Being an OCD therapist has changed my relationship to AI
(this one is mostly a rant and mostly for fun)
I’m happy to serve my bias up front here. I do not trust AI companies. As a therapist, I am encouraged every day by my electronic health record to try upgrade into some kind of AI assistance. First if was a free time-saving note taking service. First of all, if this is a great service, then let me come to it - I know where to find it. Stop hounding me. Secondly, I do not believe that saving 3 minutes of note taking time is worth agreeing to total surveillance or content mining. The offer has morphed into a general assistant who is offering to analyze my files and give me snapshots. Nope. I do not want to inadvertently train a glitchy facsimile to replace me, or the process of therapy, which I greatly respect.
Even though I dislike AI companies, I think AI itself is redeemable and even worth celebrating as a tool in many forms. Like other neurodivergent people, I find it can save me hours of wondering or research, develop a form letter to insurance companies, or help me refine and clarify my thinking. AI technology is not useless, and in some ways it can offer scaffolding for disabilities. I know people who are creating really unique and useful content in the autism community that couldn’t do it without the support of AI.
There is the AI we use to make the rat race a little less full of friction, or to help us when humans aren’t available, and then there are the stories around AI - the promise of general artificial (or superior?) intelligence, the massive investment bubble, and the lofty AI promises/threats, such as solving climate change, getting us to Mars, and eliminating the need for jobs (or maybe just eliminating the pesky demand that corporations should pay employees), or possibly destroying humanity (their claim, not mine). I find these stories at least a little bit analogous to the way OCD talks to its sufferers. Hear me out. I may be reaching, but it’s fun to strengthen correlations that are tenuous (OCD joke).
While I can’t predict what the fallout of AI as a business model will be, its billionaire proponents leave obvious clues and receipts. There’s the demonstrated environmental toll, coupled with admitted fantasies about moving to space (because Earth is apparently a lost cause). There are the copyright infringements, the tearing up of warehouses full of books, promises to eliminate jobs (and paying customers you would think, but that problem is a can to kick down the road), the invasions of privacy, the secrecy about information sources. There is also the apparent unprofitability of a sector propping up the economy. But one of the biggest tells to me about AI’s empty promises is how hard AI companies are trying to sell/give away their services.
OCD, in comparison, can sometimes feel like a sophisticated sales team, offering a “valuable” product, but also is trying a little too hard. Once we understand the facts and the strategy, what OCD tells us may actually sound more like the earnest hyperbole of someone who didn’t really understand the science fiction they read as a preteen - for example, claiming it would be easier to make Mars livable than reduce our gas emissions here on Earth. There’s a compelling story, spoken with conviction, but it just doesn’t stand up to scrutiny.
Take for example the common OCD compulsion of “contact tracing,” or mentally trying to keep up with the entire life span and travel agenda of a contaminant. It seems credible that staying hypervigilant about everything your shoes might have touched, taking as few steps as possible, buying special products, avoiding areas of the house, etc is going to save you a bunch of time and grief (You could get sick! You could get someone else sick and never forgive yourself! You could worry about this forever if you don’t do something about it!).
But the process of doing compulsions is extremely time consuming and full of grief.
In reality, basic precautions cover most of our bases, and while we may think it’s possible to track specific germs accross the house, we are not in fact experts of microbe behavior who can actually keep track of these invisible and largely benign beings. We have billions of microorganisms on us that we never think about and that live largely symbiotically with us and travel in patterns we are ignorant about. It is a fantasy to think our attention alone will mitigate certain things from spreading, or that any one contact is as important as our imagination makes it.
Contact tracing as a use of our energy is a bad deal. Even if it was free, I wouldn’t buy it. So what makes it so compelling?
I would argue that what makes OCD compelling is similar to what makes general artificial intelligence compelling - a good (and scary!) story, a lot of unearned power, and momentum. We don’t have the level of control that OCD wants us to think we have, and that limitation of ours can be hard to grapple with. We can’t optimize ourselves out of a broken employment structure, or a stressed nervous system. The stresses and fractures in structure make us tired, and that makes us vulnerable, at times desperate - drastically increasing the potency of the sales pitch.
I think it is worth asking, what makes a person vulnerable and tired? What makes a society vulnerable and tired?
When I sit in session with someone with OCD, I often witness specific vulnerabilities that might make them a willing (or maybe captive) audience to a bad sales pitch. Sometimes it’s a combination of significant sensitivity and difficulty trusting the senses. Sometimes a person reveals experiences that ruptured trust in relationships or self. Sometimes there’s total executive functioning overload. Sometimes I see a lot of creativity with nowhere to go, coupled with longing and fear. I see trauma, I see social rejection, I see frightened kids of frightened parents.
This is the sales pitch I hear from OCD, abstracted and aggregated: “Look over here. I have a short cut for you. Whatever this is you’re feeling right now - it’s a personal problem, it’s a threat, and you can’t handle it. But I have a trick that will put you in control - I will make your discomfort go away in seconds.”
But like the cost of AI, the cost of compulsions is extremely high. You can’t solve climate change with a tool that causes climate destruction, and you can’t alleviate suffering with a mental process full of suffering.
Living in these animal bodies with their hormones and their needs and their inflammation and autoimmune issues, with digestive tracts and their longings and disappointments and frustrated dreams, with their distractible minds, with their physical limitations, with their sleep sensitivities and their always wanting is punishing work much of the time. Living with others and their bodies and needs and judgments and disappointments, in communities with their quirks and demands and neglects and surprises, in societies with their rules and their shortcomings, takes effort. Living in a society that is showing signs of collapse, where economic survival requires more and more Herculean effort, where people with power are getting away with more and more absurd violations, makes it hard not to despair or feel constantly under pressure.
Sometimes you just want to give up and hold out for a different planet, a robot workforce, and virtual realities. Sometimes you want the thing that will help you keep up, or feel OK for a minute, not necessarily the thing that will solve the actual problem (or help you understand the actual problem).
But building a good life and a good society is arduous, gradual, collaborative, dramatic and often boring. The short cuts always end up being a swindle.
