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.

In episode 23 of Psychoanalysis & You, host Gail Saltz speaks with Sue Kolod, president of the North American Psychoanalytic Confederation and co-leader of the Depolarization Project, about understanding and addressing polarization in our personal and political lives.

Kolod and Salts discuss what happens when disagreement becomes toxic, like when you dash into a store to avoid walking past a person you fundamentally oppose, and asks what psychoanalysis has to offer in response. Drawing on concepts from Vanik Volkan about "chosen trauma" and "large group identity," she examines why deeply held beliefs feel so personal, and why curiosity about ourselves and others becomes nearly impossible under polarization.

Through vivid examples—including her own experience with the Boston Conversations Project where pro-life and pro-choice women found unexpected common ground—Kolod illustrates how human connection, empathy, and an understanding of the historical and family experiences shaping our convictions can help us maintain relationships across deep disagreement.

This episode offers concrete insights into the defense mechanisms (splitting, projection) that drive polarization and explores how leaders and "surprising validators" can create the safety necessary for dialogue.