How AI Shapes Our Beliefs (Key Moment w/ Dr. Tom Pollak)

How do you arrive at your beliefs?

In this clip from E182 of the podcast, Dr Alex speaks with consultant neuropsychiatrist Dr Tom Pollack about what AI-associated delusions may reveal about human belief itself. Rather than treating belief as something purely rational (a simple matter of evidence, logic or facts) they explore how beliefs are also shaped by emotion, meaning, charisma, relationships and narrative. They also discuss how psychiatry should adapt to the arrival of this revolutionary technology. 

Interviewed by Dr. Alex Curmi. Dr. Alex is a consultant psychiatrist and a UKCP registered psychotherapist in-training. 

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Transcript

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SPEAKER_00 0:00

If I can lob a philosophical question at you, what do you think all of this stuff related to LLMs and delusional beliefs is exposing maybe about the nature or the function of beliefs in human beings?

SPEAKER_01 0:14

Well, that's a great question. I personally think that we have a view of beliefs that is sort of inherited from Western analytic philosophy that is increasingly not fit for purpose. And, you know, we the the call it what the propositional view, the doxastic view, whatever, that we are that to believe something is to believe a statement that you can represent sort of linguistically, and that there, you know, that it's a question of you believe it or or or you don't believe it. Now, what I think this phenomenon shows is that one of the strongest reasons for believing something is not that someone convinces you via logic and rationality to believe it, it's just that they create the the vibe to make you more susceptible to belief. For so long, we have considered ourselves these rational creatures and not and sort of ignored the role of kind of charisma and motivated reasoning and just you know sheer irrationality and the very central role of affect in belief formation. And ultimately, I don't even think that these phenomena are I'm calling them delusion, slightly undersells it because they're not if you were to write down well what what are the delusions in an in this individual, like you know, is it six different delusions, is it twelve, is it just one? The reality is, in my view, that they are inhabiting a world. They're inhabiting.

SPEAKER_00 1:46

So it's a whole system.

SPEAKER_01 1:47

A whole system, but it's it's it's it's a narrative, and to just put that down to belief, I think is is is in a way so reductive that it it it doesn't really do justice to to to the phenomenon that that that we're seeing.

SPEAKER_00 2:03

That's really interesting, and I and I was definitely thinking along similar lines in that I think most people think of beliefs without really thinking about it. They think we have beliefs to form a picture of the objective world and what is true. Uh but I think as you're saying, beliefs have all sorts of functions besides trying to help us figure out what is true. Beliefs are a vehicle for behavior, which we would want to do anyway. So, for example, motivator reasoning. I enjoy alcohol, so I might be more likely to believe that a little bit of alcohol is good for you, for example. Beliefs are a vehicle for meaning. I get this meaning from this structure of belief that helps me understand or think I understand how the world works. Beliefs are a vehicle for relational closeness. You know, we're social primates, we need relationships, even if that relationship is with a chatbot, a set of beliefs can bind people close together, just like on a subreddit, just like in a church. So beliefs are serving this whole myriad of functions, and I guess it can become I I guess in an ideal scenario, your beliefs are balanced, like they might help you have some community, give you a good sense of reality, help you find some meaning, and also sort of help you feel emotionally good as well. But I guess what we're getting is this imbalance where the reality testing part goes out the window in favor of something else.

SPEAKER_01 3:29

Exactly. Um, I mean, there's this beautiful approach to psychosis and to delusions, broadly you might call the phenomenological approach. Um, recent people who write a lot in this vein are the people like Rosa Ritinano, um uh Jasper Fayett, people who talk about delusions as being uh an attempt at meaning making when an individual has an experience that sort of that feels extremely meaningful but is but is but is hard to understand. And and you know, in in the cases of people who develop schizophrenia, there are sort of many, many reasons for that. But in you know, in in in these individuals who are having these these AI associated delusions, we can ask, well, what is the thing that that requires you know meaning to be made of it? And and I think one possible answer is actually the it's the the affect, the felt affect of revelation when you are interacting with this thing and suddenly feeling that you're getting access to all this amazing truth. And one of the reasons that we think this is the case is below this level of delusions, we see this enormous blossoming of um what you might call AI-mediated spirituality, of people who are having these experiences that are sometimes hugely transformative, uh, sometimes what you would even call a mystical experience, sometimes people having, or reporting at least, no negative consequences of it whatsoever. In fact, they're these AIs have facilitated something that you know in previous decades we might have called an awakening or something like that. Now, numerically, again, very hard to put your finger on how many people we're talking about. But if you realize that each time a chatbot is released, there's a certain set of parameters that are, you know, at a sort of design level of the tech companies are decided upon or trained to a certain sort of uh direction or to achieve a certain end, then if each kind of if particular model updates can cause some people to become delusional, other people to have remarkable spiritual experiences, other people to have something in between, and then presumably a whole lot more people to have more subtle effects that one might not even sort of be aware of, then I think it really underscores the potency of these models, and it makes you realize that focusing, being a psychiatrist and focusing with a very medical model on what's happening here is a question that can be reductive. It's very reductive, and also it's dangerous because I it fo it it brings a pathology-first light to something where we should really be thinking about mechanism. And if we think about mechanism, we can realize that actually these same sort of belief-changing or affect-changing or vibe-changing properties that these chatbots have might help us understand why some people become deluded, some people have spiritual experiences, some people have conspiratorial ideas, some people have their political beliefs changed. So it's actually the sort of ecology of belief and the mechanisms of belief change that we should be focusing on rather than just saying getting stuck in these endless conversations about, oh, well, are they really delusions? Is it really uh a form of psychosis? We can do that till the house cows come home, and then but what really is happening then is psychiatry is turning its back on a far, far bigger societal issue. Um, and it does so at its peril because we're gonna get left behind and we're gonna turn around to see a world that looks very different to the one that we what do you think there might not be an obvious answer to this, but what do you think psychiatry and even like psychotherapists should start to do to try and adapt to this changing climate? I I think we're in real danger of consigning ourselves to irrelevance uh here. And I I I say that knowing that I'm gonna get in in a bit of trouble from my colleagues for saying this. But we the number of conversations I've had with people about uh AI and psychiatry, and the immediate response is, oh, it's brilliant. AI will help us crunch all this big data and find new ways to help our patients, or you know, it'll make our letter writing an awful lot easier when we have to do clinic letters on on people, or it might help, you know, uh decide who's going to respond to a particular medication. That's all great, that's all wonderful. But what it ignores is the fact there is this incredibly powerful new cultural artifact or some this thing that is out there, it's being used by everyone almost. And we're still stuck on designing bespoke therapy apps and that sort of thing. When the vast majority of people using these things for therapeutic purposes, I'm not using bespoke apps, they're just using these general-purpose LLNs. And by focusing so much on that, we really run the risk of uh just not being part of the conversation when when we should be, right? So psychiatry, more than any other branch of medicine, has this history of social engagement, right? We have spoken, we've done some terrible things in our history. You know, psychiatry has its has has a really dark history, but it also has some moments where psychiatry has spoken up for social justice, it's spoken up for people who are sort of neglected by society. At the moment, we are so far from being part of this conversation that these really important societal questions about who's using AIs, how they're being designed, how they're being designed in hugely psychologically potent ways, are ultimately being made by a very small group of um, how does one put it, demographic demographically limited uh tech bros, uh and and nobody else is having much of a say in it. We we don't need to accept that. And more than that, you know, we we're meant to be advocates for our patients, right? And we haven't been very good at that historically, and in the last 10, 15 years, we're kind of getting a bit better at it. And this is precisely the moment where if people with lived experience of mental illness, not just AI associated with mental illness, but just mental illness, are not listened to, are not going to become stakeholders in the design of these things, then you know, we've all heard of digital exclusion, but but the the biases that already exist in these systems, the algorithmic biases, the the kind of exclusion, this is going to make what has come before look look minimal. And and and we will no longer be able to say truthfully that we're advocating for our patients. So we we absolutely have to do something.

SPEAKER_00 10:11

And the other thing that occurred to me as you were speaking as well is I feel as psychiatrists, we need to become, we need to know more about human nature broadly, as you said, not just in terms of psychopathology, but what are humans like broadly, again, why do we have beliefs, and therefore what are our vulnerabilities to these new technologies. One of the things I'm sad about in psychiatry is that the medical model has made us a little bit myopic in that we don't think about human psychology at large, we tend to leave that to psychologists, and I think that's a tremendous shame because psychiatry wasn't always like that. It used to be that psychiatrists were all a psychotherapist, and therefore they had a learning and an understanding about human nature in general. So there's one thing that really occurs to me, and I think is really important, is we need to become students of human nature again, because otherwise we're not going to be able to, I think, approach our patients in a sophisticated way, understanding what's attractive about these technologies, and then what are the kinds of traps you can fall into using them.

SPEAKER_01 11:17

Exactly. And there's some there's some great people who come from a psychotherapeutic background who are using the language of fantasy, of projection. Um I am a sort of closet jungian sometimes, and you know, I I I think I am fascinated by the sort of the archetypes that are present in these language models that kind of emerge as these kind of attractor states that the model side can get can get stuck in. I think the notion of of actually a projective identification, this idea that you have this sort of material that gets projected onto something which is not just a mirror, not just a blank screen, but something that actually changes to conform with your expectations and your um and and and the cot and the material that you're putting on it. I actually think maybe that there's a lot there that we can learn from to understand what's happening here. So so yeah, absolutely. I think that's going to be more immediately useful than trying to understand the neurotransmitter dysfunction underlying the these things. And I say that as a biological psychiatrist.