What Code Can't Capture- A therapist's take on staying human

AI is doing everything. It even tried to write this blog post for me.

I didn't want my post written for me. And I don't want AI doing therapy for me either- and neither should you.

What I did want AI to do was give me some data on how many people are using chatbots/AI for therapy. So I asked Claude and here is what Claude "said":

Usage Rates

A survey found that 48.7% of people who both use AI and have self-reported mental health challenges are using large language models like ChatGPT, Claude, or Gemini for therapeutic support Sentio University. Among adolescents and young adults specifically, about 1 in 8 (13.1%) U.S. youth aged 12-21 use AI chatbots for mental health advice Rand, with usage highest among those aged 18-21, where 22.2% reported this behavior AJMC.

ChatGPT has 800 million active weekly users, with therapy and companionship being among the most popular use cases Teachers College. In the UK, one in three adults had used a chatbot to support their mental health or well-being Nature.

What People Are Seeking Help For

The most common conditions people seek AI support for are anxiety (79.8%), depression (72.4%), and stress (70%). Relationship issues (41.2%), low self-esteem (36.2%), and trauma (33.3%) are also significant reasons Sentio University."

This is alarming because what makes therapy effective is that it both acts on and relies upon the autonomic nervous system's Social Engagement System (the original “social network”) which literally requires HUMAN connection

Feeling SAFE and the Social Engagement System

In order to function well, our nervous system needs to “feel safe”. Oftentimes we are physically safe but we do not FEEL neurobiologically safe (this is actually the core of anxiety but more on that another time). 

When humans experience neurobiological safety, their nervous system supports health, growth, processing and restoration. This isn't just a mental experience—it's a physical shift in your body. Your heart rate becomes more variable and adaptive, your digestion improves, your immune system functions better, and your brain becomes capable of processing difficult emotions, thoughts and memories.

The Social Engagement System is a network of nerves connecting your heart, face, ears and voice that allows you to both read and send safety signals to other humans through eye contact, facial expressions, body language and tone of voice. It is a key physiological tool that developed through evolution in order to allow us to establish neurobiological safety. 

If you want to know what neurobiological safety feels like, think about how you feel physically and emotionally when you are talking to a friend, listening to music, singing, laughing or engaging with other humans in a positive way. All these activities utilize the Social Engagement System and activate a core neurobiological sense of safety. 

Why effective therapy must be Human to Human

Positive, supportive, engaged and connected human interaction is what signals neurobiological safety. Human therapists use their own Social Engagement System to connect and co-regulate with clients in the following ways:

-Therapists pick up cues about their clients' autonomic state. They can tell if a client is calm or anxious, shut down or activated based on the cues they pick up through their own social engagement system.

-Therapists then use verbal and non verbal communication to establish a sense of neurobiological safety and connection with clients

-Clients pick up on the therapists autonomic state and level of emotional regulation in the session. They are then able to connect and co-regulate based on the therapist’s calm and regulated nervous system 

-Therapists not only observe and react to the cues they pick up but they also reflect back to the client about the real time signals they receive from their clients’ nervous system

-This direct verbal feedback and cognitive processing allows clients to begin to recognize their own autonomic nervous system states

-Once aware of the cues and behaviors of their nervous system, clients are able to learn and practice how to shift into more emotionally regulated states on their own

This process establishes a neurobiological sense of safety that is in itself part of the treatment but also creates the pathway for safe, deep exploration of thoughts, feelings and behaviors that is the key to treatment and resolution of mental health issues. 

How neuroception of safety IN therapy translates OUTSIDE of therapy

The biophysical neuroceptive experience of safety is actually required for a LOT of really important things.  It is only from a neurobiological “safe mode” that we can effectively process thoughts and emotions as well as experience joy, relaxation, play and connection.  Additionally, we have not even begun to cover all of the physiological systems impacted by our nervous system- from digestion to heart rate to inflammation and just about everything in between.

Being able to recognize and access neurobiological safety in human therapy teaches and trains the nervous system to better operate from that same neurobiological space outside of therapy as well. 

Therapy is a microcosm for the real world. Talking about hard things and managing intense feelings all while in a neurobiological state of safety makes it possible to do the same in real life where it counts most. When therapy is done well, what you learn and do in therapy carries over in real life.  

What AI CAN be useful for when it comes to mental health:

While the deep insight and regulatory work of therapy requires the biological reality of another human being, AI can be a helpful source of information and psycho-education. It can even be helpful in generating homework assignments to allow for practice of new skills learned in therapy. 

AI is also an amazing resource for therapists to help with case conceptualization and the application of theoretical frameworks to help guide treatment plans. 

Takeaways and other things to consider:

Working through trauma, anxiety, or emotional pain isn't just about getting good information or advice—it's about your nervous system shifting into neurobiological safety through connection with another human being. Feeling seen and understood by another person is a core component of therapy and has an actual neurobiological impact on the nervous system. The therapeutic process is deeply rooted in interpersonal relationships built through the social engagement system which AI is unable to replicate. While AI can serve as a supplementary tool in mental health care, it cannot replace the essential human connection that therapy requires.

I also have more to say in terms of the social engagement system and the efficacy of online vs. in person therapy.  That can be a post for another time….