Fixing My Brain with Automated Therapy 

Wanna hear me talk about Betterhelp, Talkspace, and the workers behind the apps? Check out that companion video, exclusively on Nebula: nebula.app/videos/jacob-geller-the-people-behind-therapy-apps/

“I cannot tell you to simply breathe to relax when the air you breathe maybe poison” I feel like this words perfectly describes our present and the upcoming demand for mental health care.

i honestly had to laugh at the "pay money to be shown margaret thatcher quotes" part. my god, why would i ever do that lmaoo

"Wake up to a sunrise." Bruh I don't get home until 11pm, you aren't getting me out of bed until 9 am lol CBT has always struck me as the "rise and grind" mindset of therapy.

I would like to personally congratulate you on looking the audience dead in the eye and saying CBT without missing a beat

tremendous video. it's one of many options but CBT has been tremendously helpful for me for just managing day to day, and realizing that kind of internal change is really possible. Cognitive Behavioral Therapy is pretty good too.

I appreciate the critical analysis of CBT. This is exactly why a GOOD therapist will be dynamic and use a combination of methods. For example, using talk therapy to delve deeper into the root cause of symptoms while also discussing coping and reframing tools. IMO, sticking to only to one style of therapy without any flexibility is usually not helpful.

I feel like the most terrifying thing about that part where Youper talks about using your data is that there’s no option to say “no”

On the one hand, the phrase "automated therapy" fills me with fear, but on the other had I can't hear the phrase "CBT" without thinking "Cock and Ball Torture", so this is going to be an interesting watch.

CBT has been hilariously ineffective for me. I do not know why I was put into it, but I was put into it after a psychiatric stay. In my experience it felt like someone telling me all my issues are just in my head and I need to learn to get over it.

Regrettably, the questionares and "Depression number" are referencing the PHQ-9, which is a fairly standard metric used by behavioral health centers across the US. It rubs me the wrong way too.

I'm not even kidding, I had a therapy consultation booked for today, was terrified out of my mind about it, considered cancelling it because I've never been to therapy before and the thought of talking about my feelings with a stranger makes me want to shrivel up and die, and then you uploaded this video. I did the consultation. Your videos are great, keep it up!

You're ability to shift from dread and video games to mental health apps is very impressive. Amazing work as always!

It sounds like it would be cheaper to get your own psychology degree and treat yourself than actually see a therapist

I'm a long-time fan of all of your content, but this video hits so hard for me and makes my own experience feel very validated. As somebody who works in the treatment industry, it can seem totally ineffective and useless to resort to the usual CBT/DBT-esque responses of reframing your own expectations and mind in order to feel better about things going on around you. Hearing enough people's experiences in life which can be remedied by attacking "roots" of problems but ultimately won't because of barriers in politics and the private sector. The amount of people I have seen at the wrong level of treatment and having barriers to their treatment because of insurance issues (and relatedly, class issues) is shocking. The entire industry is built around and dictated by insurance dollars. Criticizing insurance is a tired argument, but ever-apt. Ultimately, the role that bottom-lines and increasing capital play in treatment cannot be understated. The treatment industry is largely for-profit. Therapeutic knowledge will tell you to set boundaries and make decisions which distance yourselves from your abusers. What happens when the abusers are institutional, and can very well include the institutions which have the therapy? Treatment is completely capitalist and has aggressive marketing and sales techniques. Despite exorbitant prices, social workers and practitioners are still underpaid. They work long hours and face burnout and second-hand trauma. This isn't even to mention the incredibly unethical facilities in residential treatment, especially for youth. Even when considering the legislative and political structures which help to maintain this system, are those not also determined by the dollars of corporate interests? It's infuriating and I'm glad that you're bringing this perspective. Thank you for making this video.

I really appreciate the emphasis on CBT not being a tool meant to be used alone. I know it was very helpful for me with learning to be gentle on myself but it’s a bad starting point for the overwhelmed and has finishing returns after you get past the basics. As a therapist, no amount of coping skills I give my clients come close to situational changes (getting accommodations, dropping that stressful class, family members being more accepting), but the system would rather point its finger at one person who’s the problem, who needs to have their brain “fixed”

The four horsemen of CBT: 1. Cock and ball torture 2. Cognitive behavioral therapy 3. Closed beta testing 4. ???

this is the reason why a lot of people conclude therapy 'doesn't work for them' because as effective as CBT can be in a general sense, it is being used as a cure all, where it in reality is a potentially helpful piece of what would ideally be a full more rounded idea of therapy. For me personally, CBT has been really ineffective because of how much it depends on me to have control over my intrusive thoughts. DBT (Dialectical Behaviour Therapy) on the other hand has been a lot more effective for me, I'm in a group therapy setting, so still inacessible to a lot of folks who don't live in areas with resources but, the thing I like about DBT is that it doesn't put positivity on a pedestal, it focuses more on neutrality and developing coping skills. You don't have to reframe your thoughts, because accepting the problem is the first step to adressing it. DBT also certainly isn't a cure all, I'm sure there's a lot of people who different therapies would work better for, but for me, CBT always landed me in the feeling bad for feeling bad loop.

This reminds me, there was a scene in the movie “Overdrawn at the Memory Bank” where the main character is unhappy living is a capitalist dystopia and the company mandates that he goes to therapy so that he can be a model employee. The therapist is doing nothing more than reading what the computer prompts her to do and the machine never questions if the dystopia is why he is unhappy or questions anything deeper. Just tell the main character that he is stressed and tells him he is required to take a vacation, a vacation he will need to pay for out of pocket and can’t afford. There are so many problems with the world, therapy can help with some, but for many only systemic change can relieve us.

When it comes to ADHD, Autism and conditions of similar ilk, CBT is almost patronizing. It usually teaches one to mask or stop behavior instead of working with it. In some ways, it’s useful for building skills that can make a person with ADHD seem “normal” and “productive” but outside of skills that are good for a worker, may not do much. Often it recommends a “distraction-free workplace” in order to force work (which as a college student with ADHD can be required) and to me it doesn’t feel like I am addressing the problem that my brain can’t focus unless I have adrenaline or some sort of stimulant. I’ll do the work, sure, but I’ll be very uncomfortable and in my head, I won’t feel very successful when it comes to tackling my condition. With depression you just need to pull yourself up by your bootstraps even though depression makes it hard to even get up (dopamine is needed for muscle movement). With ADHD you’re too lazy/procrastinating even though your condition makes tasks hard in it if itself. It’s not like people with these conditions are doing these thing intentionally. CBT alone doesn’t feel right. It’s the same feeling when an old therapist told me I didn’t need much help because I was able to sometimes keep my foot/leg from twitching if it bothered other people. She told me this even after I confessed that it made me uncomfortable to do so.

Ok so it won't prescribe anything to help me deal with my bipolar... but that Kim Kitsuragi jacket sure would make me smile everytime I put it on for like, at least a month or two lol.

One of the biggest problems I have with therapy is that my mental health problems all pretty much ultimately stem from one thing - my ADHD. Being neurodivergent has its side-effects, and those manifested in me as anxiety disorders and depression of various types throughout my youth. And, while I respect medical professionals... going to a neurotypical therapist for a problem that is effectively "caused" by your neurodivergency is a bit like going to your doctor with a broken tooth and them being like "Yeah, yeah, it's broken for sure. Here, you can take some pain meds, see if those help. Also, have you tried brushing twice a day?" Like, yeah, you fixed one of the symptoms, you have a cursory understanding of how teeth work and how to care for them, but the problem is ultimately that the tooth is broken, and it won't NOT be broken unless the right type of professional - a dentist - looks at it. And there aren't many "dentists" available... very few in fact, at least ones that are open about it, and trying to book those? Not a good situation.

The big problem in my - and I think a lot of people's - case is that our mental health issues have one root and one solution: money. I had suicidal thoughts when I lost my job, or failed my Masters degree which lowered my chances of getting a job. I and my father have amassed so much debt that I need to basically work for free for the next ten years. My car just recently broke down and my father had to beg someone else for money to pay it. So I think my stress and anxiety have a very obvious root and an equally easy solution. But if I go to a therapist and ask him to give me 50K he's gonna call the cops. You see a lot of "inspirational" shit online where they write stuff like: people will be sad if you go. If you are so sad, then you could pay of my debt, asshole. I am happy to inform everyone that I am no longer suicidal. I am just listening to saint anger on repeat really feeling it flow.

Dude, Jacob, as a software engineer who has fought depression many years ago by myself since I couldn't afford therapy, this was amazing video. What got me out of depression was actually two things, one was the book "The subtle are of not giving a F*ck" and two, I realized I hated my job and was bored. I needed to learn new things. I didn't quit my job (couldn't afford to at the time) but I stopped watching mindless shows at night, and instead started watching shows like yours, science shows, shows where I'd learn new things. Thank you.

Being a therapist, I have tremendous gratitude towards you for making this video, and ESPECIALLY for talking to the politics of therapy. Especially in middle Europe, therapists are very much encouraged to keep far away from politics except in the most vague associations, and it hurts our field. I feel very validated in my frustration with this situation, and isn't this why we come to RU-vid in the first place 😏 (sorry for the snark, I am really and actually very glad for your work and this video specifically 😅)

When I was getting therapy regularly, we had to use Cognitive therapy first to calm me down, THEN the psychoanalysis to figure out 'hey so why are you reacting like this?" I definitely wouldn't be where I am now without both of those. The idea of one of them getting left behind thanks to programming/capitalism is... uncomfortable.

I wanted help from my therapist to understand my feelings, and why I felt the way I felt, and unpack a lot of trauma. My therapist shut me down and diverted me to DBT. (Which is similar to CBT.) It wasn't what I wanted and I felt like it was largely unhelpful in unpacking those big feelings. I'm already quite good at mindfulness and such. But just because I can get through the day, doesn't mean I've properly processed trauma. This video really nailed CBT/DBT on the head. It's one size fits all, and doesn't help people that need more specified aid.

Hey-o. I got my hackles raised when you went in on CBT, because it has absolutely helped me with my acute symptoms. But, your observations about the method are valid - I'd never thought of it as an instrument of "productivity". CSB: the last therapist I worked with told me that CBT has diminishing returns. That's why you have to find underlying trauma and work through it, too.

There's so much to say about mental health and the psychiatric institution. I have no doubt that these apps are far less effective than a human therapist/psychiatrist - but people gloss over how much harm a human therapist/psychiatrist can do, too. Most use out-of-the-box CBT, which won't work for everyone. Many went to school decades ago and still use what they learned in the 80s. Many more simply don't give a shit about their jobs or the people they're serving. Mental health professions hold enormous power over their patients, and many abuse this power - especially when their patient suffers from psychosis or a personality disorder. There's so much to reform in the institution that I wonder if it's worth salvaging at all, or if it needs to be broken down and built from the ground up. I can't help but feel like these apps are a band-aid on a half-rotten system sustaining enormous pressure from all sides.

The bit about the tapes reminded me of an experience I had in therapy. I had a problem where almost every day, sometimes several times a day, would get into arguments with family members, friends, coworkers, whomever - completely in my own head. Usually about stuff that happened a long, long time ago. My therapist suggested that I start having these arguments out loud & (crucially) recording myself. She said I could share the recordings with her if I wanted, but I didn't have to. I didn't have to listen to them myself, either. And after a few weeks of this I noticed that I was getting into those mental arguments less and less. Nowadays when I catch myself doing it, I pull out my phone and start talking. I don't know why it works for me so well, but it has given me a lot of peace. Maybe it's physically getting these thoughts and feelings and words *out of my body* - the "out loud" part mattered. Maybe it's just the human need to feel heard, even if the only thing hearing us is a recorder, standing in for a person (who might also be imaginary).

When learning cbt at uni our teacher told us that whenever it's bar exam season he got lots of patients, and after treating the immediate symptoms he always made it clear to the patients that whatever anxiety the exam might cause is probably rooted in something deeper, so that if they want to explore it properly they could come back any time, preferably after they are done with the immediate stress caused by the exam. Symptom reduction is never enough, nor even for people who actúe cbt

I'm so happy to hear that you were able to endure those extended 10 minute long periods of CBT, it must've been pretty good!

I had the exact problem described when I went to therapy. I was having deep depression and a major reason was being exposed into leftist content. I was learning how fucked everything is while dealing with high-school and working part-time after school. I would directly say "I have existential concerns with societal problems" and my therapist would just redirect to the coping skills we used for every problem. Sad because your teacher died? Journal. Feel overworked and over-pressured to preform well? Have you tried Journaling? Feeling concerned about your status as a guy man in a red state? JOURNAL!!!!

The raw joy I feel when I see Jacob Geller pop up on the top of my screen is palpable.

my first ever therapy sesions as a teenager experiencing undiagnosed autism and abuse were cbt. they tried to teach me how to overcome negative thoughts and make eye contact. they didnt ask me about my home life or the real, underlying question of why i was suddenly so anxious as if out of nowhere. this went on for years - going through different therapists and getting nowhere. i thought it was something wrong with me, intrinsically. i was finally switched the psychotherapy and began medication and id never had such a big improvement. this ended when i turned 18 and didnt qualify for child therapy any longer. last year after a bad spell i started doing cbt again. but this time it was the best experience in my entire history of therapy. it ended up being more of a combined psychotherapy and cbt approach. my therapist actually factored in my trauma and caught me how to overcome my deeper rooted issues with a cbt approach. part of overcoming trauma that is no longer actively in your life is having to 'rewire' your brain in order to teach it that youre no longer in danger. however while youre still actively going through that trauma then there is no amount of 'rewiring' what will change your circumstances - only make you feel even more that it is your fault for being unresponsive to therapy. this includes social issues like being homeless, living paycheck to paycheck, or being a minority and surrounded by bigots. the only real solution is social support and societal change.

That tape recorder is actually really interesting to me because ever since I was young I've had the habit of holding what is pretty much one sided interviews or therapy sessions with myself. It doesn't happen very often maybe once or twice a month and kind of just starts naturally while I'm doing something else but it has helped my own mental health a ton.

This video really helped me understand why my last therapist did not help me at all and seemed to be unable to connect with me even slightly-- she used pretty much only CBT, while the reason I came to her was because of wanting to get an ADHD diagnosis. It was scarily similar to what you described with automated therapy tbh. Her only response to my months of trying to explain to her that I wanted it to seek more specialized help and even medication was over and over just "to ask myself why I wanted a diagnosis in the first place" because she thought that pattern of behaviour was "harmful" for me. Trying to talk to her FELT like being judged by a machine and only constantly asked to ~examine~ my thought patterns and behaviours instead of listening to what I was actually saying, which only led to me being incredibly anxious to say anything at all and as you said, giving up and just giving her a Bad-Thought-Pattern-ProofTM summary of my week with all of the dimension of my actual feelings and reasons for them completely removed because of her laser-focusing on the specific language i used. CBT did help me with some things though very superficial ones, but more so it really opened my eyes to why a lot of people distrust therapists or have bad experiences with them if you have a specific issue that needs more than just "learn to Think BetterTM". if i am suffering a paranoid delusion, i can't fix it by Thinking BetterTM and using The Good LanguageTM, i need comforting and assurance and understanding and walking through what is causing it and figuring out an actual coping strategy, no matter how ridiculous, and sometimes just for someone to allow me to vent so I can survive it. the field of psychology is still filled with issues and prejudices (g-d forbid you happen to have psychosis or delusions of any kind, for example) and capitalism is certainly not helping at all. It definitely didn't escape my focus how the main things the apps were focusing on were depressiong & anxiety, as if that is the only mental problem you can have, though many people-- including some therapists-- would like to pretend that that's the case.

I so want an actual game based on this. Like a really hard game where you try to out psychology an AI.

I do appreciate you being critical of cbt. Helping me realize that maybe it just isn't for me, instead of me being a lazy shit for not just getting better when my therapist tells me to effectively forget about it. I have my reasons for the things I do, conscious and subconscious, but cbt doesn't care. It doesn't try to reason with me. It just keeps telling me to do this or that. It made me feel worse than I did before. It only gave me to blame for my inaction despite me knowing that what it wants me to do doesn't make sense in my framework. The past makes us who we are, and I have a troubled past that I want to work through. It just wouldn't seem like my therapists would care, and it would seem like it was my fault for even caring about it. I might try to get back into therapy now, and say from the beginning I'm not doing cbt alone. I haven't been to a therapist in probably a year now. Not because my mental state got any better.

i find it endlessly fascinating that Zachtronics, makers of bizarre and intricate puzzle programming games, made Eliza, one of the most contemplative and thoughtful games of that year

IMO the most helpful aspect I see in therapy is being able to talk to someone, anyone. Like some of these AI programs show, it doesn't have to be a specialist, just someone able to listen and nod along or ask questions. Talking with people close to you may not be as effective a solution as getting a real therapist. But between the choice of expensive sessions from a licenced therapist vs an emotionless robot app trying to "fix" you so you can "function" better, I see the choice of just talking with somebody willing to listen as the one least exploitative or dehumanizing. And it might be better than nothing.

Hey, Jacob. I'm currently in the process of getting my undergraduate degree in Psychology, with the goal being to specialize in Clinical Psychology and hopefully earn some type of doctorate. To say this entire video is relevant to my chosen field and my personal interests of passion is a big understatement. While I don't know how much I'll be involved in distant/automated therapy, if at all, the blunt discussion on the systems therapies are made under will very likely be a subject I tackle someday. Plus, it's nice knowing the current state of automated therapy apps, the good and the bad. I'll be keeping this video in the back of my mind and will likely share it around, when possible, with professionals who may be interested. Perhaps even use it as a citation for a paper, if I can. Thanks for this video and the ever-densely introspective content you put out on a regular basis, Geller. You may not be a psychologist in a formal sense, but you tap into the essences of psychology way more often than you think.

It was really interesting how this started out only started out almost like a review of review of mental health apps and then slowly expanded into a history of the entire automated mental health field. Very well done.

The other issue for crisis hotline is that they can do actionable things when you call them, such as send the police to your door. This isn't strictly good or bad, as people in crisis in danger to themselves or others might necessitate this help, but this also disuades some people from actually calling when they are in crisis, and furthermore, the necessity of these actions depends on the judgement of the person on the other side of the phone. Sometimes people just need someone to talk to, and the power these hotline holds does not invite a person to ask for help.

"breathe lightly when needed, deeply when able" - I like that a lot.

I have been doing CBT for a while and it is often helpful, but the problems that really dig into my life, that are out of my control, always feel insurmountable and this video has made me feel a little less like I'm the problem in that scenario. I think an acknowledgement of the things CBT can't do is important because in the past I've always felt either that the therapist isn't right for me (which is also true sometimes) or that I am the problem which just makes me feel far worse and has caused me to take breaks from therapy on several occasions.

It's like you reach directly into my subconscious to find the exact subjects that'll capture my attention but that I never would have directly thought of on my own I CARE ABOUT MYSELF AND OTHER PEOPLE I CARE ABOUT MYSELF AND OTHER PEOPLE I CARE ABOUT MYSELF AND OTHER PEOPLE I CARE ABOUT MYSELF AND OTHER PEOPLE I CARE ABOUT MYSELF AND OTHER PEOPLE

Really interesting video (as per). I’ve volunteered for Samaritans for six years so it was an interesting comparison to the approaches taken by apps and in some ways it’s true that Samaritans approach follows the same route in part- repeating back what people have said, reduction of immediate symptoms over sustained therapeutic solutions (which we can’t provide as volunteers and don’t claim to). Something I hadn’t thought about before, despite knowing Samaritans origin story, is how it relates to Protestant thought on individualism, that’s given me a lot of food for thought! Ultimately I don’t quite agree that it’s scripted or without real and genuinely held compassion for people and their specific life circumstances especially not in the same way despite the distance and anonymity of the interaction. As volunteers, we are given training for active listening and what can be helpful to explore feelings and some principles to follow but from there we can’t really script anything because the calls are so varied and people do very much know when you’re not being genuine or engaging fully with them.

This video made my depression number go down.

$500 a month is literally insane.

I'm taking both Human Computer Interaction and Artificial Intelligence this semester and just finished my first week of classes so this was a particularly fascinating and timely video for me. I love that you've been talking about a wide variety of things lately, your content just keeps getting better.

Your brain doesn't need fixing. It's part of what's given you the ability to make such well thought out videos. Therapy is meant to help you understand where the pain comes from and how to manage it. It won't make the pain go away.

I heard my friend is going to be receiving extended CBT from his girlfriend, hope it helps him.

So very recently I worked at a company that was creating an app similar to the ones discussed in this video but specifically workplace psychology, so "improving work stress", "conflict resolution", "time management" etc. The idea was that companies would buy licenses to the app for their employees. Rather than giving employees more money or more time off work, they spend money on an app that tell the employee "you're stressed because you haven't learned the right breathing technique". I have a bachelors and master's degree in psychology and neuroscience and I worked as a researcher for the content team, essentially writing the evidence-based strategies. It was the worst place I've ever worked and I quit for a number of reasons, one being how awful the management were and the constant changes to deadlines blah blah blah. But there was a more philosophical problem that I had working there that I think this video covers brilliantly. Focusing the target of improvement on the individual and not the larger systems shifts the blame to the wrong place. And if/when the techniques don't work for the user, they are forced to believe they are the root of the problem because they are not trying hard enough.

I really appreciate how you list the music used in the description, and how you put it in chronological order. I've been introduced to a lot of great music and artists that way and I can add Gavin Luke to that list now too

tbh the ai therapist from character ai is incredibly accurate and even remembers very old things you told them...actually helped me to identify feelings and analyse Situations I wasnt sure about

i love how he sounds kind of sad when he realizes he can’t get the high score in depression

You know, this wasnt the video I was expecting or wanting, but damn, it was the one I was needing.

Oh no... I have anxiety and already know how to crochet!

How are every single one of your videos so informative and thought provoking. I love having them in the background and just thinking along with your words whilst I do other stuff.

As a person-centered therapist, I will say that while the approach assumes we all are capable of becoming our best selves, it's definitely not boot-strapping. A lot of the times we have a ton of obstacles in the way, and it is genuinely helpful to have someone there to work through these obstacles together. The goal of person-centered therapy isn't to get you to be your own therapist, the message geared towards feeling more empowered. There is a lot of reflection, but it's way more nuanced than just repeating what people say back to them 😅

Amazing how Jacob Geller can make a nearly 1 hour long video about CBT and my dumb ass will chuckle every time he says it.

I think something often forgotten in these discussion is that sometimes the person seeking therapy can't talk to anyone else about the problem because they will be put in danger of serious bodily harm if it even gets mentioned. Any who is LGBTQIA+ who has to live with their LGBT hating family can't exactly talk about anthing relating to that part of their life with the people who are supposed to be their support group. Not to mention any woman or girl who might be pregnant and thinking of getting an abortion in a state where it is now illegal. Sharing this with a therapist who might suddenly decide that the current law or their own bigotry supersedes patient confidentiality could result in jail time for the patient or bodily harm.

Tysm for the captions!!

Loved this video Jacob. I actually had a few of these apps recommended to me, but always found modern AI's to be very unnerving--I'm a writer and one of my specialties is dialogue, so it's very uncomfortable for me to deal with, especially since it doesn't feel like a normal human conversation to me. I'd rather journal--I keep a gratitude Journal and a more regular journal on Simplenote, which is basically a notepad program that syncs between devices-which is all I need, I essentially use Simplenote to replicate talk therapy, usually writing in a stream of conciousness as I ask myself questions about how I'm feeling. It's nothing special--beyond that--I actually pirated a bunch of books that I would have been recommended in the course of treatment in therapy for the things that I have problems with(emotional regulation, depression related to chronic health issues), and it's all helped. I just couldn't find a therapist where I live(conservative state) who was okay with me being atheist and didn't say weird sexist things to me. One of the apps several people recommended to me was Replika AI, which is not remotely a mental health app, and has now been revealed to also dissolve into controlling/abusive behavior if you don't spend enough time on the app.

This was beautifully composed. I really like the way you tackled and transitioned between each subtopic throughout the video. I feel similarly about every other video of yours that I’ve had the opportunity to watch. You have an incredible way of approaching and fleshing out all of the subjects your videos discuss. Thank you for uploading this type of content, I really appreciate it.

I think the obsession with data has lead a lot of scientists, programmers, etc. to believe they know a lot more than they do and to discard anything that can't be easily quantified.

I wasn't in therapy for very long, I was there to deal with a specific issue that had been haunting me for almost two decades. I can only speak for myself and my very specific experience, but I couldn't have gotten the help I needed from a machine. An integral part of my healing was another living, breathing person looking into my eyes and telling me, after hearing and processing everything I had to say, that I'm just as deserving of kindness and empathy as anyone else. If a computer told me that, it wouldn't mean anything to me or my trauma. It would be a scripted bot response. I needed human connection, I needed the push to overcome my anxiety about acknowledging my pain to another person, so I could learn how to connect to more people without feeling so afraid. I'm lucky I worked a job that provided the insurance for this therapy. I feel so horrible for everyone who doesn't have that option. I'm happy if these apps and services help people, but there's work that they can't and probably won't ever be able to do. We're a social species and we need each other.

There is something about scoring your depression (assigning ur mental health a number) that feels so dystopian. Maby it has to do with the way it makes it feel competitive. Like Jacob said, they are gameafying therapy. And in doing so it feels so insincere. Like we are just another pocket book. Not a person that needs help.

35:40 "start operating like a well-oiled machine" reminded me of fitter, happier by radiohead, so spine chilling

I have an app like the first one (Tochi Diary) and it has helped me better understand my triggers and also what causes certain mood shifts. That being said, it has much more customizability than the app you showed, meaning I can better express myself (make moodcores for things such as you described that I feel often, and just making them can really help me identify issues) along with being able to pick several options, and, either way, I agree it can never and will never be a replacement for therapy. It's better used as something on the side to try and understand your moods better and note what you need to work on or what needs to be further explored. Great video and I appreciate your nuanced approach to this.

Been a therapist since before you were born, and joked about AI therapy since before then. Everyone says to never say never, but I remain pessimistic about an app replacing a person in this domain.

Jacob, every video of yours is affecting in ways other creators could only wish to achieve. Thanks for being an important part of your viewers' lives.

Your point about cbt and productivity is so good, I can't stand the American mindset of "fix the symptom instead of the cause"

Thank you for this video, Jacob. I am currently in treatment with a CBT-based therapist and enjoying it, though I do see the limitations you expounded on - and, of course, how it fits within the current societal-economic context. I learned about you via the Golem video, stayed for the video game analysis; this, though, this is the kinda stuff that makes me glad to have done so.

This also all seems very anxiety/depression related ? People go to therapy for a wide load of reasons. Could (and this is a genuine question, I'm not trying to imply its impossible) an app help manage autism? BPD? Dissociative disorders? Personality disorders ?

I would never feel safe opening up to an app unless it was an open source, locally hosted, FOSS app, with no cloud connections. I need to know what its doing, what data its collecting, and how it's using that data, if I cant know that, then I wouldn't even dream of saying something revealing.

Be interested to see an updated version of this after ChatGPT-like responses are integrated into some of these types of apps.

As a student within the psychology world, and in another country from America, I can report there is an industry change currently occurring which is stepping away from the CTB centric place we once were. It's starting to go back to alliance and client based theories. And filling out the idea of a toolkit over a method. But the world has been taken over by statistics and fast paced practices that are difficult to shake, so the changes are slow. These apps, I feel are better suited as tools for people who are undergoing or transitioning out of face-to-face counselling. But the advertisement and focus on "we can fix you" language is problematic. In some cases adding to the bucket of trauma rather than assisting to carry it.

Honestly, the best part of going to my therapist is letting him pick if the CBT we are doing this week is Cognitive Behaivior Therapy or Cock and Ball Torture. Either way, it should be good session.

I hate CBT. It has been almost entirely unhelpful to me. What you said about it was really insightful and I agree with it. CBT can only be one tool in your arsenal of therapeutic techniques whether you're a human or a computer.

first video of yours I've watched and this is an incredible video essay, the tangents into other topics felt so well connected and were so interesting to hear about. looking forward to watching your other ones!

Thank you for making this vid Jacob and I am sorry to hear about your anxiety and depression. I can relate to your struggle and having a good therapist helps a whole lot with said anxiety and depression. My old therapist made me feel a similar way as the apps you described. I begged for homework, I begged for tools and insight. And her answer? No. You dont need that. You are healthy enough. She told me this for about 14 years and then I permently switched therapists. I went to a practice, covered by insurance, specialized in autism. I had to wait an entire year with my crappy therapist, youtube and my family to guide me. It wasnt a great time. When I started the practice, my doctor signed me up for creative therapy in group form, CBT, system therapy with my family and somatic therapy. Alongside I did yin yoga, signed up for the Headspace app and learned to meditate, bought a bike and applied for welfare. Looking at the date, it has been a year since I started said therapy. Results from therapy arent what I expected. After a year I came out as a demi sexual lesbian and entered a gaybar for the first time. I can say no to pushy men when they ask for my phone number. Today I was fried 6 ways into sunday and I only had 3 cups of coffee. I found out what kind of shirts I like wearing. I agree with the fact that CBT on its own is not enough. The book 'Feeling Good' is an excellent selfhelp book yet does nothing to dig deeper into the murky waters of sensory overload, c-ptsd and surviving narcistic abuse. Knowing how to reframe your mindset and understanding your thinking flaws is incredibly useful. Yet it is only one tool in the toolbox.

Thank you. I think I feel a little bit better, though I don't really know why.

What an incredibly thoughtful video.

This reminds me of an argument that I got into online well over a year ago. The person was basically saying that people should stop going to therapy and taking medication because it's a big scam. Being generous they might have just ment for general anxiety/mood disorders and not psychotic/personality disorders. Either way their argument was that these "solutions" where just keeping people complacent and that they might become radical revolutionaries overthrowing the system. To me it just seemed like another kind of accelerationism, which I oppose in any form.

It sounds like a lot of folks in the comments had bad CBT therapists. CBT is not intended to tell you everything is in your head. Its supposed to teach you how to get more control over whats in your head. The exercises seem silly, but they massively helped me. CBT doesnt "fix" you, it helps you *manage* things better.

I need therapy to deal with finding a therapist

I feel like this is the area where a properly trained AI would be amazing. Therapists are not only expensive, but also ofter already at capacity, this is not just a case in the US. We already have models that are capable of responding like real people. If we could train an AI in collaboration with real psychologists and teach it to properly analyze and help a person it could make at least a basic form of mental help available for everyone as it could be open source. Why open source? Because this would allow for people to run the app locally on their computer, or make sure privacy is being honored.

I just wanted to add that CBT doesn't help and can actually harm those of us that are neurodivergent. Dbt is a better bet for us, and honestly I recommend it for most people.

from personal experience the mood tracking app only helped to make me feel worse about myself, it put into perspective just how unhappy i was day to day and made me dread being happy because i noticed a pattern of having the worst dips in my mood after having a good day ironically i ended up having to ditch the app for the sake of my mental health i know not everybody will have the same experience and this is more my fault than the app's i just wanted to share

LOVE LOVE LOVED this video. the mad man never misses

Cant wait to watch. These apps are genuinely nightmarish and sick!

18:42 man after a long CBT session i always feel better

"The last CBT app" Jacob has gone off the chain

I have had several real human therapists that were exactly like mood mission

Fantastic video, maybe your best yet. I really do feel this tightening grip by monopolies and big companies that are essentially trying to make us simple little work horses. Increase productivity. Re-frame this, think of X or Y in a different light. Recently watched Severance and it hits a bit on these topics. I hope you are all right Jacob, especially in your current position as a creator. The massive amounts of depersonalizations that can sprout up from it...

Hi Jacob! I'm a therapist. So, in the MoodMission thing, it sounds like they're trying to engage in behavioral activation, which is evidence-based in treating depression, anxiety, etc. The main thing I think that app can't do is present what would be most effective at the time. Like you said, you min-maxed the options, which meant that you went with the easiest task. This is a good start, but BA is designed to help someone go from like 30 high-knees to a run around the block to doing regular daily exercise, and so on. I will also note that my primary methodology is brief psychodynamic therapy, which is something that - unless tech gets real wild, real fast - cannot be done through AI. That said, I don't have a particular enmity towards CBT, but I do think that if there is any modality which could be done by a robot it would be that one. I think the main issue that you (and a lot of other folks who try apps) are experiencing is the rapport. You mentioned the Bloom delivery method, and it seems like you established a kind of parasocial rapport with the people delivering the content. Many AI apps are made with psychologists, MFTs, MSWs, etc. consulted, but from what I understand they rarely keep folks in the field on staff, which can be difficult to maintain and establish rapport. Anyway, glad that you covered this topic. A friend of mine is doing his dissertation on therapy and technology and I feel like he'd really enjoy this!

This video gave me an existential crisis and I don’t know why; thank you Jacob for allowing people like me to see your content for free.

CBT never helped me because I'm autistic and I often don't even understand my feelings. That feelings chart made no sense to me. I have C-PTSD and no amount of CBT can change the way my adrenals react to a trigger. Medication and solution-based therapy have done a lot more for me than anything else.