet.com/journals/langas/article/PIIS2468-1253%2825%2900133-5/abstract? ↩︎

It is time to come back home.

Spoiler alert: I think it would be hard to spoil The Odyssey, written thousands of years ago, but I plan to discuss an element in Christopher Nolan’s adaptation, so if you haven’t watched the movie yet, you may want to read this afterward. You’ve been warned.

The People from the Sea

In Nolan’s Odyssey, a motif that keeps coming up is that of the “people from the sea,” an impending menace that may arrive at any moment. It reminded me of something I learned in a long-forgotten history class. Something about how the Greek (Mycenaean) Dark Age may have been caused by people “from the lands across the sea.1” Interestingly, everybody seems aware of this unknown but felt threat. In the movie, both royalty, such as Penelope and Agamemnon, and peasants feared them. They all speak of it almost like a rumor, one of those things we somehow know but can’t quite remember where we heard it.

It is one of the story’s main revelations, though one that may get lost amid the action that follows, that Odysseus, his soldiers, and perhaps even the Greeks as a whole, are the people from the sea. How could that be? Aren’t they the good guys? Isn’t history written by the victors? You see, they committed atrocities at Troy whose memory, together with stories of their cunning victory, also traveled quietly from port to port: “Beware and try to be ready for the imminent arrival of the wicked people from the sea.”

The Enemy We Do Not Recognize

The movie, mirroring the original story, works hard to teach us, and repeatedly remind us, of the importance of Greek xenia (the guest-host relationship); however, it subtly shifts its emphasis toward what later came to be called the Golden Rule: “Do unto others as you would have them do unto you.” Odysseus argues that, by violating all that was ever sacred between people, they themselves, not mysterious invaders from elsewhere, brought about civilization’s downfall. It reminds me of Walt Kelly’s famous Pogo comic strip, where, after confronting the pollution of a pond, Pogo says, “We have met the enemy and he is us.”

Of course, there are many possible interpretations of what Nolan is trying to tell us. Is it a general criticism of the horrors of war, where human beings, winners and losers alike, unleash their darkest impulses, the beasts that Circe sees beneath their human disguise? Maybe. Does it refer to how humanity has turned its back on the Golden Rule, treating one another as enemies? Possibly. Is it a nod to how immigrants are currently not treated as guests (alongside how some guests, like the suitors, abuse hospitality) and the consequences that may follow? Probably. However, I am not a movie critic; I’m a psychotherapist, so I’ll leave those questions to brighter minds than mine.

The Odyssey and Jung’s Shadow

As a therapist, the revelation that we are the feared people from the sea reminded me of Jung’s concept of the shadow.

The shadow can be understood as the unconscious repository containing our repressed aggression, envy, weakness, hatred, fear, greed, cruelty, desires, instincts, etc. These are the parts of ourselves that society has taught us to reject, so we hide them and come to fear them. We all have one. It has been suggested that the more impressive or embellished the persona(lity), the larger the shadow it casts. Collectively, nations and cultures also have shadows: denied histories, disowned violence, racial fantasies, imperial ambitions, resentments, humiliations, archaic instincts, and unacknowledged guilt. While individuals project their shadow onto other people and then proceed to criticize or hate them, when nations, cultures, or groups do the same, the result is violent confrontation. In Jung’s terms, when we don’t become conscious of our shadow, our “inner opposite,” the world must act out the conflict and be torn into opposing halves. We see this in every war; it is also evident every time we turn those who are different from us into enemies. We see it in the fear of “aliens,” regardless of whether they come from another planet or another country. Sounds familiar?

That may be why the Sirens’ song revealed to Odysseus that he really didn’t want to go home. Going home requires him to confront his actions and, perhaps more importantly, acknowledge that those unrecognized impulses, the ones that allowed Circe to turn men into pigs, also exist within him. Although consciously he declares that he wants to return to Ithaca, unconsciously he may be afraid of what the journey will demand of him. In this way, we are all Odysseus. We are all people from the sea.

What We Refuse to Own

What do we do with the parts of ourselves we don’t like? Do we try to reject them, like Dr. Jekyll? (We know how that one ends.) Jung suggests (and I agree) that we need to integrate them rather than reject them. We not only project our shadow onto others, but what we fail to own eventually ends up owning us. Repressed parts find indirect ways to express themselves. We may become passive-aggressive, judgmental (toward ourselves and others), anxious, depressed, or even explosive. Keeping those parts at bay requires psychological energy, energy we could be using elsewhere. Reclaiming those rejected parts allows us to become whole. Maturity is not perfection but integration.

The Journey Back Home

Understood this way, Odysseus’ journey is one of self-discovery. It is a journey I have witnessed countless times in therapy. To heal and grow, the client needs to confront the Cyclops, the sorceress, and the monsters within. Stop denying (or forgetting) past actions and humbly face their consequences. Become aware of old roles and stories that no longer work. Visit the underworld to extract the lessons needed to move forward. Again, as the Sirens revealed, he must face head-on all the things he wanted, all those he wished he had never wished for, all the things he will never have, all those he has lost, and all the promises he failed to keep. As Calypso tells him, once he is finally ready to return home, just like clients in therapy, he must surrender himself to the process (in his case, the sea), give up the fight, relinquish control, take a leap of faith, and return to life.

Becoming who you are meant to be is not an easy journey, but it is a worthy one. I bear witness to it.

What parts of yourself are you still denying? Would you like to stop? It is time to realize that society taught you (and me) that you are not okay and that you needed to conform by pretending to be someone else. There’s nothing to be ashamed of.  We’ve all made mistakes and can learn from them. There’s no need to keep struggling. It happened to all of us.

It is time to come back home.

  1. The expression comes from Egyptian texts circa 1100 BCE: https://www.livius.org/articles/people/sea-people/ ↩︎

When life looks fine, but something deeper feels unsettled

Picture someone with what looks like a good life: a promising career, people who love them, a full calendar, and a life that checks every box from the outside. Yet they may still wake up with a quiet, unsettling question: Is this really my life? Is this as good as it gets?

That question points toward what is often called existential anxiety in psychology. It is not necessarily a sign that something is wrong with you. It is a deeply human response to becoming aware of uncertainty, freedom, death, meaning, and the burden of taking ownership. We are all called to be fully alive, but often we do not know how.

Existential anxiety can be painful, even baffling, especially in a culture that rewards productivity, certainty, and the appearance of having “made it.” But some questions are not solved by better planning, another achievement, or the newest app. They ask us to pause and consider how we are living, what we value, and whether the life we have built still feels connected to something true inside us. Are the goals we are chasing really ours? Are they still worth it?

Key takeaways

  • Existential anxiety often arises when we confront meaning, freedom, mortality, isolation, or the responsibility of choosing a life.
  • It is not pathological, but it can become painful, persistent, overwhelming, and even paralyzing.
  • Therapy can help by listening to these questions and helping you find, or update, your own answers.

The questions beneath the anxiety

Existential anxiety is often hard to spot. It may first appear as restlessness, dread, boredom, indecision, irritability, or a sense that life has become strangely flat. It can surface as disappointment after finally achieving something we worked hard for, or unsettle us after a divorce, illness, birthday, career change, spiritual experience, accident, or the death of someone close.

On the surface, the questions may be practical: Should I stay in this job? Leave this relationship? Move? Change my life? But underneath, deeper undercurrents are at play. What really matters to me? What am I avoiding? What part of me have I ignored? Is this how I want to live the rest of my life?

Not all anxiety is existential. It can be shaped by trauma, stress, biology, social pressure, health concerns, family history, and the nervous system doing its best to protect us in a chaotic world. An integral approach does not romanticize anxiety. It asks what is happening at all the relevant levels: body, relationship, history, culture, circumstance, meaning, and soul.

Freedom and responsibility

Although it may sound paradoxical, one source of existential anxiety is freedom. We often imagine freedom as carefree, but real freedom bears responsibility. To choose one path is to let other paths go, at least for now. To stay in a relationship, leave one, become a parent or not, change careers, or admit that a former identity no longer fits, is to feel the weight of authorship. Sartre somewhat poignantly said that we are “condemned to be free.”

Many of us wish someone could tell us the right answer: “Just tell me what to do.” But while advice can be useful and guidance necessary, no one can live our life for us. We are responsible for our choices and their consequences, which is both nerve-wracking and the source of agency. The question shifts from “How do I avoid choosing wrong?” to “How can I take charge of this life that is actually mine?”

Meaning and the feeling that something is missing

This feeling usually does not arrive as a dramatic flare. It creeps into awareness while answering emails, sitting in traffic, preparing dinner, or scrolling through other people’s carefully edited lives. The question may not be “What is the meaning of life?” in some grand philosophical sense. It may be more personal: What do I really want to do? What matters enough to my limited time and attention?

Meaning can be found in relationship, work, service, creativity, devotion, family, community, play, spirituality, and care for the world. But it is different to each of us, and it changes over time. What was significant at twenty-five may not be enough at forty-five. What once felt like healthy ambition may later feel like a burden. What felt exciting may feel uninspiring.

There is no single purpose hidden somewhere that, once found, will solve the rest of life. Meaning is discovered, created, revised, lost, and found again.

Isolation, belonging, and being known

Even in close relationships, each of us carries an inner world that cannot be fully accessed by another: memories, sensations, longings, fears, and private meanings that remain ours alone. This recognition sometimes hurts, but it also makes intimacy more precious.

To know someone, and to be known, is a never-ending enterprise. It means risking being seen in our beauty, quirkiness, and uniqueness, while accepting that the seeing will never be complete. This is not an argument against relationship. It is an invitation toward deeper, more honest forms of it.

Mortality and loss

Sometimes existential anxiety emerges after a loss, a medical scare, becoming a parent, aging, or simply noticing time passing. Suddenly we face the fact that we are vulnerable and finite, something we work hard to keep below awareness. It can bring fear, sadness, urgency, or a sharper appreciation for life. These waking-up moments are often uncomfortable, but with proper support they can become opportunities to remember who we really are and what matters to us.

Since time is limited, what conversation has been postponed? What apology, creation, repair, project, or act of love matters now? The clock is always ticking. What you waiting for?

How therapy can help

Existentially informed psychotherapy offers a space for the mundane and the profound. We may talk about work stress, grief, heartbreak, family expectations, cultural identity, spiritual questions, or fear about the future.

Being seen and understood by someone can reduce the sense of isolation and create a holding space where these questions can be explored openly. There are no ready-made answers. But together, you can find your own.

Facing existential anxiety does not mean you have failed or that you made the wrong decisions. It may mean that life is knocking at your door, asking for better or updated answers. Do not ignore the call.

Sometimes existential anxiety feels never-ending or unbearable. You do not have to go through it alone. With support, things can get better. If it turns into thoughts of harming yourself, or you feel unable to stay safe, reach out immediately: call 988, contact emergency services, or seek urgent local support. There is help.

If this sounds familiar, existentially informed therapy can help you stay with the questions long enough to discover what they are asking of you. Let’s explore together meaning, relationships, grief, freedom, mortality, and the choices that shape your life. Become who you really are.

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An integral approach to meaning, spirituality, expanded states, and the deeper questions of life

A person can be outwardly competent and still feel that something essential has gone missing. Work may be stable, relationships may look fine, and life may appear to be functioning reasonably well. Yet inwardly there may be a quiet sense that life has become narrow, disconnected, or strangely without meaning.

People often come to therapy feeling anxious, depressed, stuck, overwhelmed, or lost in their job, their life, or their relationships. These are real concerns, and they deserve careful attention. But often, underneath them, deeper questions are lurking. Who am I, really? What am I here for? What is the point of it all? Why do I feel lost? What is missing?

These are the kinds of questions that often bring people toward transpersonal or integral psychotherapy1.

Key takeaways

  • Transpersonal psychotherapy is a whole-person approach that makes room for spirituality, meaning, expanded states, and mystery, without abandoning clinical care.
  • Besides focusing on the body, relationships, history, culture, grief, and present life, it also addressing existential and spiritual concerns.
  • The goal is not for me to tell you what to believe, but to help you listen more deeply to your own life and find your way.

Beyond the personal does not mean ignoring the personal

The word transpersonal means “beyond the personal”. It is an integral approach covering the many dimensions of what it means to be human. This can sound abstract, but it simply means that you and your story are more complex, and more expansive, than what you may have been told. You are more than your personality, your childhood, and your nervous system. You also include your culture, your ancestral history, your relationships, your dreams and aspirations, and perhaps something larger beyond all of these.

To heal deeply, and to move toward your potential, all these aspects deserve attention. A good transpersonal therapist will meet you exactly where you are. We may begin with your current anxiety, grief, confusion, loneliness, relationship pattern, painful memory, or the sense that what used to give your life meaning no longer does. From there, we use a larger frame to understand how your circumstances are not obstacles to spiritual or existential work. They are the ground where life unfolds.

Human beings are not only bundles of symptoms. We are also meaning-making, relational, playful, creative, imaginative, spiritual, and mysterious creatures. A dream, a loss, a book, a song, a meditation retreat, a psychedelic experience, the birth of a child, an encounter with death, or a moment in nature can expand the way we see ourselves and the world. Sometimes these experiences are blissful and healing. Other times they are confusing or destabilizing. And sometimes the sense that something is missing comes from no identifiable experience at all. It simply sneaks up on us as a quiet but persistent sense that there is something else.

How transpersonal therapy is different

Good therapy should address meaning, values, grief, and spiritual questions. What makes transpersonal therapy different is that it treats them not as secondary, but as central. If questions of Spirit, soul, purpose, death, freedom, isolation, mystery, or belonging matter to you, they are welcome in the room.

For example, someone may come to therapy after the death of a parent and say, “I had a dream where she came to me. It felt real, and since then I cannot stop thinking about it.” A therapist could explore grief, attachment, trauma, anxiety, sleep disruption, or the psyche’s way of metabolizing loss. All of that may be useful. But a transpersonal therapist would also make room for the dream’s symbolic, existential, or spiritual meaning within the client’s own worldview.

It is not about choosing spirituality over psychology. It is about engaging the whole experience of being human before reducing it to symptoms or pathology. A person can be grieving, anxious, sleep-deprived, and spiritually moved, all at the same time. They may need grounding, rest, clinical assessment, ritual, conversation, or a deeper exploration of meaning. As multifaceted human beings, we need a therapy approach that acknowledges every aspect of who we are.

Not spiritual advice

Transpersonal therapy is not spiritual advice. My job is not to tell people what their experiences mean, what they should believe, or which path they should follow. It is to help you listen more deeply to the undercurrents of your own life. Therapy can become a place where you are seen, heard, challenged, and supported while you discover what is true for you, and what kind of life wants to be lived through you.

It is not only about functioning. It is about self-realization.

Psychedelic integration and expanded states

Properly trained transpersonal psychotherapists are particularly suited to work with the integration of psychedelic and other expanded states of consciousness. These experiences are often described as unitive, transcendental, sacred, paradoxical, ineffable, and inspiring. They may involve grief, beauty, terror, forgiveness, ancestral material, or a changed relationship to death, all territory familiar to transpersonal psychotherapy.

Because we understand these experiences and their potential, we also know that, by themselves, they are not necessarily healing. A powerful experience can bring forward unresolved trauma, relationship questions, spiritual confusion, inflated certainty, or the sudden recognition that ordinary life needs to change. Integration is the slow work of helping what happened become embodied, relational, ethical, and livable.

Because integral therapists are trained to hold paradox through a trans-rational lens, they can support someone through this process without forcing the experience into either a purely clinical or purely spiritual box.

A larger room for your life

Transpersonal therapy does not need to include unusual interventions, though it may. From the outside, it can look like an ordinary conversation. But it may also include attention to dreams, symbols, body awareness, grief work, values exploration, mindfulness, journaling, creative expression, ceremonial aspects, or reflection on spiritual practices and experiences. For some, the work is straightforward and practical. For others, it becomes a significant reorientation of identity, purpose, or belonging. For many, it is a much-needed opportunity to gain a broader view of themselves.

Although this approach applies to all aspects of life, it becomes particularly useful during life transitions, bereavement, illness, aging, spiritual crisis, psychedelic integration, loss of meaning, existential crises, or the persistent feeling that familiar achievements no longer answer the deeper questions.

The value of transpersonal psychotherapy is not that it offers a grand explanation for every difficult moment. It does not. Its value is that it reminds us there is more to our story. It makes room for the possibility that suffering may contain meaning without romanticizing pain, that spiritual experience may matter without dismissing psychological realities, and that healing may involve more than symptom relief without abandoning safety and care.

Sometimes people need therapy spacious enough to take the deeper movements of the inner life seriously, while remaining grounded enough to help them live more honestly, responsibly, and fully in the world. That, to me, is the promise of transpersonal psychotherapy at its best.

Does any of this sound familiar? If your life looks like it is working but something deeper feels missing, transpersonal psychotherapy may help you explore meaning, grief, relationships, spirituality, expanded states, and the larger questions of your life with care and discernment.

I offer transpersonal and existential psychotherapy to adults in Sacramento and online throughout California. If you’d like to explore whether this approach fits what you’re looking for, you’re welcome to schedule a brief fit call.

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  1. Although these two approaches have certain technical differences, they cover similar ground, so for practical purposes I use them interchangeably in this article. ↩︎

What therapy and ancestral wisdom can learn from each other without destroying what makes each unique 1

Imagine a client who comes to your office after losing her mother. She tells you her mother appeared to her in a dream, clear, luminous, with a message she does not fully understand. Since then, she cannot sleep.

Is this grief? Trauma? Spiritual experience? Psychosis? A call to pay attention?

The honest answer is: it might be all of those things. And the way you respond will depend, more than you might realize, on which shore you are standing.

Two shores. One river. No bridge.

Western psychotherapy and ancestral wisdom traditions have, for most of modern history, operated as if they were on opposite banks of a wide river, occasionally peering at each other with curiosity, suspicion, or misplaced enthusiasm, but rarely building anything solid across the distance.

On one shore: the language of the wounded self. Unconscious patterns, attachment wounds, trauma stored in the body, the slow and careful work of making the implicit explicit. At its best, psychotherapy is a disciplined act of love, witnessing someone’s interior life with rigor, ethics, and presence.

On the other shore: the language of the sacred web of life. Community as medicine, ritual as container, ancestors as living fields of influence, illness as disharmony rather than deficit. Traditions that have never believed the self ends at the skin, or that healing is something you receive alone in a room.

Both shores see something real. Both also have their blind spots. And in our rush to integrate everything, we have often done something that helps neither: we have put it all in a blender.

A blender makes puree. A bridge respects distance.

The wellness industry loves a blender. A little mindfulness from this tradition, a ceremony from that one, a chakra system loosely attached to a somatic protocol, shamanic language grafted onto a trauma model. The result is something that sounds whole but has been stripped of the very thing that made each element powerful: its context, its ecology, its relational and ethical demands.

A bridge works differently. A bridge does not collapse the distance between two shores. It honors the distance. It makes movement possible without pretending the shores are the same place.

This is the question I keep returning to in my clinical and personal life: How do we learn from both traditions without reducing either one?

Not “how do we merge them into a new spiritual product.” But how do we allow psychotherapy to become more soulful, more ritually aware, symbolically alive, culturally humble, without abandoning the rigor that protects clients from harm? And how do we approach ancestral wisdom with enough respect to leave its roots intact?

What each shore actually offers

Psychotherapy, at its core, teaches us to listen to the wounded self. It gives us a language for the unconscious, for developmental wounds, for the patterns that repeat because they were learned before we had words. It shows us that healing often happens through relationship, not technique, and that the body keeps score long after the mind has moved on. It brings ethics, boundaries, evidence, and the kind of careful container that protects the most vulnerable moments in a person’s life.

Ancestral and wisdom traditions teach us to listen to the sacred web of life. They remind us that the human being is not a private ego floating in an indifferent universe, but a relational, ecological, ancestral, and spiritual creature. They remind us that illness can be a form of disharmony, not just pathology. That healing sometimes requires community, not just technique. That some forms of suffering respond not to interpretation but to ritual, to offering, to being witnessed by something larger than the therapeutic dyad.

Where they meet is quietly remarkable: both understand that healing happens in a field, not in isolation. Both know that relationship is medicine. Both work with symbols, one through dreams and transference, the other through ceremony and cosmology. Both recognize the body as essential, not incidental.

Where they do not meet, and why that matters

Here is where most integrative conversations go wrong: they maximize the similarities and minimize the differences. But the differences are real, and pretending otherwise is its own kind of harm.

Psychotherapy generally works within a secular frame: the person, their history, their nervous system, their relationships. Many ancestral traditions operate within a cosmological frame: the person within the community, within the land, within the ancestors, within the spirit world. When a client’s “ancestral vision” gets translated into “part of the psyche” without asking whether that translation fits, something is lost, and something is taken.

The goals also diverge. Therapy often aims to restore function, coherence, and integration. Traditions may aim at liberation, awakening, balance, or right relationship with the sacred. A psychologically healthy person is not automatically an awakened one. A spiritually intense person is not automatically integrated. Conflating these two is one of the more common errors in transpersonal practice.

And the authority structures are entirely different. Therapy protects autonomy, consent, and the right to question. Many traditions involve apprenticeship, lineage, community recognition, and earned surrender. A healer in most Indigenous contexts is not self-appointed. The community recognizes the role, slowly, over time. Modern spiritual culture tends to invert this: brand first, authority claimed second.

Standing in the middle

There is a Nahuatl word that describes what it feels like to stand between two worlds: Nepantla. Gloria Anzaldúa used it to name the liminal space between cultures, identities, and ways of knowing, not a comfortable middle ground, but a living threshold. Uncomfortable, generative, and demanding.

Nepantleros, those who inhabit that in-between space, do not belong entirely to either shore. They are called to hold the tension without resolving it prematurely. To resist the blender.

For therapists and practitioners who move between these worlds, this is the actual work. Not to choose a camp, but to develop what Mi’kmaw Elder Albert Marshall calls “Two-Eyed Seeing”: the capacity to look simultaneously from the strengths of Indigenous ways of knowing and the strengths of Western ways of knowing, using both eyes together, without forcing one to see through the lens of the other.

A different definition of mental health

What would it mean to redefine mental health not as the absence of symptoms, but as restored participation? Participation in your body. In your relationships. In your community. In the natural world. In meaning and mystery.

This definition does not dismiss symptom relief. That matters enormously. But it expands the frame. It asks not only “what is broken?” but “what relationship has been severed?” Not only “how do we reduce suffering?” but “how do we restore belonging?”

How this looks in practice

A bridge-oriented clinician does not try to become a shaman or a guru. That is not the point, and it can be its own form of harm. What shifts is the quality of listening, and the humility with which you hold your own framework.

Before a client’s spiritual or cultural experience gets translated into clinical language, a few questions help:

What world does this experience belong to? Whose lens fits it better, the psychologist’s or the tradition’s? What does healing mean from inside this person’s cosmology? And perhaps most importantly: what is my framework missing that this client’s tradition might supply?

This is not relativism. It is clinical precision. Recognizing that the tools you bring to the room were built for a particular kind of suffering, and that some suffering requires different tools.

A bridge takes two shores

Let me end where I started: with the woman whose mother appeared in her dream.

The most useful thing I can bring to that moment is not a diagnostic category or a spiritual interpretation. It is the willingness to sit with her in the not-yet-knowing, the Nepantla, to listen with what one eye sees as a clinician and what the other eye recognizes as something that exceeds clinical categories.

A bridge is not built so one shore can conquer the other. It is built so that we can move, with care and respect, between worlds.

That, I think, is what good mental health care can look like when it is brave enough to hold the tension.

Interested in a talk or workshop on this theme? I offer presentations and trainings on transpersonal psychotherapy, ancestral wisdom, cultural humility, psychedelic integration, and the bridges between clinical care and spiritual traditions.

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  1. This article is a synopsis of my presentation “Wisdom Bridges: Modern Psychotherapy and Ancient Traditions,” presented at FITRA’s 2nd International Transpersonal Conference. ↩︎

What MFTs Need to Know

I just finished teaching a six-month training for Marriage and Family Therapists (MFTs) on Psychedelic-Informed Care, in collaboration with Sacramento Valley CAMFT. These trainings are needed for a simple reason: increasingly, the topic of psychedelics comes up in therapy sessions. Should I do it? Would it help? What are the risks? Can you help me think this through? This is why psychedelic-informed care for MFTs matters.

The fact is that, with a few exceptions, therapists are not trained to answer these questions. If psychedelics are discussed at all, it is usually in a psychopharmacology class as “drugs.” Very few programs address their healing potential, and even fewer teach clinicians how to work skillfully with clients who are curious about them, considering them, or trying to integrate an experience afterward.

As a result, many MFTs are clinically, ethically, and legally underprepared. We may feel curious, nervous, excited, skeptical, or unsure. And yet, the client is already there. Invited or uninvited, psychedelics are finding their way into the therapy hour.

This is why MFTs need to learn Psychedelic-Informed Care (PIC).

To be clear, PIC is not psychedelic-assisted therapy (PAT). PAT refers to clinical work that includes administering a psychedelic substance within a legal, medical, or research structure.

Psychedelics may also come up through underground ceremonies, psychedelic tourism, ketamine clinics, religious practice, or solo use. Regardless of where the client’s interest originates, PIC provides licensed clinicians with tools to discuss, educate, reduce harm, clarify motivation and risk, and support integration, while respecting self-determination and avoiding the encouragement of illegal behavior.

In brief, PIC helps therapists help clients think clearly, make informed decisions, and integrate psychedelic experiences while remaining ethically and legally grounded.

Base Camp, Not Sherpa 1

A useful metaphor for the MFT’s role is that of the Sherpa and the base camp. The Sherpa helps the client climb the mountain. That is not our role. Our job is not to dose, source, guide, or facilitate the psychedelic session. We are base camp: a stable place where clients can prepare thoughtfully, assess risk honestly, and return when the experience needs integration, or if something goes wrong.

This is not a small role. Clients do not need us to be enthusiastic cheerleaders or frightened gatekeepers. An acronym I developed to explain this is that PIC therapists listen to WCIG. We must be:

  • Warm enough that clients tell the truth.
  • Curious enough not to impose our agenda.
  • Informed enough not to minimize risk.
  • Grounded enough not to cross legal or ethical boundaries.

Some questions clients often ask:

“Should I Do It?”

When a client asks whether they should use a psychedelic, the temptation is to answer too quickly. But underneath one question, there are often deeper ones: Can you help me? Will you reject me? Can you hold my uncertainty? Aware of the power differential, we must be careful not to lead the client in either direction. Instead, we can welcome the conversation without judgment and help them explore their assumptions, alternatives, motivations, and risks.

“What Are the Risks?”

MFTs do not need to become physicians, pharmacologists, or attorneys to be helpful. Still, we need enough literacy to know when something may be risky and when to consult or refer. Clinician and educator Kristina Hunter offers a useful concept here: the three mirrors: body, mind, and life context.

  • The body: medical issues, medications, substance interactions, cardiac concerns, pregnancy, neurological factors.
  • The mind: history of psychosis, mania, severe dissociation, suicidality, or current crisis. Is the client sufficiently resourced to handle intense material?
  • The life context: housing stability, relational support, time to recover. Or isolation, impulsivity, secrecy, and the hope that one experience will fix everything.

We should not medically clear clients or encourage use, even if we think it might help. We are helping them think more honestly and, when warranted, inviting them to discuss medical concerns with a qualified professional. And although we should not tell clients what to do, it is part of our duty of care to name our clinical concerns.

“Can You Assist Me?”

A client may ask for our involvement in many ways: “I’d feel safer if you were there.” “Can you talk to the underground guide?” “Can you help me figure out how much to take?” These requests may express attachment needs, fear, hope, or trust and should be explored rather than dismissed. But they also require boundaries.

We must clearly separate preparation and harm reduction, exploring intention, expectations, support systems, and aftercare, from facilitation, dose coaching, procurement, or participation in an unregulated session. The latter falls outside our role and can move dangerously close to ethical and legal transgressions. Being clear about this protects the client, the therapist, and the profession.

The Morning After

Clients may show up the following week and report that they used psychedelics over the weekend and now want, or desperately need, to process the experience. When things go well, they return inspired, tender, and full of insights to propel therapy forward. Other times they return confused, inflated, ashamed, or dysregulated. “I saw God.” “I think I remembered a trauma.” “I haven’t slept for two days.”

Integration is not about forcing the experience into a neat clinical interpretation. It is the slow, vital process of helping raw experience become embodied, relational, and livable, turning psychedelic states into psychological traits.

Sometimes this means supporting meaning-making. Other times, it means grounding or assessing whether consultation, psychiatric evaluation, or medical intervention is required. This is not always easy. Separating a spiritual emergency from a psychotic break requires real care and expertise. Psychedelics do not exempt us from ordinary duty-of-care responsibilities. Safety always comes first. Do not hesitate to reach out for support when needed.

Why PIC Matters for MFTs

MFTs understand relationships, systems, attachment, trauma, and the complicated ways people change and resist change. Psychedelic experiences may open doors, but clients still have to walk through them in real life, with partners, children, parents, and responsibilities.

Every therapist working in this area should be able to say clearly what they do and do not do. Our role is to provide PIC, not PAT: to help clients explore motivations, risks, expectations, meaning, and integration, while avoiding providing, recommending, sourcing, or facilitating psychedelic use.

The psychedelic landscape is changing quickly. Laws differ by jurisdiction, research findings keep emerging, and public enthusiasm often outpaces regulation and training. We need more than opinions. We need ethical steadiness, clinical humility, and a robust consultation network. Part of our role is to help clients separate hype from reality.

As I have said elsewhere, even for experienced guides, psychedelics are terra incognita. Old maps used to warn us that there may be dragons out there. Psychedelics can be powerful, healing, destabilizing, and sacred, sometimes all at once. We need to be prepared.

Psychedelics do not make therapy irrelevant or outdated. They can amplify our impact on a client’s healing process. Our training gives us a reliable compass to keep clients safe within ethical and legal boundaries, helping them think, prepare, integrate, and stay connected to themselves and their relationships. By maintaining solid boundaries, we can support the client’s journey without losing our own way.

I offer talks, workshops, and consultation for MFTs, clinicians, and organizations navigating Psychedelic-Informed Care, integration, ethics, boundaries, and clinical risk.

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  1. A note on language: Sherpa refers both to an Indigenous Himalayan ethnic group and, in common usage, to a profession associated with high-altitude mountain guidance. I use the term here in the latter way, with respect and awareness of both meanings. ↩︎

A therapist’s guide to responding without panic, shame, or avoidance

In previous articles, I have written about how AI is being used in connection with therapy, why it should not replace psychotherapy, and where it can safely support the work. Here I want to speak to therapists who are already feeling the presence of AI in their offices. You can find the full series here: AI and Psychotherapy.

Clients are asking chatbots about relationships, symptoms, dreams, diagnoses, attachment patterns, and what they should do about all kinds of personal situations. Some of this may be useful. Some of it may be risky. Most of it is worth talking about.

Professional organizations are trying to catch up. The APA, CAMFT, BACP, and even the WHO have all issued warnings, guidance, or ethics updates. As valuable as that is, warnings do not help us know what to do when a client says, “ChatGPT told me to…” So, what can we do when AI enters the therapy room?

Do not criticize or lecture. Be curious instead.

If clients feel judged, they may simply stop telling us (or stop therapy altogether). Many people are turning to AI because it is available, inexpensive, fast, and seemingly nonjudgmental. Some are lonely. Some are trying to make sense of their pain at 2 a.m. Some may not be able to afford more therapy. From the client’s perspective, it makes sense. Curiosity helps us understand the function of a behavior before we decide what to do about it.

Ask better questions.

Why are they using it? Do they feel heard by it? Is there a rupture in the therapeutic relationship? Is there something they told AI that they have not told us? These are not nosy, but clinical questions. Psychotherapy is not a polite endeavor. Everything is available for exploration. Is AI functioning as a journal? A rehearsal partner? A reassurance machine? A surrogate relationship? An alternate therapist? Depending on the role it is playing, we can begin to consider appropriate clinical interventions.

Bring AI into the room. It is already here anyway.

Why is the client choosing AI instead of the therapist or another supportive relationship? What felt easier to tell a machine than a person? Is the client outsourcing agency to it? If so, is this part of a familiar pattern? All is grist for the mill.

AI-generated material should not be treated as objective truth. Even when it feels empathic or accurate, it is still a complex probabilistic system producing a plausible response based on patterns. Yet it can be treated as material, the same way a dream, a journal entry, or a relational enactment would be. If the response resonates with the client, it can reveal something about their longings, fears, defenses, and assumptions.

Avoid the temptation to compete with AI at the information level. There is no way you can win. Just as you hopefully would not compete with information a client got from a self-help book, your role is to remain grounded, curious, and open. You can offer something the machine cannot: a real human connection. That is where the healing power of therapy lies.

Watch for red flags.

Not every use of AI is dangerous. Still, some uses deserve concern. Pay attention when a client is using AI as their main emotional support, especially during crisis, intense loneliness, paranoia, suicidal thinking, substance relapse risk, or loss of reality testing. Also, be attentive to use that increases isolation, replaces difficult conversations, reinforces a fixed narrative, or becomes a secret part of the client’s life. It is okay to express concern (not disapproval) in these cases. It is part of our duty to care.

Another red flag is certainty. AI can sound confident even when it is hallucinating. It can validate or intensify a client’s interpretation without understanding the larger clinical picture. As Carl Rogers used to say, the client often talks about the thing next to the thing. AI may miss what is not being said.

A useful response might be: “Let’s slow down. What feels true about this? What might be missing? What would happen if we did not treat this as the final word?”

There is room for education.

Clients need to understand that AI is not confidential in the way therapy is. Sharing deeply personal material with a chatbot means sharing it with an external technology platform, not with a licensed professional bound by clinical and legal duties.

For therapists, the bar is even higher. When therapists use AI in clinical work, we need to think carefully about informed consent, confidentiality, documentation, vendor policies, legal compliance, and whether identifying client information is being exposed. The basic principle is simple: do not let technological convenience outrun clinical responsibility.

We should also keep reminding clients, and ourselves, that AI does not understand in the human sense. It has never been on a date. It has no children, dreams, fears, body, or even an ego.

The therapist’s role

It is unlikely that AI will stop entering the therapeutic ecosystem. The therapist’s role is neither to panic nor to ignore it, but to help clients use discernment. We can ask better questions, notice when AI is helpful or potentially harmful, and, as with everything else, talk about it.

The task is not to become anti-AI or dazzled by AI, but to remain deeply human when, invited or uninvited, it shows up in the therapy room.

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Want a grounded conversation about AI and psychotherapy for your group? I offer talks, workshops, and consultations for clinicians, organizations, and training programs navigating the ethical and relational implications of AI in therapy. Contact me to keep the conversation going.

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