When I started thinking about the relationship between therapy and technology, my smart friends and some VCs snickered.
It was one thing, they told me, to disrupt the hotel industry, or to develop a more efficient way of hailing a taxi or finding the perfect pair of loafers. But therapy was… different. Therapy was about trust, about relationships, deep psychodynamic processes that happened slowly and in person and were all but immune to the steely touch of machines or the scrutiny of algorithms. Maybe you could help people find therapists more easily, they said, or even talk to them online if they so please, but, in essence, therapy’s time-honored model, the 50-minute-long talking session, could never be replaced.
Having now run a company for a few years in this space, I’ve very good—or, depending on your perspective, deeply troubling—news: my friends were wrong. Applying technology and analyzing data gives therapists new and exciting tools that radically expands the horizons of the care they offer their clients. Equipped with technology, therapists can work in new ways and offer a range of approaches, tools and insights they could never offer before. In addition, therapists now have the flexibility to support clients that traditionally could never reach high-quality care.
Let me explain.
Consider your traditional encounter with your therapist: You slouch in, plop yourself on the therapist’s couch or chair, and begin talking. Your meetings are weekly, so it’s inevitable that your first five or ten minutes will be spent merely recapping the past week’s session. In New York, where I used to live, an average hour of therapy now goes for about $350; wasting a sheer 20 percent of that precious, precious time saying things you had already said is, from a strictly economic viewpoint, an awful waste.
But what, you may say, can be done? Such is the nature of the practice! It used to be true. And then, big data came in.
If the very term “big data,” mentioned in the context of something as intimate and emotional as mental health, makes you deeply suspicious, take a minute to contemplate what big data does. Put simply, it’s a way of using machines to analyze very large data sets very quickly to identify patterns and prescribe a preferred course of action. You can now see how and why this tool could make an exceptional contribution in the therapy space: imagine a machine learning platform that, given access to anything from therapist’s notes to questionnaires you yourself fill out, has the capacity to keep track of your progress, note recurring patterns, and provide helpful insights a trained therapists could then use to guide the course of the conversation more quickly and more efficiently, and to have as more input with conversations. It also provides feedback to therapists about their work and how things are going.
With a tool like that, therapists can do things they never could before. Especially to help reduce the cost for most people who would think twice before spending upwards of $800 a month for therapy. Therapists can now easily see patients for 20, not 50, minutes and reduce the cost by more than half. And tools like that, thankfully, already exist and are already in use; my own company, for example, OurRitual, allows couples to answer a simple quiz, see a therapist online for a short burst of impactful meetings, and then use a host of digital tools to help them maintain a healthy, robust relationship. And all that at a much lower cost than a traditional relationship with a therapist.
Don’t get me wrong: I am not, for a moment, advocating the complete overhaul of the therapeutic tradition, or replacing human beings with AI, as some start-ups in the therapy space are advocating. Nothing, I firmly believe, could ever replace the deep human bond between therapists and their clients, that intimate relationship based on trust that has helped so many of us heal. But I do believe that using the latest technological tools will help therapists make sure that their practice is enhanced rather than merely disrupted.
Here are some questions every therapist should now be asking: if you could know much, much more about your clients—with their consent, of course—at the click of an app, how would that change the course of the therapy you provide? If you had access to such a vast database of your clients’ behaviors, views, and sentiments, which questions would you like answered? If you could have access not only to the big and consequential things your clients choose to share, but also to the smaller peccadillos going on just below the surface and often not easy to grasp right away, how would you apply this insight in therapy? And if you no longer depended on set, hour-long meetings, how would you go about seeing your patients? In short, how could you remold therapy to suit different types of clients and patients?
These questions are provocations, to be sure, but they’re increasingly more urgent—and promising. Technological change, understandably, can make some of us nervous, but as the great German Jewish philosopher Walter Benjamin reminds us, technological change also has the power to make even the most intricate human pursuits more impactful. “The amazing growth of our techniques,” he wrote about a century ago, “the adaptability and precision they have attained, the ideas and habits they are creating, make it a certainty that profound changes are impending in the ancient craft of the Beautiful.”
The approach that seems healthiest to me, is that adopted by Erich Fromm, the author of the Art of Love, perhaps the most well-known book on love and relationships. In 1968, Fromm saw the potential danger that technology posed to society, making everything mechanical and squeezing the beauty of human life into mechanical structures. However, rather rejecting all forms of technology and progress, Fromm believed that if we put the human at the very center or progress and build technology around human values, if we ‘humanize technology’ then society really has the potential to propel ‘the growth of man with all his potentialities’.
Amen to that. Ultimately, of course, nothing ever can or ever will replace the sacred bond of one human being talking to another and offering observations that inspire and heal. How fortunate are we, then, to stand at the cusp of another golden age of therapy, one in which this sacred bond could be strengthened tenfold by introducing a human-centered technology that can unlock new depths and open new horizons.