“What is originality, after all, but the shape that results from the natural impulse to communicate to others that feeling of freedom, that unconstrained joy?”― Haruki Murakami, Novelist as a Vocation

"I would be very upset if I found out my therapist was using AI to write emails to me," I heard recently.

I understood this intuitively. AI-generated drafting and writing is fast becoming ubiquitous. I recently started to write back to a friend and saw there was an entire email drafted in the window—in wording I would never use. There appears to be no way to avoid the presence of AI-assisted language. LinkedIn has been found to be the most saturated platform, with an estimated 41% of long-form text that appears there being AI-generated.

Generative AI drafting tools are now frequently built into electronic medical record systems to assist clinicians. Yet people still seem to prefer human-generated messages—even though, as one study found, AI-generated messages may be rated more empathic. But AI-generated empathy may be template-driven, while human-generated responses are more diverse, according to another recent study.

The Shadow Artificial Third

This hypothetical case of the clinician using generative AI to draft emails falls under the specter of the artificial third in the therapeutic relationship, a term from Yuval Haber et al. describing "a new artificial presence" in therapy. Here, it is quietly brought in by the clinician—a shadow AI use I describe as the shadow artificial third.

Shadow artificial third can refer to secret AI use by either clinicians or clients who may be using large language models for emotional support, companionship, or personal guidance in ways that they do not share with their therapist or clinicians.

Therapists may turn to generative AI tools to draft communications for........

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