Daniel Oberhaus, "The Silicon Shrink: How Artificial Intelligence Made the World an Asylum" (MIT Press, 2025)
Feb 4, 2025
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Daniel Oberhaus, a science and technology journalist motivated by personal tragedy, discusses his book exploring AI's unsettling role in psychiatry. He reveals how AI promises accessible mental health care but risks creating a psychiatric surveillance economy that manipulates emotions. Oberhaus introduces 'swipe psychology,' revealing its dominance in mental health diagnostics. He critically examines the ethical implications of AI in mental health, cautioning against its implementation without rigorous evaluation of patient outcomes.
The discussion examines both the potential advantages and alarming challenges of using AI in psychiatric settings to treat mental health issues.
Daniel Oberhaus shares his personal motivation rooted in loss to critically explore AI's role in identifying individuals at risk for suicide.
The podcast reveals ethical concerns regarding data privacy and surveillance, warning about the potential for an 'invisible asylum' impacting personal autonomy.
Deep dives
The Promise of AI in Psychiatry
The episode discusses the potential of artificial intelligence (AI) to revolutionize psychiatry, offering promises of improved access to mental health support and potential innovations in treatment. Advocates claim that AI could make therapy more affordable, enable precision therapy, and even lead to the development of new medications. However, the speaker emphasizes the importance of critically evaluating whether these technological advancements can effectively fulfill these promises. The prevalence of AI within the mental health field has surged recently, raising essential questions about its actual effectiveness and the risks associated with its implementation.
The Personal Journey Behind the Inquiry
Daniel Oberhaus, the guest of the episode, reveals that his motivation for writing the book stems from personal tragedy, specifically the loss of his younger sister to suicide. This painful experience prompted him to explore the potential role of AI in identifying and helping individuals at risk of suicide by analyzing digital data for early indicators of mental health crises. As he delved deeper into the research, he discovered that the topic brings forth both potential benefits and alarming challenges, forcing him to confront the implications of relying on AI for emotional and psychological assessment. His narrative sheds light on how personal loss can ignite inquiries about the intersection of technology and mental health.
Understanding Mental Disorders and Diagnoses
The episode delves into the complexities of defining mental disorders, distinguishing between terms like mental illness, mental disorder, and mental disease. It highlights that while mental diseases have biological origins, many mental illnesses are socially constructed and can change over time, as evidenced by the reclassification of homosexuality from a mental disorder. The discussion raises significant questions about the adequacy of current diagnostic systems, especially the DSM, which lacks definitive biomarkers for most mental disorders. This ambiguity in definitions complicates the application of AI in psychiatry, as it operates on an inconsistent and sometimes flawed understanding of mental health.
The Historical Development of AI in Psychiatry
A historical perspective is provided on the evolution of AI, illustrating how its roots are intertwined with psychiatry dating back to the mid-20th century. Early AI pioneers recognized the importance of understanding the human brain to create intelligent systems, leading them to collaborate with psychologists. Notable early AI applications involved mimicking therapeutic interactions, raising ethical questions about the humanization of technology and the possible dehumanizing effect of substituting human therapists with machines. The episode underscores that modern AI developments are, in essence, built on decades of exploration, but also brings to light the struggles and mistakes of past approaches, which must not be ignored in current conversations.
Ethical Concerns and Societal Implications
The podcast addresses significant ethical concerns regarding the use of AI in psychiatry, particularly the collection and security of sensitive data. It highlights alarming instances where private health information has been mishandled, exposing the potential for privacy violations and misuse of patient data. The conversation emphasizes the broader societal implications, warning that the increasing reliance on AI to monitor mental health can lead to a scenario where individuals are under constant surveillance, creating an 'invisible asylum' that invades personal lives. These dynamics raise important questions about consent, autonomy, and the impact of ever-present technology on mental health treatment and societal standards.
AI psychiatrists promise to detect mental disorders with superhuman accuracy, provide affordable therapy for those who can't afford or can't access treatment, and even invent new psychiatric drugs. But the hype obscures an unnerving reality. In The Silicon Shrink: How Artificial Intelligence Made the World an Asylum(MIT Press, 2025), Daniel Oberhaus tells the inside story of how the quest to use AI in psychiatry has created the conditions to turn the world into an asylum. Most of these systems, he writes, have vanishingly little evidence that they improve patient outcomes, but the risks they pose have less to do with technological shortcomings than with the application of deeply flawed psychiatric models of mental disorder at unprecedented scale.
Oberhaus became interested in the subject of mental health after tragically losing his sister to suicide. In The Silicon Shrink, he argues that these new, ostensibly therapeutic technologies already pose significant risks to vulnerable people, and they won't stop there. These new breeds of AI systems are creating a psychiatric surveillance economy in which the emotions, behavior, and cognition of everyday people are subtly manipulated by psychologically savvy algorithms that have escaped the clinic. Oberhaus also introduces readers to the concept of “swipe psychology,” which is quickly establishing itself as the dominant mode of diagnosing and treating mental disorders.
It is not too late to change course, but to do so means we must reckon with the nature of mental illness, the limits of technology, and what it means to be human.
This interview was conducted by Dr. Miranda Melcher whose new book focuses on post-conflict military integration, understanding treaty negotiation and implementation in civil war contexts, with qualitative analysis of the Angolan and Mozambican civil wars.
