Can Computers Eliminate The Need For Traditional Therapy?

Proponents of Cognitive-bias modification (CBM) feel that for many, the therapy-and-drugs-free method could mean the end to psychological problems. For those of us wary of having a computer do that job, it may be a hard sell.

So what, exactly, is CBM? Let the Economist break it down for you:

[CBM is] based on the idea that many psychological problems are caused by automatic, unconscious biases in thinking. People suffering from anxiety, for instance, may have what is known as an attentional bias towards threats: they are drawn irresistibly to things they perceive to be dangerous. Similar biases may affect memory and the interpretation of events. For example, if an acquaintance walks past without saying hello, it might mean either that he has ignored you or that he has not seen you. The anxious, according to the theory behind CBM, have a bias towards assuming the former and reacting accordingly. The goal of CBM is to alter such biases, and doing so has proved surprisingly easy. A common way of debiasing attention is to show someone two words or pictures-one neutral and the other threatening-on a computer screen. In the case of social anxiety these might be a neutral face and a disgusted face. Presented with this choice, an anxious person instinctively focuses on the disgusted visage. The program, however, prods him to complete tasks involving the neutral picture, such as identifying letters that appear in its place on the screen. Repeating the procedure around a thousand times, over a total of two hours, changes the user's tendency to focus on the anxious face. That change is then carried into the wider world.

And you can do this, with just a computer, in a series of 15-minute sessions. Proponents say they have already had success with anxiety and addiction, and it may work for PTSD, too. However, it's proved ineffective for arachnopohobia, and in the case of alcoholism, results have been mixed. It's still early days: the next few months will bring a number of major studies putting CBM to the test — so don't think you can download an anxiety cure from iTunes just yet; even should these studies prove fruitful, there would still need to be a full batterie of clinical trials before any form was available to the public.

While I'd certainly be willing to give it a try — like most people I know on powerful medications, I'd just as soon not be — but it seems like at best the approach will not be a panacea for all ills, nor a substitute for many medications. And since it's unwise to take meds without a doctor's care, it seems that for many of us, it would be an additional approach rather than a substitute. Then too, therapy is undeniably helpful for some people — this seems to serve a different enough function that therapists, psychologists and psychiatrists need not worry any time soon. That said, in some cases it may indeed help — and if it encourages getting treatment in those who'd otherwise avoid it, even as a starter, it's hard to object.

Well, for most of us — the more imaginative can always see sinister capabilities. As one commenter writes, "A military training program could use this technique to reprogram recruits to overcome their natural aversion to killing or maiming other people, or even to overcome their reluctance to follow orders. A less scrupulous military force could use it to train a select group to feel good about raping and torturing people." I'm guessing even the strongest proponents would be surprised to hear they've created The Manchurian Candidate.

Therapist-Free Therapy [Economist]