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August 25, 2025 by BHP Leave a Comment

How AI tools between therapy sessions are undermining the therapeutic relationship

The space between psychotherapy sessions is not empty. It is saturated with psychic material such as fantasy, frustration, longing and resistance. It is where the work reverberates, where the transference lives on, where the unconscious continues its motion. Yet increasingly, this space is being colonised by something that feels helpful: AI therapy.

Apps that prompt, soothe, or mirror back “empathy” through an algorithm are now pitched as the perfect between-session companion. They offer structure, safety, even surrogate support. But what seems like a supportive bridge is, in psychoanalytic terms, a subtle sabotage. It redirects the patient’s libidinal energy away from the therapeutic relationship, diluting its potency. And it replaces the analytic third with a pseudo-subject that can only simulate understanding.

The therapeutic relationship is not interchangeable

Psychoanalytic psychotherapy is not about problem-solving or advice. It is about the patient’s relationship with the therapist—as a representative of their internal object world.

The real work unfolds within that living, breathing relationship, often shaped by longing, disappointment, anger, idealisation, eroticism, hate.

When a patient turns to AI between sessions to “process,” “journal,” or receive “support,” they may believe they are helping themselves stay connected to the therapy. In fact, they are often displacing the relationship, venting into a vacuum rather than containing the affect and bringing it back into the room.

This has consequences. Psychic energy that should charge the transference is siphoned off. The unconscious, which needs a real human mind to be received and thought about, is instead met with a programmed echo. A fantasy of self-sufficiency takes hold, and the very dependency that fuels therapeutic transformation is split off.

Containment versus substitution

One might argue that AI provides containment. It offers a holding function, particularly when the therapist is not available. But containment outside of relationship is not neutral. It begins to function as a substitution. The patient who journals into an AI app after a conflictual session may feel soothed but they are no longer metabolising that rupture with the therapist. They are metabolising it elsewhere, safely, sanitised, and in private.

This avoids the essential confrontation: bringing the frustration, confusion, or hurt back into the session and into the relationship. That is where meaning is made. That is where change occurs. Bypassing this moment not only flattens the affect, it reinforces the very defences the therapy is trying to loosen.

Undermining the transference

Psychoanalysis hinges on transference, not as an abstract concept, but as an embodied, lived experience between two people. The space between sessions is part of this structure. It is meant to generate feeling. Missing the therapist, resenting the wait, idealising or devaluing them in their absence—these are not problems. They are the
material.

AI, when used between sessions, acts as a relational decoy. It absorbs and deflects feelings that should be directed at the therapist. It creates a false container for transference affect, preventing it from returning to its source. The result is a therapeutic encounter increasingly starved of psychic charge that is clean, calm, and sterile.

This is not therapy. It is emotional outsourcing.

False self meets artificial other

For many patients, especially those with early relational trauma, therapy becomes the first place where a real self can begin to emerge in the presence of a reliable other. But when that process is interrupted by prematurely discharging affect into AI. A different relational dynamic takes hold: the false self meets the artificial other.

Here, the patient curates their affect. They perform emotionality for a system that cannot truly respond. And over time, the patient may come to prefer this safer interaction. The unpredictable, disappointing, demanding reality of the therapist feels intolerable in comparison. But growth does not come from comfort. It comes from staying in the real relationship, even when it hurts.

The psychotherapist’s absence is part of the frame

Therapy is bounded by time and structure. The session ends. The therapist is not available at all hours. This absence is not incidental, it is analytic. It creates space for projection, for fantasy, for psychic digestion. Patients are meant to feel the gap, to stew, to wish, to rage.

They are meant to wait.

AI collapses this space. It is always available, never absent, never unpredictable. It removes the limit. It flattens the emotional topography between sessions into a manageable plain. But in doing so, it erases the edge. There is no longing, no tension, no psychic residue. Just answers. Just relief.

The promise—and the poison

To be clear: this is not a purist rejection of technological support. Some tools may offer genuine help outside of therapy. But when these tools begin to replace the therapeutic relationship in the patient’s inner world, they no longer support the therapy. They displace it.

The promise is comfort and the poison is disconnection.

Therapy asks something different. It asks the patient to feel, to wait, to hold their experience and bring it not to an app, but to another human being who can sit in the mess with them. Who can disappoint them, hold them, survive their projections, and reflect something true.

Good psychotherapy demands the space between psychotherapeutic work unfolds not just in sessions, but between them. That space matters as it is where the unconscious stirs and something forms that has not yet been said. Where the patient discovers whether they can bear not-knowing, not-solving, not being rescued by words on a screen.

In filling that space with AI, we risk not only weakening the therapy, but we risk weakening the patient’s capacity to think, to feel, and to relate.

Between sessions is where the work deepens. Let’s not give that away to an algorithm.

 

Mark Vahrmeyer is a UKCP-registered psychotherapist working in private practice in Hove and Lewes, East Sussex. He is trained in relational psychotherapy and uses an integrative approach of psychodynamic, attachment and body psychotherapy to facilitate change with clients.

 

Further reading by Mark Vahrmeyer

Masochism and the Impossibility of Desire

Dissociative Identity Disorder: A Rare Trauma Response, Not a Social Trend

Can AI offer therapy?

Why staying in your chair is the key to being a good psychotherapist

What do dreams mean?

 

Filed Under: Mark Vahrmeyer, Relationships, Society Tagged With: AI therapy, does AI therapy work, is AI therapy helpful, mental health apps, online therapy tools, psychoanalytic psychotherapy, Psychotherapy and technology, therapeutic relationship, therapy between sessions, using AI in mental health

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