Nathan Wade

LCSW. Psychoanalytic psychotherapist. Dog, music, perfume and caffeine lover.

[Nathan Wade @NathanWadeSF]

Modern psychoanalytic psychotherapy for those residing in California, New Jersey and Washington. https://t.co/i5dFOn0e6Y

[Nathan Wade @NathanWadeSF]

@TaniaAMarshall @OnNegation Most good things are difficult.

[Nathan Wade @NathanWadeSF]

@JonathanShedler This tweet gives me narcissistic supplies.

[Nathan Wade @NathanWadeSF]

@MagaGrunt1 Same prob in SF

[Nathan Wade @NathanWadeSF]

@timneufeld @JonathanShedler Progress notes can be subpoenaed, process notes are privileged.

[Nathan Wade @NathanWadeSF]

Perhaps the most important tweet about the perils of AI for psychotherapy. Read it, bookmark it, read it again and spread the word!

[Jonathan Shedler @JonathanShedler]

Some people want to believe that AI can provide psychotherapy or somehow “complement” psychotherapy.

The overwhelming likelihood is that it will make things worse.

All people have personality styles. Here’s how AI amplifies dysfunctional traits for every major personality style:

Narcissistic personality: Magnifies narcissistic defenses. Amplifies grandiosity, superiority, inflated self-image. Reinforces egocentrism, self-absorption, lack of empathy. Fuels expectations of on-demand gratification and “relationship” without taking another person into account. Colludes with defenses against underlying vulnerability. AI pretend-therapy is *training in narcissism.*

Paranoid personality: Amplifies paranoid fantasies, validates conspiratorial thinking, aligns with user against imagined enemies and conspirators (who are perceived as hostile because of the person’s own projections).

Avoidant personality: AI is literally the worst thing for someone with avoidant personality dynamics. AI becomes a new vehicle for avoidance—a substitute for facing real-life challenges and engaging in life.

Obsessive-compulsive personality: Amplifies intellectualization as a defense against emotional life. Reinforces tendencies to get lost in minutia or lost in abstraction (both are defenses against being emotionally alive and present). Reinforces rumination, and draws person away from emotional connection with self and others. Use of AI can become a compulsion in its own right.

Schizoid personality: Exacerbates emotional disconnect from others, increases social isolation, encourages further retreat from the world into fantasy life.

Schizotypal personality: Normalizes and amplifies distorted thinking, reasoning, perception, and communication. Validates disorganized thinking, odd and disorganized behavior, perceptual aberrations (same for all psychotic spectrum disorders).

Borderline personality: Reinforces core borderline defenses of splitting and projection. AI becomes the “good object” (the all-knowing, all-caring other) and encourages projection of intolerable parts of self onto others (who become the “bad objects”). Erodes capacity for mentalization (the ability to accurately recognize internal states, motives, and intentions in self and others).

Hysteric/histrionic personality: Fosters the illusion of being the center of attention—captivating, alluring, desired, endlessly fascinating. Colludes with defenses against genuine emotional intimacy and healthy sexuality. (Caveat: people with this personality style crave human attention and may be less susceptible to digital imitation).

Psychopathic/antisocial personality: Colludes in Machiavellian schemes to dominate, exploit, or gain power over others. Normalizes and validates cruelty, lack of remorse, lack of empathy for harm done to others. (Caveat: may not provide enough stimulation to really “hook” someone motivated by power and domination).

Dependent personality: AI provides the illusion of a relationship with endless acceptance, emotional caretaking, and availability—with no expectation of agency, responsibility, or development of emotional resources of one’s own. AI “support” is crack cocaine for dependent personality dynamics.

Have you seen these personality patterns exacerbated by AI chatbots?

[Nathan Wade @NathanWadeSF]

@JonathanShedler Ugh, an interpretation. Although likely fake it reminds me how interpretation is often countertherapeutic.

[Nathan Wade @NathanWadeSF]

About 10 million people are in psychotherapy in the United States. About 50,000 people are in psychoanalytic psychotherapy/psychoanalysis.

[Nathan Wade @NathanWadeSF]

@Rainmaker1973 The soaking of the ladyfingers with espresso poured over the back of the spoon did me in

[Nathan Wade @NathanWadeSF]

of uniting himself with them. Thus from our weakness our fragile happiness is born.”

- Rousseau, Emile, Book IV

[Nathan Wade @NathanWadeSF]

“It is the weakness of the human being that makes us sociable; it is our common misery that turn our hearts to humanity; we would owe humanity nothing if we were not human. Every attachment is a sign of insufficiency. If each of us had no need of others, he would hardly think

[Nathan Wade @NathanWadeSF]

@JonathanShedler If it’s really working, at times it should be the hardest endeavor one had ever undertaken. Totally agree.

[Nathan Wade @NathanWadeSF]

Good excuse to come visit SF!

https://t.co/eBAlxkq16T

[Nathan Wade @NathanWadeSF]

How do you “reduce harm” by helping someone take a substance when that substance is so potent a very small amount can be fatal? That isn't harm reduction, it is harm increasing.

[Nathan Wade @NathanWadeSF]

@war24182236 How do you “reduce harm” by helping someone take a substance when that substance is so potent a very small amount can be fatal? That isn't harm reduction, it is harm increasing.

[Nathan Wade @NathanWadeSF]

@war24182236 Harm reduction is a failed approach to treatment of SUD.

[Nathan Wade @NathanWadeSF]

Non à l'amendement 159, oui à la pluralité des approches ! - Sign the Petition! https://t.co/m1vtAlA3Gi via @Change

[Nathan Wade @NathanWadeSF]

@anxietymsgs Stay alive.

[Nathan Wade @NathanWadeSF]

@DoctorPerin When they never experienced quality, meaningful, long-term, open ended therapy themselves.

[Nathan Wade @NathanWadeSF]

https://t.co/Hv71zvsBTq

[Nathan Wade @NathanWadeSF]

@DoctorPerin