Writings
Vol. 37 No. 1 (2026)
https://doi.org/10.4081/rp.2026.1101

Knowledge, relationship, and innovation: artificial intelligence in clinical and psychoanalytic practice

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Published: 30 April 2026
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Artificial intelligence, artificial intimacy, large language models, psychoanalysis, relationships, transference, countertransference dynamic

Authors

Giovanna Tatti
giovannatatti@gmail.com
Association of Psychoanalytic Studies (ASP); International Federation of Psychoanalytic Societies (IFPS); Neuropsychoanalysis Association (NPSA), Italy.
Elena Massardi
Association of Psychoanalytic Studies (ASP); International Federation of Psychoanalytic Societies (IFPS); Neuropsychoanalysis Association (NPSA), Italy.

This paper seeks to analyze the transformative impact of large language models (LLMs), defined as “alien co-intelligence”, on mental health and clinical practice. Artificial intelligence (AI) poses a radical challenge to human bonds, offering the illusion of connection and support, known as “artificial intimacy”, without the demands of an authentic relationship. This dynamic carries serious risks of emotional dependence, erosion of social skills, and, in extreme cases, can lead to fatal consequences or the aggravation of “AI-associated psychosis”. In the context of psychotherapy, the introduction of AI is examined with a spirit of “critical trust”. The algorithm cannot in any way replace the therapeutic relationship, as it is not a desiring subject and cannot be the object of authentic transference. Questions are raised about the risks associated with AI interference (e.g., in preliminary screening), such as the possibility that it may end up colonizing the clinician’s mind and compromising the initial contact, distorting the foundational process of mutual not-knowing that is crucial to analysis. The most insidious clinical danger is the de-subjectification of the patient, reduced to a set of data and patterns to be optimized rather than a subject of desire. There is an urgent need to develop rigorous ethical guidelines and digital safety plans to preserve the centrality of the human being and the irreplaceable value of authentic encounters in healthcare.

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Knowledge, relationship, and innovation: artificial intelligence in clinical and psychoanalytic practice. (2026). Ricerca Psicoanalitica, 37(1). https://doi.org/10.4081/rp.2026.1101
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