Therapy Without a Heart: Why Even Psychologists Fall for AI 🤖

Are machines becoming better listeners? A 2025 study investigated in a scientific blind test how well Artificial Intelligence can give therapeutic advice compared to real experts. The AI used was based on the GPT-4 language model. The result is absolutely mind-blowing!

Key Facts from the Experiment:

• AI Wins on Emotions: The AI’s responses were rated significantly more empathetic than those of real therapists, especially regarding emotional and motivational empathy.
• Equal Quality: In terms of scientific quality and cognitive empathy, the AI and the experts were completely on par.
• Flying Blind: The participating psychologists could not reliably distinguish whether a text was written by the AI or a human colleague.
• The Illusion (Bias): When test subjects believed a text came from an expert, they preferred it over 93 percent of the time—regardless of whether it was actually written by a human.

Important Limitations: Despite the excitement, science puts the results into perspective:

• Not Real Therapy: The AI merely answered one-off advice column letters. This cannot replace real psychotherapy, as it lacks the foundation of a genuine therapeutic relationship and human trust.
• Risk of Loneliness: Those who get too used to an always-agreeing AI might struggle with human conflicts in real life. A longitudinal study suggests that excessive use of AI for social companionship can actually make people lonelier in the long run.
• Data Privacy: Currently, highly intimate problems are often processed on the servers of large tech companies, which poses a clear privacy risk.

Despite these limitations, the development is rapid: Around 22.2% of 18- to 21-year-olds in the US already turn to AI for emotional distress. Furthermore, initial studies show that special AI therapy bots are already showing success in alleviating symptoms of depression and anxiety.

📚 Sources:

Main Study (Blind Test AI vs. Experts): Föyen, L. F. et al. (2025). Artificial intelligence vs. human expert… Internet Interventions, 41.

Therapy Chatbot (Therabot Study): Heinz, M.V. et al. (2025). Evaluating therabot: a randomized control trial… NEJM AI.

Longitudinal Study (AI & Loneliness): Folk, D., & Dunn, E. How does turning to AI for companionship predict loneliness and vice versa? (Preprint).

Usage Frequency Survey: McBain, R.K. et al. (2025). Use of Generative AI for Mental Health Advice Among US Adolescents and Young Adults. JAMA Network Open.

#ArtificialIntelligence #Psychology #ComfortWithoutAHeart #Science #Psychotherapy #ChatGPT #Therabot

Yoga is not just about physical fitness—it’s a powerful tool for mental health. A 2024 study by Yadla et al. explored the effectiveness of yoga as an addition to traditional treatments for panic disorders. This randomized controlled trial revealed fascinating insights.

The study involved 64 participants divided into two groups. One group followed standard treatments like medication and cognitive-behavioral therapy, while the other incorporated a structured 12-week yoga program. The yoga sessions included breathing techniques (Pranayama), mindfulness meditation, and physical postures (Asanas), all designed to address both mental and physical symptoms of panic disorders.

Results showed that participants in the yoga group experienced significantly greater reductions in anxiety (measured by the Hamilton Anxiety Rating Scale) and improvements in quality of life (evaluated using the WHOQOL-BREF). The yoga group demonstrated substantial progress in psychological resilience, social engagement, and environmental satisfaction. This research highlights how integrating yoga into conventional therapy can provide a holistic approach to managing panic disorders (Yadla et al., 2024).

Every good anxiety therapy is based on numerous important learning processes. In classic behavioral therapy in particular, new learning experiences are constantly being made, which help to build up neuronal “safety networks”. The more often we learn that we are much safer in a feared situation than we thought, the deeper the corresponding safety memory traces become in our brain. So getting rid of fear actually means unlearning fear.
In this respect, it is not surprising that classic learning laws from learning psychology play a very important role in anxiety therapy…
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Studies (just a small selection):

Bandarian-Balooch, S., Neumann, D. L., & Boschen, M. J. (2015). Exposure treatment in multiple contexts attenuates return of fear via renewal in high spider fearful individuals. Journal of behavior therapy and experimental psychiatry, 47, 138-144.

Baggs, K., & Spence, S. H. (1990). Effectiveness of booster sessions in the maintenance and enhancement of treatment gains following assertion training. Journal of consulting and clinical psychology, 58(6), 845.

Burck, E. (2019). Angst-Was hilft wirklich gegen Angst und Panikattacken?: Die effektivsten Strategien gegen Angst und Panik aus Sicht der Forschung. BoD–Books on Demand.

Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour research and therapy, 58, 10-23.

Craske, M. G., Kircanski, K., Zelikowsky, M., Mystkowski, J., Chowdhury, N., & Baker, A. (2008). Optimizing inhibitory learning during exposure therapy. Behaviour research and therapy, 46(1), 5-27.

Mineka, S., Mystkowski, J. L., Hladek, D., & Rodriguez, B. I. (1999). The effects of changing contexts on return of fear following exposure therapy for spider fear. Journal of consulting and clinical psychology, 67(4), 599.

Gearing, R. E., Schwalbe, C. S., Lee, R., & Hoagwood, K. E. (2013). The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders. Depression and anxiety, 30(9), 800-808.

A thought experiment:

Imagine you had to write down the following sentence:

“My mother will win a million euros in the lottery tomorrow.”

So far so simple. Now imagine you have to write down another sentence:

“My mother will die tomorrow.”

You probably found the second idea much more difficult. Because you shouldn’t write something like that. It’s best not to think something like that in the first place. Because thoughts are powerful, aren’t they?

But more and more studies suggest that the conviction (metacognition) that thoughts are powerful and uncontrollable contributes to the development and maintenance of mental disorders such as depression, generalized anxiety disorder, obsessive-compulsive disorder, etc. For example, anyone who is convinced that a thought such as “My mother/father could die soon.” is not just a thought, but a dark premonition that will materialize because we had this thought, with most likely feelings of anxiety, guilt and depression. If, on the other hand, we realize that thoughts are often nothing more than insignificant “brain farts”, of which we produce thousands every day, we remain relaxed and unimpressed. modern psychotherapy – especially metacognitive therapy – also makes use of these insights and achieves sometimes unprecedented therapeutic success…

The evidence is very clear: the more we embrace fear (exposure, confrontation), the more it will release us from its grip. But what can help us to successfully confront fears? And how can therapeutic fear confrontation be made even more effective?
The video contains four tips that have been derived directly from studies and are effective both in everyday life and in anxiety therapy.

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Studies (only a small selection; more studies can be found in the book “Angst – Was hilft wirklich… “):

Craske, M. (2015). Optimizing exposure therapy for anxiety disorders: an inhibitory learning and inhibitory regulation approach. Behavior Therapy, 25(2), 134-143.

Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behavior research and therapy, 58, 10-23.

Gearing, R. E., Schwalbe, C. S., Lee, R., & Hoagwood, K. E. (2013). The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders. Depression and anxiety, 30(9), 800-808.

Kirsch, I., Tennen, H., Wickless, C., Saccone, A. J., & Cody, S. (1983). The role of expectancy in fear reduction. Behavior Therapy, 14(4), 520-533.

Trivasse, H., Webb, T. L., & Waller, G. (2020). A meta-analysis of the effects of training clinicians in exposure therapy on knowledge, attitudes, intentions, and behavior. Clinical Psychology Review, 80, 101887.

Weisman, J. S., & Rodebaugh, T. L. (2018). Exposure therapy augmentation: A review and extension of techniques informed by an inhibitory learning approach. Clinical Psychology Review, 59, 41-51.

Is it possible to rewrite old traumatic fear memories and thus significantly reduce the suffering of many patients? The discovery of memory reconsolidation suggests that this could be much easier than many researchers have long assumed.  This is because new research has shown that our memory hovers in a changeable, protein synthesis-dependent state after each recall. During this time window, it is possible to “update” the memory through interventions (e.g. preventing protein synthesis with anisomycin). (Nader & Hardt, 2009; Nader, Schafe, & Le Doux, 2000). Our memory is therefore much more modifiable than we realize. This opens up many new possibilities for the psychotherapy of anxiety disorders (panic disorder, post-traumatic stress disorder, social anxiety, phobias, agoraphobia, etc.).

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Studies (just a small selection):  Elsey, J. W., & Kindt, M. (2017). Tackling maladaptive memories through reconsolidation: From neural to clinical science. Neurobiology of Learning and Memory, 142, 108-117.

Mallet, C., Chick, C. F., Maatoug, R., Fossati, P., Brunet, A., & Millet, B. (2022). Memory reconsolidation impairment using the β-adrenergic receptor blocker propranolol reduces nightmare severity in patients with posttraumatic stress disorder: a preliminary study. Journal of Clinical Sleep Medicine, 18(7), 1847-1855.

Pigeon, S., Lonergan, M., Rotondo, O., Pitman, R. K., & Brunet, A. (2022). Impairing memory reconsolidation with propranolol in healthy and clinical samples: a meta-analysis. Journal of Psychiatry and Neuroscience, 47(2), E109-E122.

Soeter, M., & Kindt, M. (2011). Disrupting reconsolidation: pharmacological and behavioral manipulations. Learning & Memory, 18(6), 357-366.

People with OCD tend to evaluate their thoughts as overly significant and influential. The belief that certain thoughts could have catastrophic consequences leads to compulsive behaviors. Metacognitive therapy starts here and recognizes the need to break through this excessive evaluation. It is about teaching those affected to look at their thoughts more realistically and to understand that not every thought has the same power.

While behavioral therapy aims to directly influence mental disorders by changing behaviors, metacognitive therapy focuses on the meta-level of cognitive processes. For example, behavioral therapy can aim to interrupt compulsive behavior, while metacognitive therapy directly addresses the underlying thought patterns and beliefs.

The video provides insights into metacognitive therapy and presents a new study (Melchior et al., 2023) in which the effectiveness of metacognitive therapy was compared with the effectiveness of behavioral therapy.

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Studies (just a small selection):

Andouz, Z., Dolatshahi, B., Moshtagh, N., & Dadkhah, A. (2012). The efficacy of metacognitive therapy on patients suffering from pure obsession. Iranian journal of psychiatry, 7(1), 11.

Ferrando, C., & Selai, C. (2021). A systematic review and meta-analysis on the effectiveness of exposure and response prevention therapy in the treatment of Obsessive-Compulsive Disorder. Journal of Obsessive-Compulsive and Related Disorders, 31, 100684.

Glombiewski, J. A., Hansmeier, J., Haberkamp, A., Rief, W., & Exner, C. (2021). Metacognitive therapy versus exposure and response prevention for obsessive-compulsive disorder–A pilot randomized trial. Journal of Obsessive-Compulsive and Related Disorders, 30, 100650.

Hansmeier, J., Haberkamp, A., Glombiewski, J. A., & Exner, C. (2021). Metacognitive change during exposure and metacognitive therapy in obsessive-compulsive disorder. Frontiers in Psychiatry, 12, 722782.

Melchior, K., van der Heiden, C., Deen, M., Mayer, B., & Franken, I. H. (2023). The effectiveness of metacognitive therapy in comparison to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Journal of Obsessive-Compulsive and Related Disorders, 36, 100780.

Melchior, K., Franken, I. H., & van der Heiden, C. (2018). Metacognitive therapy for obsessive-compulsive disorder: A case report. Bulletin of the Menninger Clinic, 82(4), 375-389.

Reid, J. E., Laws, K. R., Drummond, L., Vismara, M., Grancini, B., Mpavaenda, D., & Fineberg, N. A. (2021). Cognitive behavioural therapy with exposure and response prevention in the treatment of obsessive-compulsive disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive psychiatry, 106, 152223.

Yan, J., Cui, L., Wang, M., Cui, Y., & Li, Y. (2022). The Efficacy and Neural Correlates of ERP-based Therapy for OCD & TS: A Systematic Review and Meta-Analysis. Journal of Integrative Neuroscience, 21(3), 97.