It’s therapy, but not as we know it

Anna Connell went searching for artificial intelligence. What she found was something unexpectedly real

For the last week I’ve been chatting with a robot. A chatbot called Woebot, to be precise.

A chatbot is a computer program which conducts a conversation and is designed to simulate how a human might behave in that conversation. They are increasingly common in customer service environments, with Air New Zealand trialling one called Oscar this year. You’ll find them popping up on websites and, increasingly, in Facebook Messenger. Some bots use natural language processing systems, but many simply scan for keywords in the conversation you’re having and reply with something from a database that seems to approximate a match.

Woebot is the brainchild of a Stanford University psychologist and is billed as the first chatbot clinically shown to improve symptoms of depression and anxiety. Each day around 8pm, Woebot messages me on Facebook Messenger, enquiring about my mood and playing word games to teach me about how my own thoughts negatively affect how I feel.

It’s basic cognitive behavioural therapy (CBT) designed to make me aware of self-defeating patterns of thinking and ways of disrupting them.

I found Woebot while researching for a radio show I am a guest on. Before talking about anything, I like to take it for a spin. As such I have signed up for dating apps despite being in a committed relationship, taught myself some basic Te Reo using an app built for kids, and tried to book a holiday online using emoji as the primary method of communication. Usually the apps or sites get downloaded or bookmarked for a day or two and then they’re gone. Keeping on top of technology news and developments can be a vacuous trudge sometimes – wading through the useless, the dystopian and the purely-for-profit - but Woebot has been a bit different.

Like a lot of people, I was cynical about the impact a cute cartoon chatbot could actually have on one’s mood. It’s also difficult to cast aside the idea that it’s a bit sad and pathetic – talking to a robot online about your life seems the domain of the ultra-lonely, or the beginnings of a dystopian nightmare. A few people I’ve mentioned it to have laughed about it and I have laughed along with them. Surely this is just a bit of experimentation and really, no robot or digital experience will replace the face to face exchanges so inherent in our health care system today. The robots might be coming but when it comes to matters of the mind, no robot could possibly understand our inner workings, our anxieties and melancholia right?

"Doing something requires a strategy and a starting point."

I have been living with and managing depression since my early twenties. "Living with" and "managing" are two pretty different things and the distinction is deliberate. For years I didn’t really do anything about it because I didn’t know there was an "it". Like many young people I wore all of what was happening to me as a cloak of my own failings, so wrapped up in shame and fear that the idea of talking to anyone about it, or seeing a doctor, wasn’t just a tough one to contemplate, it seemed pointless because whatever it was, it was entirely of my own making.

Years later and I’ve learned otherwise but at the time, the idea of being able to turn to something that wasn’t human and was therefore unable to judge me or tell anyone about what I was saying would have been comforting. After years of grappling with depression I have also come to realise that so much of dealing to it is in doing, not thinking. You can’t think yourself out of something that, for me anyway, often feels like the result of endless overthinking in the first place. And doing something requires a strategy and a starting point.

"I'm ready to listen, 24/7," reads Woebot's site. "No couches, no meds, no childhood stuff. Just strategies to improve your mood. And the occasional dorky joke."

Woebot offers responses tailored to users' stated mood and a decision-tree model that enables it to offer increasingly personalised responses. It’s not a cure-all or a replacement for myriad other options for treating and managing depression and anxiety. It’s not an on-demand crisis helpline and it’s very quick to state up front that if you need immediate help, you should type SOS for a list of resources or call the emergency number where you live.

It’s a fairly basic CBT experience but for someone looking to take a step in any direction that’s not down, it’s a non-confrontational and almost non-committal way to start the shift. And sometimes that’s exactly what you need. Just a tiny nudge or turn of the dial to begin the road to putting pants on. Rather than it being something that’s regarded as a bit odd, sad or frightening, adding more stigma to mental health issues and illness, perhaps small interventionist programmes like Woebot become part of a mix of ways to treat anxiety and depression.

Given the state of New Zealand’s mental health system and our shocking youth suicide statistics, now seems like a good time to stop cracking 2001: A Space Odyssey jokes about things like chatbots and to start accepting technological experimentation and development as something of a gift in an area of health where so much is still unknown.

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