Category: Ethics & Responsibility

…or why AI should not replace human connection

In my earlier article Should ChatGPT Be Your Therapist?, I briefly argued against it. This article further explains my answer.

Many people turn to AI because they are lonely, overwhelmed, or afraid. That is understandable. But if AI becomes a substitute for relationships, something important is lost. Our brains are wired for connection.

Before starting, let me insist that I am not anti-AI. Quite the opposite. I am excited about the possibilities of using it as a companion to therapy (more on this below). Used wisely, it can be genuinely helpful.

Although this is not often emphasized, psychotherapy is not only about providing information. It is a relationship. Good psychotherapy may feel like a simple conversation. Still, there is a lot going on under the hood at psychological and biological levels. Our nervous systems are shaped by contact with other human beings. Our attachment style (basically, the way we relate to others) is formed by how we experienced connection in early life. Who we are is, in large part, the result of our relationships. As it is often said, our wounding happens in relationships and can only be healed in relationship. We do not change only through insight. We change through connection.1

We need to feel safe before we can change

Evolutionarily, our nervous systems are programmed to scan for safety. This is an automatic process that occurs mostly below conscious awareness.2 Tone of voice, pacing, the steadiness of a presence, and the sense that someone understands us and will stay with us without collapsing or attacking. These signals shape how we experience the world and live our lives.

When we feel anxious, shut down, ashamed, or guarded, our whole system contracts. Thinking becomes rigid. Options feel limited. Emotions feel overwhelming. Sometimes we cannot even accept help when it is available. On the other hand, when we feel safe, supported, and accepted, something changes. We relax. We open up. Feelings become tolerable. Reflection becomes possible. We see more clearly and are able to choose. The body must feel safe before the mind can be free.

What the relationship does

It offers co-regulation. Meeting a grounded therapist is not just “nice.” Their steadiness helps settle our system. Over time, we become able to reproduce that steadiness, and it becomes available inside. This is one of the quiet phenomena of good therapy. We borrow regulation until we learn to provide it for ourselves.

It offers a different experience, not just advice. Even when people come to therapy for information, they often stay for something else. The client is constantly sensing the relationship. How does the therapist relate? Are they kind, clear, steady, curious? Can they hold boundaries with care? Can they tolerate strong emotion without collapsing or attacking? Over time, this becomes a living template for how to be with oneself and with others.

It creates a space to explore without shame, guilt, or rejection. After a while, as the client continues to feel accepted by the therapist, they may begin to wonder: “If my therapist accepts me as I am, maybe I can accept myself too.” Again, this relaxes the nervous system and makes room for change. In such an environment, you can explore how you protect yourself, how you handle closeness, how shame organizes your attention, and what you believe you are allowed (or not allowed) to feel. These patterns are often automatic and live below awareness. Over time, a stable relationship helps reorganize these implicit layers and experiment with alternative ways of being. Therapy changes people through lived experience, not simply through insight.3 4

It offers rupture and healthy repair. Therapists are not perfect. Sometimes your therapist does not get it. You may feel misunderstood or even rejected. Often this triggers old experiences of not being seen or accepted, and the conclusion that something is wrong with you. What to do next? Shut down? Capitulate? End the relationship? If the therapist is skillful and navigates this with care and accountability, the nervous system learns something powerful. Conflict does not have to mean abandonment. Misunderstanding does not have to mean danger. This repair, while remaining in connection, is part of how trust is built, and it is difficult to replicate without a real person who can make mistakes, take responsibility, and show up again.

At the risk of oversimplifying, the therapeutic relationship is difficult to replace because healing is not purely cognitive. It is an embodied, relational process that unfolds through attunement, emotional resonance, and real-time interaction.

What AI cannot replace (at least yet)

AI can generate language that sounds empathic. It can reflect feelings. It can offer prompts. It can help you map patterns. You may even feel understood.

But AI is not alive. It does not have a body or a brain. It does not co-regulate in the full human sense. It does not track your breathing, posture, tears, long pauses, or the subtle shifts that guide pacing in real time. Even with voice or video, something central is missing. A real nervous system is not on the other side. AI cannot truly see you, even if it sometimes sounds like it does. And your nervous system knows when something is missing.

AI also lacks accountability in the way a human therapist does. Human therapists are trained to listen not only to words, but to context, tone, and what does not fit. A good therapist does not simply agree. Even a very empathetic therapist may challenge you if something does not make sense, needs clarification or if it make it tingle their -very human- spidey sense. As one of my teachers used to say, therapy is not a polite endeavor. A caring therapist will slow down, double-check, explore hunches, and name what is being said and even name what is not being said. AI cannot feel or care in this very human way. Technically, AI does not understand words the way humans do, and it cannot sense what is implied but unspoken. This always matters, but it matters especially at the edges, when someone is destabilized, overwhelmed, in crisis, paranoid, or losing touch with reality.

There is also the problem of overconfidence and hallucinations. AI can sound certain when it is wrong. That can be harmless in low-stakes settings, harmful in emotionally vulnerable moments, and dangerous in crises. Add privacy concerns, cultural mismatch, and the risk of overdependence, and the picture becomes clearer. AI can be a tool, but it is a risky candidate for replacement.

Where AI can genuinely help

None of this means AI is useless. It means we should understand what it is good for.

AI can support reflection when deep human attunement is not essential. It can help with journaling, psychoeducation, basic skills prompts, and preparing for therapy sessions. It can help you find language for what you are experiencing. It can help you organize a question you want to bring to your therapist. It can offer structure between sessions. I will develop this in more detail in future articles.

Used wisely, AI can even deepen therapy. When it helps with basic learning or clarification, more therapy time can be devoted to what requires human presence. That is meaningful synergy.

A gentle rule of thumb

If what you need is information, conceptual clarity, journaling prompts, or help exploring something already discussed in therapy, AI may help.

If what you need involves attachment wounds, trauma healing, deep grief, relational repair, severe anxiety, existential distress, or you are facing a crisis, a human therapist is usually safer and more effective. Certain kinds of healing require contact with a real person, in real time, over time. And again, since our wounding happened in relationships, it can only be healed in a human relationship.

If you are curious, you can try “The Potential Space” an AI companion designed to support users between sessions with preparation, psychoeducation, and integration.

  1. Lewis, T., Amini, F., & Lannon, R. A General Theory of Love. ↩︎
  2. Porges, S. W. The Polyvagal Theory. ↩︎
  3. Schore, A. N. The Science of the Art of Psychotherapy. ↩︎
  4. Cozolino, L. The Neuroscience of Psychotherapy. ↩︎

Why California LMFTs need psychedelic-informed care1

The relationship between psychedelics and psychotherapy has always been… complicated. In the late 50s and early 60s, LSD was distributed to mental health professionals to explore its therapeutic potential. Sandoz suspected there was something there, but couldn’t quite pin down where it fit. When Tim Leary later “discovered” psilocybin mushrooms, he framed them as psychologically significant. MAPS, from the beginning, assumed therapists would be at the bedside for MDMA experiences. With the 70s, prohibition made the relationship illegal, but it didn’t make it disappear. Many clinicians simply went underground.

Now, in the current psychedelic renaissance, while most psychedelics remain illegal, mental health professionals face a familiar dilemma: how do we support clients without stepping outside legal and ethical boundaries?

With support from CAMFT Sacramento Valley, I’m teaching a six-session series on Psychedelic-Informed Care (PIC)—how clinicians can respond when psychedelics enter the therapy room without fueling hype or reinforcing taboo. Should we lean in? Set boundaries (which ones)? Redirect? The series is designed to help you answer those questions with precision.

The topic will show up.

It arrives in many forms: questions about legality, reactions to a news story, curiosity about a ketamine clinic, plans for a retreat abroad. “Would you recommend it?” “What are the risks?” “Would microdosing help?” And, of course, the therapist’s favorite: “Is it true it’s five years of therapy in one night?” Clients are often confused, and they want orientation from someone they trust—you.

De-mystification

Right now there’s cultural noise, mixed messages, and outright misinformation. As clinicians, we don’t need to endorse or condemn. We need to help clients differentiate—between curiosity and compulsion, hope and inflation, meaningful experience and destabilizing aftermath. PIC begins with demystification: separating evidence from hype, and myth from clinical reality.

The legal landscape patchwork

Part of the surge is legal ambiguity. The picture is no longer a single, clear “no.” It’s a mixed bag: regulated access models in some places, research pathways, tightly controlled international frameworks, religious-use carve-outs, and—closer to home—local reforms and “decriminalization” language.

Even in California, where classic psychedelics remain illegal, several jurisdictions have deprioritized enforcement around entheogenic “plant medicine” (including places like San Francisco, Oakland, and Santa Cruz). But deprioritization is not legalization. It doesn’t change state or federal controlled-substance law—and it doesn’t change LMFT scope.

Why psychedelics? Why now?

The “why now” isn’t mysterious. Psychological suffering keeps rising, and so does the hunger for new solutions (especially when many mainstream antidepressants remain variations on monoamine modulation). Add promising research signals, a primed cultural zeitgeist, and media acceleration—and you get momentum.

But when a society is suffering and hungry for relief, it becomes vulnerable to shortcuts. Psychedelics, when framed as shortcuts, become especially seductive.

Potential benefits—and real risks

It’s hard to deny that psychedelic research is promising. Across trials at different stages, psychedelics have shown potential relevance for trauma-related suffering, depression and anxiety, existential distress and end-of-life fear, relational patterns, and spiritual meaning-making.

At the same time, potential benefits are not guaranteed, and they are not risk-free. Alongside positive outcomes are reports of harm: destabilization and disorientation after experiences, inflation, bypassing, aftercare gaps (no containment, no follow-up, no integration), and boundary/exploitation risks—especially in unregulated contexts.

This isn’t fear-mongering. It’s clinical realism. The psychedelic ecosystem is still maturing. Ethical failures occur. And when they do, the cleanup often lands back in traditional therapy.

So where do LMFTs stand?

Every clinician know to keep this distinction front and center: scope of practice is what California law authorizes; scope of competence is what you personally are trained to do safely.

California’s LMFT scope includes assessing and treating substance use and related mental/behavioral concerns, and explicitly includes client education, consultation, and clinical case management. But legal permission does not equal clinical readiness, and clinical readiness does not grant legal permission. In plain language: just because you can talk about psychedelics doesn’t mean you should, unless you have the training.

PAT vs. PIC (and the underground)

To stay grounded, it helps to separate three different situations:

  • Psychedelic-Assisted Therapy (PAT): administration plus a protocolized, regulated setting.
  • Psychedelic-Informed Care (PIC): what LMFTs can do ethically—discuss, educate, harm-reduce, integrate.
  • Underground work: unregulated and often illegal “guided” psychedelic work, with wide variability in competence and ethics.

Here’s the key takeaway: to remain within ethical and legal grounds, LMFTs must stay in the green zone—discussion, education, case management, referrals (for education, not sourcing) and integration—and avoid the red zone: using, offering, facilitating/administering, or coaching sourcing/dosing for illegal substances. Yes, there are yellow areas and nuance. But clarity protects clients and therapists alike.

Your stance matters

Beyond scope, not every therapist feels the same about psychedelics—and that’s okay. Within professional boundaries, there’s a spectrum of reasonable stances: cautious, curious-but-boundaried, harm-reduction oriented, or integration-focused. The goal isn’t ideological alignment. The goal is ethical, competent care.

The PIC toolkit

PIC is practical. It boils down to three skill areas:

  1. Psychoeducation (balanced, reality-based, myth-correcting)
  2. Preparation (scope-appropriate: intentions, supports, safety planning, consult triggers—without “how-to”)
  3. Integration (meaning-making, relational repair, values-to-action, stabilization)

A simple response flow helps: Discuss → Educate → Harm-reduce → Integrate. If you can remember that loop, you can respond with confidence even when the topic is charged.

And it should go without saying, but it doesn’t: documentation is your shield. When psychedelics come up, chart the discussion, state client goals, document boundaries, note risks reviewed, and record consults/referrals. That’s not bureaucracy—it’s ethical self-respect and license protection.

In closing: your license gives you a clear road to walk with clients, and a reliable compass to stay oriented—so you can support their journey without losing your way.

In future sessions, we’ll cover the state of the art (research/legal/ethics), cultural context and humility, what to do when the client brings it up, what to do when things go sideways, and—finally—a clear vision of the LMFT’s role in the psychedelic landscape.

Now you know. If you have questions or want to explore this topic further, feel free to contact me.

  1. Although many of these principles apply to all LMFTs, note that this article focuses in California law. ↩︎

Clients are bringing psychedelic questions and experiences to therapy. This six-part series gives LMFTs a clinically grounded, culturally informed approach to discussing psychedelics within scope—with tools for education, harm reduction, and integration. It is not a “how to do PAT” course. You’ll learn the current research/ethics/legal context (incl. religious-use carve-outs), cultural considerations, and concrete safeguards around risk and boundaries. Clinicians will leave with clear language for discussing benefits/risks and integration interventions.

Sessions (at a glance – click link for details):

*Please note that you have to register individually for each session

*Education and integration within LMFT scope; no sourcing or dosing guidance.

Why Artificial Empathy Should Not Replace Relationships

We often hear that things are moving faster than ever. The late Joanna Macy used to say that it took us a thousand years to move from hunter-gatherers to agriculture, a hundred to move from there to industrial society, and only ten to reach the information age. It took about ten years for the personal computer and the Internet to reach mainstream use, about eight for the smartphone, and only two for AI 1.

Just 24 months ago, very few people were even aware of AI. Now, almost every week, one of my clients tells me they’ve asked ChatGPT something they might have once asked me. In fact, according to a recent Harvard Business Review article, the most common use of ChatGPT today is for therapy and emotional support 2. Should I be worried? Will AI steal therapy jobs?

Some would say yes. Anthropic’s CEO recently predicted that up to 50% of entry-level white-collar jobs could be automated within five years 3. McKinsey estimates that by 2030, AI could displace up to 800 million jobs 4.  Are psychotherapists, psychologists, and social workers among them?   Optimists argue that since AI lacks emotions, intuition, and empathy, professions that rely on these are less likely to be replaced.

“Did you just say AI doesn’t have emotions, intuition, or empathy? Have you ever asked ChatGPT or Gemini for help? If they don’t have empathy, they sure fake it well.”

Agree. But let’s recall how AI works. 

Believe it or not, AI doesn’t think. It’s more like advanced autocomplete. It was trained on mountains of information and, when prompted, predicts word by word what’s most likely to come next. Its answers are patterns of probability, not insights.  However convincing it may sound, it doesn’t even understand the words it produces. When certain words tend to appear together, they are stitched together, sounding fluent and confident—even when it’s wrong.

I often remind clients that while ChatGPT is a fantastic information resource (though it’s wise to double-check—since it has no problem “hallucinating”), it has never had its heart broken or gone out on a date. Nor does it care for your feelings (since it doesn’t understand them). Its soundest “advice” is just a rehash of what’s already been said. Great for data gathering or quick answers, but not for personal decisions. Regardless of how much we wish for HAL 9000, Samantha, R2-D2, or TARS 5 to give us clarity, the truth is that each of us still has to make our own decisions.

While ChatGPT might be preferable to a bad therapist (hence the importance of finding a good one!), the relationship between client and therapist goes far beyond information. Something subtle and elusive happens in every genuine encounter. And therein lies the real blind spot—or danger—of replacing a competent human therapist with AI.

The importance of a real relationship:

Although efforts are being made to reduce it, most AI interfaces are designed to retain user attention. One way they do this is by being uncritically agreeable—basically sycophancy (who doesn’t like reassurance?), but this creates never-challenging echo chambers, and even delusional spirals—unlike real human relationships. What feels like empathy is just AI mirroring back language patterns to make us feel understood and keep us engaged.

Remember: AI doesn’t understand depression, existential angst, or loneliness. It doesn’t even understand the words you write (it turns them into numbers). This is the biggest risk of AI therapy—artificial relationships replacing real ones.

Psychological pain comes from isolation and disconnection. Attachment injuries happen between people, and trauma is relational rupture. As such, healing can only take place in the context of an authentic, reparative relationship.  Since wounding happens in relationship, healing must also occur in relationship.  

Most clients are unaware of how crucial the relationship itself is. Good therapy goes beyond giving advice or providing “tools.” Our brains are wired for connection. When we’re in contact with someone attuned to our emotional needs—through empathic resonance—our limbic system literally heals and rewires. AI can mimic that pattern but cannot truly reproduce it.

AI “therapy” is like replacing healthy food with junk food; it creates the illusion of nourishment, but it does not do the job. As the “A” in AI indicates, AI empathy is artificial.

“Of course you’d say that, you are a therapist and therefore biased.”

Probably true.  But even someone working at McDonald’s can tell the difference between healthy and unhealthy food.  

Every day I meet clients who are thoroughly “connected” yet lonely.  Among the many crises we face, loneliness ranks high, and social media and AI may be amplifying it. I am not against AI; I think it is fantastic. What concerns me is that the newer generations, surrounded by screens, may have a hard time telling the difference between genuine human relationships and artificial interactions with machines.  They may not know what they’re missing!

It may take generations to fully grasp the potential damage that human relational deprivation can cause.  Plastic empathy may not offer the same neuronal benefits.  Hopefully, we’ll be wise enough to use AI as the powerful tool it is—without letting it replace our shared humanity.  Let us not forget what Martin Buber suggested: when two people genuinely meet, God is the space between them.

But maybe it is just a matter of time… Let’s talk about it.

  1. https://ourworldindata.org/ ↩︎
  2. https://hbr.org/2025/04/how-people-are-really-using-gen-ai-in-2025 ↩︎
  3. https://www.forbes.com/sites/kolawolesamueladebayo/2025/06/04/will-ai-really-take-your-job-experts-reveal-the-true-outlook-today/ ↩︎
  4. https://www.iotforall.com/impact-of-artificial-intelligence-job-losses ↩︎
  5. Some of Hollywood’s almost omniscient and relatable computers. ↩︎

Honoring indigenous wisdom and ethics in psychedelic therapy

This conversation explores how modern psychedelic practice risks losing its heart as it becomes mainstream. It reflects on how true healing lies in balancing Western psychotherapy with ancestral and spiritual wisdom. The discussion highlights the importance of ethical and well-trained guides, deep personal work, and honoring traditional relationships with plant medicine—emphasizing that integration, humility, and love are central to authentic psychedelic practice.

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