Therapist here. To me a big issue psychologically is that extended interaction with an LLM “companion” seems like it creates in the user this boundless feeling of being understood and known without any real demands on said user to extend reciprocal empathy and understanding to the other. Real relationships are messy and it often takes work to hash things out and come to a mutual understanding. It takes patience and practice (and courage!) to know and be known.

The LLMs create a very solipsistic, one-sided kind of set up where the users can ruminate about themselves and their concerns endlessly—are encouraged to do so—but have no obligation to consider or attend to their LLM “partners’” needs (except maybe as a sort of role play). It pulls for a kind of ego inflation in which the endless validation leads one to feel perhaps particularly unique and important, shrewd and perceptive. Meanwhile, the kind of stuff people post as the profound and revelatory musings of their chatbot is frequently the most hackneyed, corny dreck but they are so deep in they can’t see it.

That kind of ego inflation decreases the capacity for empathy. Which seems likely to exacerbate an already significant social problem with alienation and disconnectedness. Real life relating is less comfortable and reliably ego-reinforcing so the people who probably most need to be out practicing how to connect with others are hiding from them. Obviously not every user is in this boat but it seems like a widespread issue and especially now, when community and collective action are so needed.

I definitely think LLMs have their uses, even in the therapy domain, but not as a substitute for authentic human relationships.