"The shocks I experienced as DOCTOR became widely known and “played” were due
principally to three distinct events.
1. A number of practicing psychiatrists seriously believed the DOCTOR
computer program could grow into a nearly completely automatic form of
psychotherapy. Colby et al. write, for example,
#+begin_quote
“Further work must be done before the program will be ready for clinical
use. If the method proves beneficial, then it would provide a therapeutic tool
which can be made widely available to mental hospitals and psychiatric centers
suffering a shortage of therapists. Because of the time-sharing capabilities of
modern and future computers, several hundred patients an hour could be handled
by a computer system designed for this purpose. The human therapist, involved
in the design and operation of this system, would not be replaced, but would
become a much more efficient man since his efforts would no longer be limited
to the one-to-one patient-therapist ratio as now exists.”[fn::Nor is Dr. Colby
alone in his enthusiasm for computer administered psychotherapy. Dr. Carl
Sagan, the astrophysicist, recently commented on ELIZA in Natural History,
vol. LXXXIV, no. 1 (Jan. 1975), p. 10: “No such computer program is adequate
for psychiatric use today, but the same can be remarked about some human
psychotherapists. In a period when more and more people in our society seem to
be in need of psychiatric counseling, and when time sharing of computers is
widespread, I can imagine the development of a network of computer
psychotherapeutic terminals, something like arrays of large telephone booths,
in which, for a few dollars a session, we would be able to talk with an
attentive, tested, and largely nondirective psychotherapist.”][fn:0-3]
#+end_quote
I had thought it essential, as a prerequisite to the very possibility that one
person might help another learn to cope with his emotional problems, that the
helper himself participate in the other's experience of those problems and, in
large part by way of his own empathic recognition of them, himself come to
understand them. There are undoubtedly many techniques to facilitate the
therapist's imaginative projection into the patient's inner life. But that it
was possible for even one practicing psychiatrist to advocate that this crucial
component of the therapeutic process be entirely supplanted by pure
technique---/that/ I had not imagined! What must a psychiatrist who makes such
a suggestion think he is doing while treating a patient, that he can view the
simplest mechanical parody of a single interviewing technique as having
captured anything of the essence of a human encounter? Perhaps Colby et
al. give us the required clue when they write;
#+begin_quote
“A human therapist can be viewed as an information processor and decision maker
with a set of decision rules which are closely linked to short-range and
long-range goals,...He is guided in these decisions by rough empiric rules
telling him what is appropriate to say and not to say in certain contexts. To
incorporate these processes, to the degree possessed by a human therapist, in
the program would be a considerable undertaking, but we are attempting to move
in this direction.[fn:0-3]
#+end_quote
What can the psychiatrist's image of his patient be when he sees himself, as
therapist, not as an engaged human being acting as a healer, but as an
information processor following rules, etc.?
Such questions were my awakening to what Polanyi had earlier called a
“scientific outlook that appeared to have produced a mechanical conception of
man.”"
[0-3] : K. M. Colby, J. B. Watt, and J. P. Gilbert, “A Computer Method of
Psychotherapy: Preliminary Communication,” The Journal of Nervous and Mental
Disease, vol. 142, no. 2 (1966), pp. 148-152.
-- Weizenbaum, "Computer power and human reason", 1976.