Yeah, that's triggering for people. So, so - Yeah, I'd punch the computer if it talked
to me like that. But not if - it's not gonna be like Snoop Dogg. Can artificial intelligence
handle mental health questions? Or could ChatGPT take my job someday? ChatGPT has taken over,
and it's pretty incredible. Like so far it's helped me figure out Excel formulas, it's
helped my assistant write emails, it's summarized videos, and it's suggested topics for future
videos. It's a super powerful tool. And my husband is also obsessed with it. So I have
asked some of my audience to submit questions, and today I'm going to try and answer them,
and then we're going to ask ChatGPT for its opinion. And today I've got my friend, my
boss, my colleague, Clinical Director Monica Blume, LCSW, here. She's going to be our um
arbiter, our judge of which of us did a better job. And she's also going to throw out her
suggestions for um what the treatment might be for these questions. I'm going to be completely
impartial, even if it means you lose. Cool. Sounds good. And um yeah, so cue the artificial
intelligence-created Rocky music.
So let's jump into the first question. So we're going to start with this question from
Swords & Keyboards. And this person asked um, "What are the differences between hypervigilance
and paranoia?" So I would answer this question, I would say that hypervigilance is a state
of the nervous system. So when someone's experienced trauma or they have a highly sensitive nervous
system naturally, they're going to be more alert to threats. So they're going to notice
more potential cues for threats, like a loud noise might make them jump or they might be
constantly scanning the people around them for any signs of rejection or disapproval.
That's how I would see hypervigilance. It's more of like a present-moment experience.
And I would say paranoia is like persistent thoughts and beliefs that someone is out to
get you, like that bad things are going to happen or people are conspiring against you.
That's how I would answer this. I'm curious to hear your response. Let's see what ChatGPT
says. Okay. It says hypervigilance and paranoia are related but distinct psychological states.
Hypervigilance is a state of heightened awareness and sensitivity to one's surroundings. It's
often associated with PTSD and can result in an excessive need to be on guard and ready
for danger. People who experience hypervigilance may be easily startled, have trouble sleeping,
and feel physically and emotionally exhausted. Paranoia, on the other hand, is a type of
delusion characterized by distrust and suspicion of others without justification. People with
paranoia often believe they are being threatened, persecuted, or conspired against even in the
absence of evidence. Paranoia can be a symptom of mental illnesses such as schizophrenia,
but it can occur in response to severe stress or trauma. Um I like it. What do you think?
Really, you defined both in the very same way, except that the computer sounds like
I'm reading a Wikipedia page about it or a description of it from a definition. Yeah.
And yours felt more approachable, like I could perhaps hear and understand it better. Yeah.
And I think that might be something we'd see in general with AI, right? Therapist is going
to have a little bit more approachability and hopefully some warmth. Right. I think
it takes a little bit of warmth to be able to hear and understand things sometimes and
hard questions like this. But that was a more thorough description. Yeah. It was more thorough.
It mentioned a few things I forgot. Yeah. Okay. I want to ask ChatGPT this question.
One of my viewers asked how to deal with ergophobia? And to be honest, I have no idea what ergophobia
is. I was just trying to dissect the word. Okay. I would I would have to say I have no
idea. I don't know what that is. To be clear, though, if it is a phobia, there is a general
treatment approach, which is like, oh, let's acknowledge what this is. Let's identify triggers,
and then change how you think about those triggers, and then build up an exposure hierarchy
with scaffolding to support people to very gradually face those triggers. So if I had
a client in my office who's like I have ergophobia, my first question would be, 'What is that?"
And then I would probably know what to do with it. So let's type this into ChatGPT and
see what it has to say. Okay. It says ergophobia, also known as work phobia or employment phobia,
is a type of anxiety disorder that causes excessive fear or avoidance of work-related
situations. So this person is afraid of their work. If you're struggling with ergophobia,
there's several strategies. It just automatically proposed a treatment plan - Right - too. CBT
gradual exposure, relaxation techniques, medication, support from friends and family, and, if necessary,
work accommodations. Huh, interesting. Yeah, I feel like this is a really good bullet-point
list of what to do if you're struggling with a phobia or any disorder that's affecting
your work in general. Yeah. And I think it's very clinical. Like it's dry. It's just like,
"This is what it is." Yeah. Yeah. And if I start talking like this with a client, they're
shutting down, they're glazing over. It's like going to a conference where they just
read the slides. We, and we didn't even say, we should have said, would you give Chat a
point this time, or would I get the point? I mean, if we're scoring this, this is now
a competition. I agree. I almost want to give last time's a wash, and this time I'm giving
you a point. Okay. All right. Even though I didn't know what ergophobia was. Even though
- I still won the round - because you did know how to get help for a phobia. Can I throw
a question at you? Because I read this question that was submitted by a user, and I had thoughts
on it, but I'm not sure I'm gonna - I'm curious how you're gonna respond to this question.
All right. If you're gonna be grading it. Yep, I'm grading. I'm grading you this time.
This uh will play into my secret hope of being a talk show host. Yes. Nice. Okay. So this
question is from Shelly Lewis. She says, "I'm not sure if it's nervousness or exactly what,
but my son who is an adult now pulls at the front of his shirt and will shrug his arms
and shoulders almost constantly like his clothes are bothering him. And it's even worse if
he's talking about something that's bothering him or in a stressful situation. What could
this be? It's gotten worse as he's gotten older." I would say this sounds like a tic
disorder of some sort. Tics can be rolling, we know they're neurological, and it sounds
like a tic to me. So when he's concentrating more, the tic is going to be more evident.
Let's see what ChatGPT says because I saw this question and I was like, "Huh."
ChatGPT says this the behavior your son is exhibiting could be indicative of a condition
known as body-focused repetitive behavior, such as dermatillomania, which is skin picking,
trichotillomania, which is hair pulling, body-focused repetitive behaviors are repetitive behaviors
that involve repeatedly touching, picking, pulling, or rubbing one's own skin, hair,
or nails. They can cause distress. Seek help. Mental health professional, psychologists,
psychiatrists. Treatment for BFRBs often involve a combination of therapy and medication, including
SSRI. That's interesting. So I read this question, and I thought, "That sounds like a tic. It
sounds like a tic. I wouldn't put that in the same category as trichotillomania. I wouldn't
- it's not - so I was curious about this question because she's not mentioning a diagnosis or
a name. This mom is like, something's going on. I don't know what it is. Can AI diagnosis
accurately? I would say no. So I would say that on this one ChatGPT gave bad advice.
Agreed. And it could send that mother or that son down a a long road with an unsuccessful
result. Yeah. And like if in the situation if that Mom took her son to a psychologist
who was really skilled and really expert, that psychologist would probably be able to
give a good differential diagnosis right away. But if this was like a 15-year-old who was
like on the internet, it's like you just got diagnosed with XYZ disorder and anyone on
TikTok or on the internet who's like, you got diagnosed with, you know, this is your
disorder, gives them a name for it, then all of a sudden they start building an identity
around that disorder. Then that can lead to actually a lot more problems down the road.
I agree. And it's also a little bit risky with in-person therapy or provider. Therapists
also are quite valuable, and there's some research showing that, you know, if you compare
diagnostic accuracy, a lot of the times therapists do not agree on what diagnosis best fits people.
So to be fair, often therapists might mess it up too. So I think if you put a therapist
here that's fairly inexperienced or maybe, like you said, was just a support-oriented
therapist. So I think ChatGPT can do a lot against it. It has something to offer. It
really has something to offer. So disclaimer: ChatGPT is not always accurate. It doesn't
provide medical advice, and it can miss like the whole context of a situation, right? It
also makes stuff up. It can also make stuff up that's completely false. Right? It can
make stuff up that's completely false. What else should we add to our disclaimer? I would
just say don't trust it over a professional therapist. Yeah. I would absolutely say that
at this point do not trust AI over your personal provider, absolutely. Huh. Okay. Let's pick
another question. Where does perfectionism stem from, and how can we let go of it? I've
recently been conceptualizing anxiety a little bit differently. So when it comes to anxiety,
anxiety is inherently uncertainty. And our attempts to deal with uncertainty can either
go one of two directions: one is trying to control the uncertainty, trying to make sure
nothing bad ever happens, trying to make sure, you know, if I'm worried that something might
happen when I leave the house I never leave the house. Or if I'm worried that I might
make a mistake in a presentation or on a YouTube video I will never, you know, do a YouTube
video again. Yeah. Or - so that's that's the first option to dealing with uncertainty,
is trying to be control the uncertainty. And the second option to dealing with uncertainty
is trying to increase your own sense of resilience in the face of challenges. And so that would
look like, well, I might make a mistake on a YouTube video, and I will learn from it
and take feedback and keep trying. Or, you know, something bad might happen when I leave
the house, and I will adapt and I'll cope and I'll be okay. Right? And so when I look
at where does perfectionism stem from, I I would consider perfectionism as a maladaptive
or an unhelpful attempt to manage uncertainty or manage fear about maybe not being good
enough or worries about whether you can pass a class, and you try to manage that by never
ever messing up and controlling and controlling and controlling in an attempt to create a
sense of certainty by controlling kind of outside factors or performance factors instead
of trying to increase your capacity to tolerate uncertainty, failure, mistakes. Get really
good at making mistakes and failing and messing up and feeling those emotions and then being
resilient in the face of them.
That's my thought. Okay. Okay. Let's see what Chat GPT has to say about it.
Where does perfectionism stem from, computer? Does a computer know anything about perfectionism?
They are the classic example of perfection. Perfectionism is a complex and multi-faceted
phenomenon that can stem from a variety of factors, including childhood experiences - so
parents, teachers, and other authority figures who set high expectations - trauma - perfectionism
can develop as a coping mechanism after experiencing trauma. Number three is social comparison:
perfectionism can also stem from a constant comparison with others and a desire to measure
up to their achievements and genetic factors. There is also evidence to suggest that perfectionism
can have a genetic component and run in families. Okay. And then its treatment approach suggests
- I didn't even mention a treatment approach - mindfulness, challenging negative thoughts,
setting realistic goals, seeking support, practicing self-compassion, and celebrating
progress and successes.
I'm noticing ChatGPT is finding a couple of words and then using a a model to address
them. Right. And throwing out some treatment ideas. Yeah. Which I like. I think that's
very intuitive. I think what was different here was that they went with foundational
beliefs about perfectionism, and you suggested a new conceptualization for anxiety and therefore
for perfectionism. I certainly think anxiety and perfectionism are connected. I conceptualize
it slightly different than you. I think of it as like fear of fear. And perfectionism
would be a way to lower my fear by controlling things. I liked the additional what you've
been studying and your conceptualization of it currently because you study it all the
time, and I think that's valuable. So I'm giving you a point on this one. Wow. Okay.
I I personally think ChatGPT did a great job answering this person's question directly.
Ryan, our AI expert, has a question. With that last question, I wonder if you actually
dug into that topic a little bit with ChatGPT, I wonder how it would respond? Say, okay,
let's break down point one of that treatment. How would I implement that in my daily life?
And tell me in a kind, loving voice how I should do that. Oh, interesting. Tell me in
a kind, loving voice how I could overcome fear of failure. It begs the question of whether
relationship-based treatment is is more than a kind, loving voice. Let's see what it says.
Of course! I'm here to support you. There's that putting you off right there. Let me give
you some loving and kind words of encouragement to help you overcome your fear of failure
and perfectionism. First of all, it's important to remember that you are not alone in your
struggles. And to be honest, I am not a fuzzy, warm therapist like this. Like I actually
would never say that to my clients. No, no.
First of all, remember you are not alone. But there are therapists like that, and those
do match up with clients who like that. And they do sometimes work. Right. Like there
are, there are, like there's a lot of different approaches. Going back to this. Many people
struggle with a fear of failure and perfectionism, and it's a common challenge. Here are some
tips that can help you um treat yourself with kindness. Practice self-compassion. Set realistic
goals. Focus on the progress. Enjoy the journey. Embrace failure. This sounds incredibly big
to me. This also feels like what we think of when we think of a therapist - yeah - telling
us something. And it, you know, that connect, that human connection is more than - but I
- it's more than a kind, loving voice. But I love that. That's what we looked for. Right.
Yeah. Like I feel like you could, like like a therapist on a TV show would say all of
these things, and a good therapist in session would be so much more individualized. Specific
to the person. And would like hit you with like little zingers. It's - here's a here's
a fun experiment. Ask it to give you the same thing again, but in the voice of Snoop Dogg.
Okay. Let's see what ChatGPT says. Tell me as if you were Snoop Dogg how I could overcome
the fear of failure and perfectionism. I'm scared. Yo, what's good, my homie? I'm Snoop
Dogg, and I'm here to give you some straight-up advice on how to overcome that fear of failure
and perfectionism. Does he talk like this? Yeah, he does. It also makes me feel old because
he is really old now, isn't he? Yes. Here's what you need to do, playa. Apparently he
reads the Bible too. Keep it real. Don't try to be perfect; just be yourself. I will tell
you that I already like Snoop Dogg's version more than the kind, loving version. I mean
does seem more like, okay, keep it real. Yeah. Like rather than, "Try not to envision yourself
in a an unpleasant place -" "Just be gentle." Yeah. Yeah. That's triggering for people.
So so yeah, I'd punch the computer if it talked to me like that. But not if it's not gonna
be like Snoop Dogg. Well, interesting. It's really interesting to explore. This has been
very interesting. And I'm gonna start doing most of my therapy in Snoop Dogg's voice because
I found that to be really effective. That's excellent. Yeah. Well, that's, yeah, why not?
Okay. So it seems that ChatGPT is really good at answering topic-based questions. It's good
at providing information about typical treatment options. Kind of good at even laying out like
a treatment structure for some problems. It definitely it has like a single-minded lens
of like, let's just take the average of what the internet says and call that informative.
And I definitely gave a wrong answer at least once. Definitely. But it also can never provide
a supportive relationship and the structure, the motivational supportive structure of actual
therapy with a real person. Or the hopefulness or the experience of seeing people change,
heal, recover. Right. Yeah. Yeah. I think in the middle of the night, you don't have
a real person to talk to, this could be a place to start. Yeah. Not not a place to take
and act upon advice, but, you know, a place to start working out what to do. Yeah. But
take it all with a grain of salt. Right. Yes. Definitely. Yeah. Well, cool. Thank you so
much for coming, Monica. It's so fun to see you. It's always fun to talk with you. Yep.
So. Cool. All right. Well, thank you everyone for watching. Hope that's helpful. And take
care.