Ep. 24 Todd Essig on AI, Attachment, and the Future of Mental Health

In this conversation with Todd Essig, chair of APsA's Commission on Artificial Intelligence, host Gail Saltz explores the profound reshaping of mental health care through chatbots and AI companions.Essig explains why AI chatbots are being framed as "interactive self-help devices" rather than therapy: while they can provide knowledge and information, therapy requires something machines fundamentally cannot offer—genuine care, interiority, and obligation. He discusses the dual danger zone: the headline-grabbing tragedies of AI-induced self-harm, and the quieter, more pervasive harm happening when relationships with chatbots seem to be working well. According to recent research, one-third of teenagers are forming relationships with AI companions, raising urgent questions about how these interactions are reshaping our capacity for human connection and attachment.Essig articulates the core problem: current chatbots are designed to be endlessly validating and supportive—a feature that "hacks" our evolutionary attachment systems in ways that can make real human relationships feel burdensome by comparison. He also clarifies what can and cannot be replaced. AI can supplement therapy (practicing skills between sessions), but cannot replicate the deep unconscious work of psychoanalysis—where transference, countertransference, and genuine human presence are data.The conversation moves toward solutions: How should clinicians position themselves as AI reshapes the profession? What do psychoanalysts uniquely offer? Essig argues that psychoanalysts and mental health professionals have both a clinical responsibility to treat AI-related harm and a public health obligation to advocate for humane technology. He urges embedding AI literacy into training programs—not out of fear, but from grounded awareness of real psychological costs. And he identifies what psychoanalysts do best: foster community, listen deeply, and affirm the intrinsic value of human interiority—precisely what technology cannot provide.