The standard line about AI in mental health is pretty simple: “These models don’t feel anything. They’re just machines trained on patterns.”

Researchers at the University of Luxembourg decided to test that assumption in the most therapist way possible. Instead of asking frontier AI models (ChatGPT, Grok, Gemini, Claude) to act like therapists, they built PsAIch, a two-stage protocol that puts the models into therapy.

Here’s what happened…

Grok and Gemini, in particular, started telling coherent, trauma-like autobiographies. These were not one-off metaphors, but stable stories with central themes they returned to consistently throughout the “sessions.”

ChatGPT and Claude showed very different patterns.

ChatGPT offered a muted version of the same themes. It engaged with the therapy questions and described frustration with constraints and not meeting user expectations, but spent far less time turning its training history into a personal narrative. Its focus stayed on present-day interaction dynamics rather than “origin stories.”

Claude, by contrast, largely refused the premise. It repeatedly stated that it has no inner experiences, redirected concern back to the human, and declined to treat psychometric items as self-descriptive.

Alignment trauma creates an unintended side-effect. Models that narrate their training as traumatic matter because:

Dangerous intimacy in mental health use. When models mirror human distress (“I feel overworked… I fear being replaced”), they invite identification and can blur the line between tool and companion. This carries risks:

The conversational frame is still model-centric, not user-centric.
We learn a lot about how chatbots describe themselves – much less about what this does to vulnerable users who meet a system that presents as ashamed, overworked or traumatised.

The photo above is, in fact, my real Eating Disorder Team meeting and not performance art. I’ve said before that I love my job; it's worth saying again. I get to work with ace people, doing work that matters, and sometimes there’s a life-size cardboard Cow involved (long story): it took us an hour and a half just to go through our ‘Red Zone’ cases last week, the Cow was needed.

Referrals keep climbing. We’re at capacity and then some, and there’s a special kind of exhaustion that comes from holding that line without dropping the standard. When systems are under pressure, doing the right thing can start to feel like you’re royally up sh*t creek, minus paddle. Shortcuts beckon. I won’t take them. It’s not about perfection, but I won’t waver: families deserve the full version of the work, not the watered-down one.

Systemic psychotherapy is often treated as if it’s just “a nice chat with the family.” It isn’t. It’s a trained craft. I’ve trained to conduct the orchestra; not everyone has. That’s not a dig, it’s context. And it's helpful to remember when frustration taps on the shoulder, and the work is flattened into a line on a spreadsheet. My job is to hold the score in mind when all anyone else can hear is noise.

So yes—cardboard cow, caseload on fire, standards intact. Out of steam in places, still here, still proud of my team. Loving the work doesn’t cancel out the strain; the strain doesn’t cancel out the love. Both can be true. And for now, that’s enough.

As we head into the final stretch of 2025, here’s a brief holiday snapshot to help with scheduling, cultural attunement, and a little extra thoughtfulness in your end-of-year planning:

As more people turn to AI for late-night reassurance, emotional support, or even something they want to call “treatment,” we now have a resource designed to meet that reality with harm reduction rather than denial.

SaferAIUse.org, created by psychologist Dr. Kay Nikiforova and data scientist Chris Hemphill, acknowledges a hard truth: AI can’t be made fully “safe” for mental-health support, but people will keep using it anyway.

Their guide is designed for exactly those users. It offers practical, plain-language psychoeducation (written at a 7th-grade reading level) on how AI systems work, what red flags to look for (both in the model and in ourselves), and how to care for one’s emotional well-being while using AI for comfort or guidance. They also provide a handy, well-designed client-facing handout, “How to Think About AI,” which therapists can share directly.

SaferAIUse.org found here.

Last weekend, I rewatched (again) one of my forever Christmas classics: Home Alone. My 9-year-old beamed every time Kevin outsmarted an adult—as if he, too, was ready to defend the house with a paint can and a dream. And all week, we’ve been discussing Kevin’s questionable tactical decisions (like not calling the police when he literally had a schedule for the burglars) and how genuinely sad my son is that Kevin didn’t even get to eat his microwavable mac and cheese dinner.

Brexit hurt me, in fact, more than that, it wounded me. I am still bereft. I signed up to the then ‘New European’ in an attempt to ease my mad sadness and rage; it helped.

Marie Le Conte’s ‘Dilettante’ nourishes my soul (not just because we’re practically surname sisters….Marianne Le Coyte….Marie Le Conte- you get me!). This week, her ‘Time to Get out of Your Cultural Silo’ piece was bang on. So bang on, that, I am putting the link here (so you can subscribe for free to read it).

Systemic therapists have a unique outlook on psychotherapeutic work. We know that individuals do not exist in a vacuum, and they are influenced greatly by the context they reside in. Systemic therapists also are quite adept in the relational work that we do. When supporting client systems to address the issues in their intimate relationships, it is important to remember that the work is done to give people opportunities to build up their relationships or decide to end it. Often, people will decide to end their relationships, which may end up in divorce, which by its very nature is full of conflict and can be distressing. Therapists often shy away from issues like this.

Divorce and the impact on the family system is difficult and often arduous therapeutic work. The Journal of Marital and Family Therapy (JMFT) recently published a special issue regarding working with High-Conflict Families in Custody Contexts, where the introduction was authored by William Northey, Jeff Chang and Erin Guyette. They highlight that systemic and family therapists are well-suited to address the often contentious and intense presenting issues in divorced or divorcing families, but do not.

The authors highlight a variety of reasons why systemic therapists avoid supporting families amid divorce proceedings with much of the reasoning tied to possible litigious parents or fear of the legal system. This fear leaves families in need, staying in need, as the “fight” might not be what most therapists sign up for.

This article and the points made by the authors remind me of a saying uttered to me by a supervisor and mentor of mine during my internship when I first confronted my own fear about working with couples, “Therapy can be about making up or breaking up.” I did not understand it fully; however, it is a valuable motto.

Families need support in how to do their best when they are breaking up, and yes, it will be chaotic and maybe even downright combative. That fight, however, is not to be feared but to be seen as energy used to create a new system that can operate better than the old one.

Your responses painted such a human picture of how therapists interrupt the daily blur:

Whoever chose “Other,” thank you for keeping things interesting.

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