JMIR Publications

ABSTRACT

This article explores a significant shift in the field of mental health in general and psychotherapy in particular, following generative artificial intelligence's new capabilities in processing and generating human-like language. Following Freud, this lingo-technological development is conceptualized as the "fourth narcissistic blow" that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, inter-relationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act, following the emergence of what we terms the "artificial third" in the field of psychotherapy. The introduction of an "artificial third" marks a critical juncture, prompting us to ask important core questions which address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships?; (2) How does it reshape our perception of ourselves and our interpersonal dynamics?; (3) What remains of the irreplaceable human elements at the core of therapy?. Given the ethical implications that arise from these questions, this article proposes that the "artificial third" can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy.