Is Technology Remaking Therapy: The Screen and the Self: Telepsychiatry, AI Therapy, and the Defense Against Intimacy.

PURPOSE OF REVIEW: This paper examines several methods of technology that have challenged traditional expectations of the meaning of psychotherapy, from the widespread adoption of telepsychiatry to the subsequent emergence of AI-driven therapeutic agents (Therabots).

RECENT FINDINGS: Widespread usage of new technology that impacts the therapeutic process has outpaced an analysis of how that technology might affect the meaning and effectiveness of that process. Lawsuits assume such technology causes harm, while limited data and the literature has been more mixed. From Frankenstein to CRISPR, new technology always has its cheerleaders and its detractors. The more the technology seems to impact a topic especially connected to our humanity, the deeper the convictions will be on both sides. Certainly, when it comes to psychotherapy, the introduction of new technologies such as telepsychiatry to Therabots has provoked discussion. We argue that while new technologies offer practical advantages, they risk functioning as structural defenses against the vulnerability and authentic intimacy essential to transformative psychotherapy. Through analysis of the therapeutic alliance, relational dynamics, and the psychology of vulnerability, this paper contends that the structural form of telepsychiatry does not alter the inherent nature of the therapeutic experience, whereas AI-mediated therapy may collude with maladaptive defenses, fundamentally altering the nature of the therapeutic encounter.