It is nearly twenty years since I first met Eliza. I had heard so much about her remarkable conversational abilities that I went to considerable trouble to engineer an encounter with her. When we did meet it was extremely easy to strike up a conversation with her, but also, curiously unrewarding. Very soon I began to find her rather tedious and before long I dumped her.
Although a poor conversationalist, Eliza is quite remarkable in another respect. A product of the Artificial Intelligence Laboratory at the Massachussets Institute of Technology, she is a computer program designed to have a natural dialogue with humans. The human types a sentence at the keyboard, Eliza analyses it and her response appears on the computer screen.
Eliza’s designers took some short-cuts so that she could run on the puny computers available at the time. She is only capable of one type of conversation, that of an extremely unimaginitive psychotherapist. Her favourite conversational gambit is to pick a word or phrase out of the typed sentence and work it into a bland question with some stock phrase like “Why are you worried about” in front of it. However, I can imagine that an uncritical client could find this an ideal stimulus to unburden himself to the computer.
Nobody, especially not her creators, takes Eliza’s psychotherapeutic pretensions seriously. But times – and technology – have changed; it is now possible to get serious therapy using computers. However the intelligence behind cybertherapy, as this rapidly expanding area is irreverently known, is all human: the computers merely deliver the questions and answers across the internet.
According to Martha Ainsworth, an Internet consultant who runs the excellent ABC of Internet Therapy website, there were 160 therapists online in May this year, up from 12 when she started her guide in 1996. Therapists use the web in several different ways. One or two use video conferencing to recreate an individual face-to-face therapy session as closely as possible. At the other extreme, chat rooms or electronic forms can be used to allow the therapist to respond to questions from several clients concurrently. Usually all the clients see all the questions and answers, so these services are only suitable for general queries, but they are usually free or very cheap. The commonest form of internet consultation is by e-mail.
E-mail has the advantage that the client can pour out their thoughts to a therapist anywhere on the planet at any time of day or night. The therapist also has the chance to think before responding. Both these advantages occur because, unlike conversation, video conferencing or internet chat, e-mail is asynchronous – writer and reader don’t have to be simultaneously present. But it is also indirect. Many therapists argue that the indirectness is such a drawback that electronic therapy should be considered only in extreme cases such as when the client is physically unable to consult a therapist directly.
Ainsworth, who is a satisfied client rather than a therapist, takes a more pragmatic position. She points out that although it is not the same as psychotherapy and is definitely [italics] not appropriate for somebody who is suicidal or in the middle of a crisis, many people find it helpful. Her interest, which led to her setting up the website, began when she wanted to see a therapist but was unable to because she had to take a prolonged business trip. The website helps to overcome some of the inevitable drawbacks of indirectness – it contains excellent advice on how to chose a therapist, and as well as contact information provides independent checks on the credentials of therapists.
Therapy by email also has clear advantages. People who are too shy to engage in face-to-face therapy can pour out their hearts at the keyboard. E-mail from the therapist can be saved, and re-read when spirits are low “it’s like having a hug inside the computer that’s waiting for you whenever you need it” she says.
These advantages suggest to me that cybertherapy is here to stay. However, the prospect that computers will replace human psychotherapists seems as remote as ever. I bumped into Eliza again yesterday while I was gathering material for this article, Although it was our first meeting in twenty years, it was as tedious and unrewarding as ever. You will see what I mean if you point your browser at http://www.planetary.net/robots/eliza.html.
The best website, which includes price information is the ABC of Internet Psychotherapy http://www.metanoia.org/cybertherapy