A psychiatrist’s quiet concern about AI, the mind, and what we lose when thinking becomes optional.
You’ve probably asked an AI for something today already. To summarise an email, perhaps. To rephrase a difficult message. Or — and this is the part I think about most — to listen, for a moment, when you couldn’t quite face calling a friend. We are folding artificial intelligence into the small spaces of our days with extraordinary speed. Most of it is useful. Some of it, in my work, I am beginning to worry about.
The conversations I have in clinic now increasingly include sentences like these: I asked ChatGPT what was wrong with me. I told the chatbot the thing I couldn’t tell my partner. The app said I probably have ADHD, so I came in to confirm. Each describes a small, sensible-seeming shortcut. Each also carries a quieter cost.
The first cost is clinical. An AI can describe patterns from textbooks, but it cannot see you. It cannot notice the pause before you answer, the way your shoulders shift when grief is mentioned, the inconsistency between what you say and what you do. It cannot ask the follow-up question that turns a self-diagnosis into something accurate. A chatbot will give you an answer; a clinician will give you a conversation, and the conversation is usually where the real understanding lives.
The second cost is harder to name. The more we outsource thinking, the less we practise it. The more we type a feeling into a chat window and accept the soothing response, the less we sit with the feeling long enough to understand it. Discomfort, in mental health, is often the doorway to insight — and AI is built, by design, to close doorways quickly with reassurance.
None of this is an argument against AI. It is genuinely useful — for information, for drafts, for organising a thought you’ve already had. The question is what we ask it to be. A tool to assist your mind is one thing. A substitute for the friction of being a person with other people, including a clinician when needed, is another.
— Dr. Melvin Chagas Silva, consultant psychiatrist, Goa