New computer systems aim to peer inside our heads—and to help us fix what they find there

In the nineteen-sixties, Joseph Weizenbaum, a computer scientist at M.I.T., created a computer program called Eliza. It was designed to simulate Rogerian therapy, in which the patient directs the conversation and the therapist often repeats her language back to her:

User: My boyfriend made me come here.

Eliza: Your boyfriend made you come here.

User: He says I’m depressed much of the time.

Eliza: I am sorry to hear you are depressed.

User: It’s true. I am unhappy.

Eliza: Do you think coming here will help you not to be unhappy?

Weizenbaum made Eliza as satire. He doubted that computers could simulate meaningful human interaction. He was alarmed, therefore, when many people who tried the program found it both useful and captivating. His own secretary asked him to leave the room so that she could spend time alone with Eliza. Worse, doctors saw it as a potentially transformative tool. “Several hundred patients an hour could be handled by a computer system designed for this purpose,” three psychiatrists wrote in The Journal of Nervous and Mental Disease, in 1966. “The human therapist, involved in the design and operation of this system, would not be replaced, but would become a much more efficient man since his efforts would no longer be limited to the one-to-one patient-therapist ratio as now exists.”

Weizenbaum became an outspoken critic of artificial intelligence. “But the genie was out of the bottle,” Brian Christian, who chronicled the episode in his book “The Most Human Human,” told me. A few years later, a Stanford psychiatrist named Kenneth Colby created Parry, a program that attempted to simulate the language of a person with paranoid schizophrenia, to train students before they cared for real patients. Psychiatrists given transcripts of therapy sessions often couldn’t tell the difference between Parry and humans; in this narrow sense, the chatbot passed the Turing test. In 1972, Parry and Eliza met up for a therapy session:

Parry: Do you know anything about bookies?

Eliza: What makes you think I know anything about bookies?

Parry: A bookie didn’t pay me off once.

Eliza: What does that suggest to you?

Parry: I beat up the bookie who did not pay off, and I thought he might use his friends in the underworld to get even with me.



Over time, programmers developed Jabberwacky, Dr. Sbaitso, and alice (the Artificial Linguistic Internet Computer Entity). Exchanges with these chatbots were often engaging, sometimes comical, and occasionally nonsensical. But the idea that computers could serve as human confidants, expanding therapy’s reach beyond the limits of its overworked practitioners, persisted through the decades.

In 2017, Alison Darcy, a clinical research psychologist at Stanford, founded Woebot, a company that provides automated mental-health support through a smartphone app. Its approach is based on cognitive behavioral therapy, or C.B.T.—a treatment that aims to change patterns in people’s thinking. The app uses a form of artificial intelligence called natural language processing to interpret what users say, guiding them through sequences of pre-written responses that spur them to consider how their minds could work differently. When Darcy was in graduate school, she treated dozens of hospitalized patients using C.B.T.; many experienced striking improvements but relapsed after they left the hospital. C.B.T. is “best done in small quantities over and over and over again,” she told me. In the analog world, that sort of consistent, ongoing care is hard to find: more than half of U.S. counties don’t have a single psychiatrist, and, last year, a survey conducted by the American Psychological Association found that sixty per cent of mental-health practitioners don’t have openings for new patients. “No therapist can be there with you all day, every day,” Darcy said. Although the company employs only about a hundred people, it has counseled nearly a million and a half, the majority of whom live in areas with a shortage of mental-health providers.

Link to original article on The New Yorker