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"This is a serious matter and we have to maintain our practices even as many people are relaxing restrictions and the economy is opening back up," Reed said in a phone interview.

Social distancing and masks "really work," she said.

Most states across the country can ease some restrictions safely, but projects spikes in areas that have broadly reopened early, according to the model put together by a team at the Children's Hospital of Philadelphia and the University of Pennsylvania.

"While our models show that rising temperatures and humidity levels are having an impact on reducing the spread of Covid-19, those hot, humid days of summer are not going to eliminate the threat of virus resurgence," said PolicyLab's Dr. Gregory Tasian, senior scholar in the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania's Perelman School of Medicine.

Jefferson County, where Birmingham is located, had 1,453 confirmed cases as of Thursday, according to the state's health department data -- which is a jump of 35% from the 1,075 cases reported two weeks ago. The county has had 85 deaths attributed to Covid-19.

As of May 11, restaurants and bars were allowed to serve customers on site, gyms and athletic facilities, hair and nail salons and barber shops were allowed to open. Groups of any size are allowed, as long as the 6 feet distance guidance is followed.

Figuring out exactly what happened that Saturday night will take time and require generous listening to reveal important details about exactly what events took place, how law enforcement became involved and whether permitting and operational procedures were followed.

I'm convinced that the depiction of the event and the actions of law enforcement is contrary to what was initially reported. This was not a pop-up Spring Hill block party that spontaneously became massive, disruptive and violent. Instead, it involved groups gathered for a series of events (including, among others, a car show, a concert and memorial for a former Spring Hill resident who in 2008 was a victim of gun violence) that were promoted successfully enough to attract attendees from as far away as Orlando, Tampa and Jacksonville.

And instead of becoming yet another incident where unarmed African Americans were shot by law enforcement officers who felt threatened based on preconceived fears and racist assumptions, there have been no reports or claims that these law enforcement officers shot, killed or inflicted life-threatening injury on any residents or visitors

law enforcement officers claim they were hit and injured that night by a sucker punch and the hurling of bottles, a bar stool and a mason jar; that they recovered one loaded Ruger 9 mm and other guns, some narcotics and $3,840 in cash; that they made seven arrests and issued five traffic citations. It remains the subject of further investigation and reporting to resolve community complaints in social media posts about undue provocation, escalation and unlawful business interruption. Videos of the incident shed some light but do not capture all aspects of a crowd this large -- the Volusia sheriff's office estimated it at 3,000 -- moving across multiple locations.

To facilitate effective community policing during this pandemic crisis, law enforcement leaders and African American leaders and residents need to further discuss and endeavor to reach consensus on four practical steps: suspending plans for any large gatherings until public health officials say they are safe; advocating for national and state leaders to put health over politics by warning about the continuing risks of asymptomatic virus transmission as the economy reopens; using social media to promote a consistent message about the danger of asymptomatic spread, especially given that the African American community is experiencing a disproportionate number of Covid-19 deaths, and ensuring that when large events are permissible organizers comply with local permitting requirements, which should be consistently enforced in ALL communities, not just in African American neighborhoods.

Ironically, on the same morning as the Spring Hill neighborhood events in question, I was part of a group of 19 racially, politically and socially diverse individuals from eight states and 11 cities gathered for a virtual "Color Line Roundtable."

participants thoughtfully discussed what values, beliefs and principles would guide their votes -- or abstentions -- in the November election. Each of us had a slightly different way of articulating those foundational beliefs, but, as one first-time participant emailed me after the discussion, it was "affirming to hear the commonality of beliefs and principles amongst a group of people who obviously also have some significant differences in opinions and positions."

upon further reflection, I have come to appreciate the value of our community's years-long series of roundtable discussions. Covid-19 restrictions and Floyd's murder might have complicated relations with law enforcement officials, but they offer yet another opportunity for us to talk candidly about the complex issues of effective community policing, racial diversity, equity and inclusion.

I was relieved -- we wouldn't have to make what felt like an impossible decision -- but then I kept reading. My father had noted that he did not want to be supported by a ventilator or hooked up to a feeding tube for any length of time. He had been connected to both for nearly two weeks.

There was grief on her face, but also curiosity. What had finally gotten to her younger son, the one who so rarely showed emotion during his father's hospitalization?

I called the hospital and approved the DNR. They told me his status was still dire. I called my dad's closest friends and started preparing them for the worst.

My father's lungs showed no signs of progress. The double pneumonia they diagnosed days before was worsening. His kidneys were failing. Dialysis was required but would put a strain on his blood pressure, which was already dangerously low. There was a special form of dialysis designed for delicate situations like this -- continuous veno-venous hemofiltration -- but it wasn't available at Lawrence

The morning after I searched for my father's health directive and drafted his obituary, I woke up and tried to turn on my laptop. It wouldn't start. When it eventually booted up, it asked if I wanted to restore an unsaved document. No, I thought, let's see what happens today.

It was the same doctor as yesterday, the one who asked about the DNR. "Look, your dad is on a ventilator. That's a form of life support. He's experiencing kidney failure and requires dialysis. His situation is still very acute. He was in good health before the Covid, but his kidney, heart, and lungs are 69 years old. It's tough for them to recover. But the numbers from today are undeniably better than yesterday. There's been an improvement at almost every level. Your dad is a tough guy."

One of my close friends, a nurse practitioner, would help me understand all the terminology and its implications. He was treating Covid patients at an ICU upstate. At the end of our calls I'd ask him how he was doing. "We ran out of gowns," he told me one day. "My ICU is out of ventilators -- we're diverting people to Albany," he said another time.

"There's a difference between good intentions and good outcomes," I explained to her. She would wave me away and pick up. Inevitably the call would bring her tears. I stewed on the porch. My brother, uncle and I would spend hours trying to ease her mind and pacify her anxiety. Any inquiry or outreach was like sticking a finger in the open wound of her anguish.

I called my friend, the nurse practitioner, and gave him the latest update. He seemed upset. "You OK, dude?" "A nurse from my hospital died," he explained.

The nurses and doctors who took care of my father -- first for four days at NewYork-Presbyterian Lawrence Hospital, then for nearly a month at NewYork-Presbyterian/Columbia -- were always empathetic, straightforward and willing to trust me with complicated details.

About a week after writing -- then refusing to recover -- my father's obituary, his condition was continuing to improve.

"He's only improving," I told her, "because of the life-saving care you guys have given him. The whole city is in awe of you. They should have a parade for you down the Canyon of Heroes."

Covid-19 was new and largely unstudied. Maybe one of these seemingly odd treatments would work.

"Yesterday was a stumble, but we're getting back on course," I emailed the group. "We always knew this recovery wasn't going to be a straight line. It's important to remain resilient and optimistic even when there are temporary setbacks."

"Oh Lou, I've been waiting for your call. I have such good news. They are planning to extubate him tomorrow. They are going to take your father off the ventilator!" She was practically screaming with excitement. I was speechless.

I had been withholding certain information from my family and friends during this whole ordeal. My dad had developed a blood clot two weeks into his hospitalization. Clots are extremely dangerous, of course, but it was small and in a relatively manageable location.

I called my brother and told him about the plan to get my father off the ventilator. Since there were a number of contingencies, we debated telling my mother. She was living and dying with every update.

My father's breathing was labored on the morning they were planning to extubate. They delayed the procedure a day. That next morning, April 16, a doctor called. I was in the shower and rushed out to answer my cell. He said they were doing the extubation within the hour. What do we want to do if the extubation fails?

"It went as well as we could have hoped for," the doctor said. "His vitals are stable and he's breathing well. He's resting now." She explained that my father was disoriented and it probably wasn't a great idea to speak with him that day. Whatever, I thought, I'll speak with him when he gets home. He had been on a ventilator for 28 days.

I called the doctor later in the day. She told me my dad seemed distressed. He was trying to speak, but his vocal cords were too swollen. "It's so frustrating," she told me. "I don't know what he wants to tell me."

"Each facility has their own Covid rules," she explained. "I'll send you over a list." On the list was the nursing home where my grandfather had died several years before. My father had visited him every day.

I called the step-down unit where he had been the past three days. They transferred me to his nurse. "He's doing better, love. We took him off the pressor and his blood pressure is in a good range. His heart rate is good. He's breathing fine. The doctors decided he didn't need to go back to the ICU. He's ok."

"I've repeatedly said that recovery isn't a straight line. ... Yesterday we managed the roller coaster ride as a family. My brother, uncle and I were with my mother the entire day. We never lost hope or confidence in my dad's medical care and ultimate recovery. If there's a light at the end of the tunnel, it's a blinking one. Right now, it shines again."

I drove back to my mom's house. I scanned the block for my brother's car. He had not arrived. I parked. I have to wait for him and then tell my mother, brother and uncle all at once, right? Should I call my wife first? Should I call my dad's best friend?

I called my wife. I called my dad's best friend. I called the guys he grew up with. I called his former colleagues. I began every conversation the same way, "This is that call." I listened to each of them yell and cry and ask if I was serious. Then I said I had to make another call.

I wrote about my father's career. How he got his law degree at night school and became a prosecutor at the city, state, and federal level. How he convicted mobsters, drug dealers, and those who abused power.

I wrote about my dad's volunteer work -- at the Special Olympics, at an organization he founded that helps police families with special needs, and at just about any Italian-American group that needed a lawyer. He was so proud of his Italian-American heritage. He loathed the mafioso caricatures and stereotypes found on TV -- he wrote countless op-eds attacking those -- but he revered the old-school virtues he associated with his Italian-American upbringing: loyalty, humility, hard work, dedication to family.

He was a Covid patient for 31 days. It was a painful experience, but ultimately unimportant. It doesn't matter how a man dies. It matters how he lives.

The Yale-led study investigated the timing of this outgassing by modeling the effects of carbon dioxide and sulfur emissions on global temperatures and comparing them with paleotemperature records spanning the extinction. They found that at least 50% or more of the major outgassing from the Deccan Traps occurred well before the asteroid impact, and only the impact coincided with the mass extinction event.The volcanoes did "cause a warming event," but its effect had gone by the time extinction happened, said Michael Henehan, a former researcher at Yale who is now based at the GFZ German Research Centre for Geosciences.

The result has been a hidden revolution in how information is produced, circulated and acted upon

The world’s liberal democracies now confront a tragedy of the “un-commons.” Information spaces that people assume to be public are strictly ruled by private commercial interests for maximum profit.

The internet as a self-regulating market has been revealed as a failed experiment. Surveillance capitalism leaves a trail of social wreckage in its wake: the wholesale destruction of privacy, the intensification of social inequality, the poisoning of social discourse with defactualized information, the demolition of social norms and the weakening of democratic institutions.

These social harms are not random. They are tightly coupled effects of evolving economic operations. Each harm paves the way for the next and is dependent on what went before.

There is no way to escape the machine systems that surveil u

All roads to economic and social participation now lead through surveillance capitalism’s profit-maximizing institutional terrain, a condition that has intensified during nearly two years of global plague.

Will Facebook’s digital violence finally trigger our commitment to take back the “un-commons”?

Will we confront the fundamental but long ignored questions of an information civilization: How should we organize and govern the information and communication spaces of the digital century in ways that sustain and advance democratic values and principles?

Mark Zuckerberg’s start-up did not invent surveillance capitalism. Google did that. In 2000, when only 25 percent of the world’s information was stored digitally, Google was a tiny start-up with a great search product but little revenue.

By 2001, in the teeth of the dot-com bust, Google’s leaders found their breakthrough in a series of inventions that would transform advertising. Their team learned how to combine massive data flows of personal information with advanced computational analyses to predict where an ad should be placed for maximum “click through.”

Google’s scientists learned how to extract predictive metadata from this “data exhaust” and use it to analyze likely patterns of future behavior.

Prediction was the first imperative that determined the second imperative: extraction.

Lucrative predictions required flows of human data at unimaginable scale. Users did not suspect that their data was secretly hunted and captured from every corner of the internet and, later, from apps, smartphones, devices, cameras and sensors

User ignorance was understood as crucial to success. Each new product was a means to more “engagement,” a euphemism used to conceal illicit extraction operations.

When asked “What is Google?” the co-founder Larry Page laid it out in 2001,

“Storage is cheap. Cameras are cheap. People will generate enormous amounts of data,” Mr. Page said. “Everything you’ve ever heard or seen or experienced will become searchable. Your whole life will be searchable.”

Instead of selling search to users, Google survived by turning its search engine into a sophisticated surveillance medium for seizing human data

Company executives worked to keep these economic operations secret, hidden from users, lawmakers, and competitors. Mr. Page opposed anything that might “stir the privacy pot and endanger our ability to gather data,” Mr. Edwards wrote.

As recently as 2017, Eric Schmidt, the executive chairman of Google’s parent company, Alphabet, acknowledged the role of Google’s algorithmic ranking operations in spreading corrupt information. “There is a line that we can’t really get across,” he said. “It is very difficult for us to understand truth.” A company with a mission to organize and make accessible all the world’s information using the most sophisticated machine systems cannot discern corrupt information.

This is the economic context in which disinformation wins

In March 2008, Mr. Zuckerberg hired Google’s head of global online advertising, Sheryl Sandberg, as his second in command. Ms. Sandberg had joined Google in 2001 and was a key player in the surveillance capitalism revolution. She led the build-out of Google’s advertising engine, AdWords, and its AdSense program, which together accounted for most of the company’s $16.6 billion in revenue in 2007.

A Google multimillionaire by the time she met Mr. Zuckerberg, Ms. Sandberg had a canny appreciation of Facebook’s immense opportunities for extraction of rich predictive data. “We have better information than anyone else. We know gender, age, location, and it’s real data as opposed to the stuff other people infer,” Ms. Sandberg explained

The company had “better data” and “real data” because it had a front-row seat to what Mr. Page had called “your whole life.”

Facebook paved the way for surveillance economics with new privacy policies in late 2009. The Electronic Frontier Foundation warned that new “Everyone” settings eliminated options to restrict the visibility of personal data, instead treating it as publicly available information.

Mr. Zuckerberg “just went for it” because there were no laws to stop him from joining Google in the wholesale destruction of privacy. If lawmakers wanted to sanction him as a ruthless profit-maximizer willing to use his social network against society, then 2009 to 2010 would have been a good opportunity.

Facebook was the first follower, but not the last. Google, Facebook, Amazon, Microsoft and Apple are private surveillance empires, each with distinct business models.

In 2021 these five U.S. tech giants represent five of the six largest publicly traded companies by market capitalization in the world.

As we move into the third decade of the 21st century, surveillance capitalism is the dominant economic institution of our time. In the absence of countervailing law, this system successfully mediates nearly every aspect of human engagement with digital information

Today all apps and software, no matter how benign they appear, are designed to maximize data collection.

Historically, great concentrations of corporate power were associated with economic harms. But when human data are the raw material and predictions of human behavior are the product, then the harms are social rather than economic

The difficulty is that these novel harms are typically understood as separate, even unrelated, problems, which makes them impossible to solve. Instead, each new stage of harm creates the conditions for the next stage.

Fifty years ago the conservative economist Milton Friedman exhorted American executives, “There is one and only one social responsibility of business — to use its resources and engage in activities designed to increase its profits so long as it stays within the rules of the game.” Even this radical doctrine did not reckon with the possibility of no rules.

With privacy out of the way, ill-gotten human data are concentrated within private corporations, where they are claimed as corporate assets to be deployed at will.

The sheer size of this knowledge gap is conveyed in a leaked 2018 Facebook document, which described its artificial intelligence hub, ingesting trillions of behavioral data points every day and producing six million behavioral predictions each second.

Next, these human data are weaponized as targeting algorithms, engineered to maximize extraction and aimed back at their unsuspecting human sources to increase engagement

Targeting mechanisms change real life, sometimes with grave consequences. For example, the Facebook Files depict Mr. Zuckerberg using his algorithms to reinforce or disrupt the behavior of billions of people. Anger is rewarded or ignored. News stories become more trustworthy or unhinged. Publishers prosper or wither. Political discourse turns uglier or more moderate. People live or die.

Occasionally the fog clears to reveal the ultimate harm: the growing power of tech giants willing to use their control over critical information infrastructure to compete with democratically elected lawmakers for societal dominance.

when it comes to the triumph of surveillance capitalism’s revolution, it is the lawmakers of every liberal democracy, especially in the United States, who bear the greatest burden of responsibility. They allowed private capital to rule our information spaces during two decades of spectacular growth, with no laws to stop it.

All of it begins with extraction. An economic order founded on the secret massive-scale extraction of human data assumes the destruction of privacy as a nonnegotiable condition of its business operations.

We can’t fix all our problems at once, but we won’t fix any of them, ever, unless we reclaim the sanctity of information integrity and trustworthy communications

The abdication of our information and communication spaces to surveillance capitalism has become the meta-crisis of every republic, because it obstructs solutions to all other crises.

Neither Google, nor Facebook, nor any other corporate actor in this new economic order set out to destroy society, any more than the fossil fuel industry set out to destroy the earth.

like global warming, the tech giants and their fellow travelers have been willing to treat their destructive effects on people and society as collateral damage — the unfortunate but unavoidable byproduct of perfectly legal economic operations that have produced some of the wealthiest and most powerful corporations in the history of capitalism.

Where does that leave us?

Democracy is the only countervailing institutional order with the legitimate authority and power to change our course. If the ideal of human self-governance is to survive the digital century, then all solutions point to one solution: a democratic counterrevolution.

instead of the usual laundry lists of remedies, lawmakers need to proceed with a clear grasp of the adversary: a single hierarchy of economic causes and their social harms.

We can’t rid ourselves of later-stage social harms unless we outlaw their foundational economic causes

This means we move beyond the current focus on downstream issues such as content moderation and policing illegal content. Such “remedies” only treat the symptoms without challenging the illegitimacy of the human data extraction that funds private control over society’s information spaces

Similarly, structural solutions like “breaking up” the tech giants may be valuable in some cases, but they will not affect the underlying economic operations of surveillance capitalism.

Instead, discussions about regulating big tech should focus on the bedrock of surveillance economics: the secret extraction of human data from realms of life once called “private.

No secret extraction means no illegitimate concentrations of knowledge about people. No concentrations of knowledge means no targeting algorithms. No targeting means that corporations can no longer control and curate information flows and social speech or shape human behavior to favor their interests

the sober truth is that we need lawmakers ready to engage in a once-a-century exploration of far more basic questions:

How should we structure and govern information, connection and communication in a democratic digital century?

What new charters of rights, legislative frameworks and institutions are required to ensure that data collection and use serve the genuine needs of individuals and society?

What measures will protect citizens from unaccountable power over information, whether it is wielded by private companies or governments?

The corporation that is Facebook may change its name or its leaders, but it will not voluntarily change its economics.

The devices have become part of many students’ daily lives, despite various attempts over the years by state legislatures and cities to keep them out of classrooms.

Despite any emotional benefits for adults or educational use for children, screen-time and security experts don’t recommend taking smartphones to class, at least not without some ground rules and guidance on how to use them in a worst-case scenario.

A phone can make unwanted noises, and in a silent lockdown, even a vibration could be too loud. Depending on their age, kids might also be tempted to post about an ongoing incident to social media, which Trump said could both inspire other potential gunmen seeking fame or reveal details about their location. Even the ability to call 911 isn’t a good reason, because an entire school full of people calling at once could overload a switchboard.

She said it’s a distraction, and she worries it could replace in-person social interactions and knows she can’t have oversight over many conversations or posts that might happen via smartphone.

She’s also worried about misinformation that her daughter could see or read.

“Phones are not going to stop school shootings. Gun control might,” Twenge said.

The state law, referred to as HB 20, makes it illegal for large social networks like Facebook and Twitter to "block, ban, remove, de-platform, demonetize, de-boost, restrict, deny equal access or visibility to, or otherwise discriminate against expression."

HB 20 does carve out exemptions, including those that allow social networks to remove content that "directly incites criminal activity or consists of specific threats of violence targeted against a person or group" based on certain characteristics, or that "is unlawful expression."

We need to fix social networks by removing toxic content. This month's appeals court ruling does the exact opposite and could even deal a fatal blow to social media as we know it. The only thing worse than not fixing the social platforms we have now would be to see them be subject to a constant slew of lawsuits or devolve into platforms that become bastions of hate speech and misinformation. Let's hope Congress doesn't let us down.

Quantum teleportation — what he called “spooky action at a distance” — can transfer information between locations without actually moving the physical matter that holds it.

This technology could profoundly change the way data travels from place to place. It draws on more than a century of research involving quantum mechanics, a field of physics that governs the subatomic realm and behaves unlike anything we experience in our everyday lives. Quantum teleportation not only moves data between quantum computers, but it also does so in such a way that no one can intercept it.

These entangled systems could be electrons, particles of light or other objects. In the Netherlands, Dr. Hanson and his team used what is called a nitrogen vacancy center — a tiny empty space in a synthetic diamond in which electrons can be trapped.

Traditional computers perform calculations by processing “bits” of information, with each bit holding either a 1 or a 0. By harnessing the strange behavior of quantum mechanics, a quantum bit, or qubit, can store a combination of 1 and 0 — a little like how a spinning coin holds the tantalizing possibility that it will turn up either heads or tails when it finally falls flat on the table.

Researchers believe these devices could one day speed the creation of new medicines, power advances in artificial intelligence and summarily crack the encryption that protects computers vital to national security. Across the globe, governments, academic labs, start-ups and tech giants are spending billions of dollars exploring the technology.

Although it cannot move objects from place to place, it can move information by taking advantage of a quantum property called “entanglement”: A change in the state of one quantum system instantaneously affects the state of another, distant one.

“It does not work that way today. Google knows what you are running on its servers.”

The information also cannot be intercepted. A future quantum internet, powered by quantum teleportation, could provide a new kind of encryption that is theoretically unbreakable.

Perhaps the best example of what Twitter offers now—and what we stand to gain or lose from its demise—is illustrated by the path charted by public-health officials, epidemiologists, doctors, and nurses over the past three years.

They offered guidance that a flailing government response was too slow to provide, and helped cobble together an epidemiological picture of infections and case counts. At a moment when people were terrified and looking for any information at all, Twitter seemed to offer a steady stream of knowledgeable, diligent experts.

But Twitter does another thing quite well, and that’s crushing users with the pressures of algorithmic rewards and all of the risks, exposure, and toxicity that come with virality

t imagining a world without it can feel impossible. What do our politics look like without the strange feedback loop of a Twitter-addled political press and a class of lawmakers that seems to govern more via shitposting than by legislation

What happens if the media lose what the writer Max Read recently described as a “way of representing reality, and locating yourself within it”? The answer is probably messy.

here’s the worry that, absent a distributed central nervous system like Twitter, “the collective worldview of the ‘media’ would instead be over-shaped, from the top down, by the experiences and biases of wealthy publishers, careerist editors, self-loathing journalists, and canny operators operating in relatively closed social and professional circles.”

many of the most hyperactive, influential twitterati (cringe) of the mid-2010s have built up large audiences and only broadcast now: They don’t read their mentions, and they rarely engage. In private conversations, some of those people have expressed a desire to see Musk torpedo the site and put a legion of posters out of their misery.

Many of the past decade’s most polarizing and influential figures—people such as Donald Trump and Musk himself, who captured attention, accumulated power, and fractured parts of our public consciousness—were also the ones who were thought to be “good” at using the website.

the effects of Twitter’s chief innovation—its character limit—on our understanding of language, nuance, and even truth.

“These days, it seems like we are having languages imposed on us,” he said. “The fact that you have a social media that tells you how many characters to use, this is language imposition. You have to wonder about the agenda there. Why does anyone want to restrict the full range of my language? What’s the game there?

in McLuhanian fashion, the constraints and the architecture change not only what messages we receive but how we choose to respond. Often that choice is to behave like the platform itself: We are quicker to respond and more aggressive than we might be elsewhere, with a mindset toward engagement and visibility

it’s easy to argue that we stand to gain something essential and human if we lose Twitter. But there is plenty about Twitter that is also essential and human.

No other tool has connected me to the world—to random bits of news, knowledge, absurdist humor, activism, and expertise, and to scores of real personal interactions—like Twitter has

What makes evaluating a life beyond Twitter so hard is that everything that makes the service truly special is also what makes it interminable and toxic.

the worst experience you can have on the platform is to “win” and go viral. Generally, it seems that the more successful a person is at using Twitter, the more they refer to it as a hellsite.

“I continued to be duped by ChatGPT. It’s embarrassing,” Mr. Schwartz said.

As Mr. Schwartz answered the judge’s questions, the reaction in the courtroom, crammed with close to 70 people who included lawyers, law students, law clerks and professors, rippled across the benches. There were gasps, giggles and sighs. Spectators grimaced, darted their eyes around, chewed on pens.

“This case has reverberated throughout the entire legal profession,” said David Lat, a legal commentator. “It is a little bit like looking at a car wreck.”

The episode, which arose in an otherwise obscure lawsuit, has riveted the tech world, where there has been a growing debate about the dangers — even an existential threat to humanity — posed by artificial intelligence. It has also transfixed lawyers and judges.

Avianca asked Judge Castel to dismiss the lawsuit because the statute of limitations had expired. Mr. Mata’s lawyers responded with a 10-page brief citing more than half a dozen court decisions, with names like Martinez v. Delta Air Lines, Zicherman v. Korean Air Lines and Varghese v. China Southern Airlines, in support of their argument that the suit should be allowed to proceed.After Avianca’s lawyers could not locate the cases, Judge Castel ordered Mr. Mata’s lawyers to provide copies. They submitted a compendium of decisions.It turned out the cases were not real.

Mr. Schwartz, who has practiced law in New York for 30 years, said in a declaration filed with the judge this week that he had learned about ChatGPT from his college-aged children and from articles, but that he had never used it professionally.He told Judge Castel on Thursday that he had believed ChatGPT had greater reach than standard databases.“I heard about this new site, which I falsely assumed was, like, a super search engine,” Mr. Schwartz said.

Irina Raicu, who directs the internet ethics program at Santa Clara University, said this week that the Avianca case clearly showed what critics of such models have been saying, “which is that the vast majority of people who are playing with them and using them don’t really understand what they are and how they work, and in particular what their limitations are.”

“This case has changed the urgency of it,” Professor Roiphe said. “There’s a sense that this is not something that we can mull over in an academic way. It’s something that has affected us right now and has to be addressed.”

In the declaration Mr. Schwartz filed this week, he described how he had posed questions to ChatGPT, and each time it seemed to help with genuine case citations. He attached a printout of his colloquy with the bot, which shows it tossing out words like “sure” and “certainly!”After one response, ChatGPT said cheerily, “I hope that helps!”

we’re networked organisms who move around in shifting surroundings, environments that have the power to transform our thinking

Annie Murphy Paul’s new book, “The Extended Mind,” which exhorts us to use our entire bodies, our surroundings and our relationships to “think outside the brain.”

In 2011, she published “Origins,” which focused on all the ways we are shaped by the environment, before birth and minute to minute thereafter.

“In the nature-nurture dynamic, nurture begins at the time of conception. The food the mother eats, the air she breathes, the water she drinks, the stress or trauma she experiences — all may affect her child for better or worse, over the decades to come.”

a down-to-earth take on the science of epigenetics — how environmental signals become catalysts for gene expression

the parallel to this latest book is that the boundaries we commonly assume to be fixed are actually squishy. The moment of a child’s birth, her I.Q. scores or fMRI snapshots of what’s going on inside her brain — all are encroached upon and influenced by outside forces.

awareness of our internal signals, such as exactly when our hearts beat, or how cold and clammy our hands are, can boost our performance at the poker table or in the financial markets, and even improve our pillow talk

“Though we typically think of the brain as telling the body what to do, just as much does the body guide the brain with an array of subtle nudges and prods. One psychologist has called this guide our ‘somatic rudder,’

The “body scan” aspect of mindfulness meditation that has been deployed by the behavioral medicine pioneer Jon Kabat-Zinn may help people lower their heart rates and blood pressure,

techniques that help us pinpoint their signals can foster well-being

Tania Singer has shown how the neural circuitry underlying compassion is strengthened by meditation practice

our thoughts “are powerfully shaped by the way we move our bodies.” Gestures help us understand spatial concepts; indeed, “without gesture as an aid, students may fail to understand spatial ideas at all,”

looking out on grassy expanses near loose clumps of trees and a source of water helps us solve problems. “Passive attention,” she writes, is “effortless: diffuse and unfocused, it floats from object to object, topic to topic. This is the kind of attention evoked by nature, with its murmuring sounds and fluid motions; psychologists working in the tradition of James call this state of mind ‘soft fascination.’”

The chapters on the ways natural and built spaces reflect universal preferences and enhance the thinking process felt like a respite

agents will open up many more learning opportunities.

Already, AI can help you pick out a new TV and recommend movies, books, shows, and podcasts. Likewise, a company I’ve invested in, recently launched Pix, which lets you ask questions (“Which Robert Redford movies would I like and where can I watch them?”) and then makes recommendations based on what you’ve liked in the past

Productivity

copilots can do a lot—such as turn a written document into a slide deck, answer questions about a spreadsheet using natural language, and summarize email threads while representing each person’s point of view.

before the sophisticated agents I’m describing become a reality, we need to confront a number of questions about the technology and how we’ll use it.

Helping patients and healthcare workers will be especially beneficial for people in poor countries, where many never get to see a doctor at all.

To create a new app or service, you won’t need to know how to write code or do graphic design. You’ll just tell your agent what you want. It will be able to write the code, design the look and feel of the app, create a logo, and publish the app to an online store

Agents will do even more. Having one will be like having a person dedicated to helping you with various tasks and doing them independently if you want. If you have an idea for a business, an agent will help you write up a business plan, create a presentation for it, and even generate images of what your product might look like

For decades, I’ve been excited about all the ways that software would make teachers’ jobs easier and help students learn. It won’t replace teachers, but it will supplement their work—personalizing the work for students and liberating teachers from paperwork and other tasks so they can spend more time on the most important parts of the job.

Mental health care is another example of a service that agents will make available to virtually everyone. Today, weekly therapy sessions seem like a luxury. But there is a lot of unmet need, and many people who could benefit from therapy don’t have access to it.

I don’t think any single company will dominate the agents business--there will be many different AI engines available.

The real shift will come when agents can help patients do basic triage, get advice about how to deal with health problems, and decide whether they need to seek treatment.

They’ll replace word processors, spreadsheets, and other productivity apps.

Education

For example, few families can pay for a tutor who works one-on-one with a student to supplement their classroom work. If agents can capture what makes a tutor effective, they’ll unlock this supplemental instruction for everyone who wants it. If a tutoring agent knows that a kid likes Minecraft and Taylor Swift, it will use Minecraft to teach them about calculating the volume and area of shapes, and Taylor’s lyrics to teach them about storytelling and rhyme schemes. The experience will be far richer—with graphics and sound, for example—and more personalized than today’s text-based tutors.

your agent will be able to help you in the same way that personal assistants support executives today. If your friend just had surgery, your agent will offer to send flowers and be able to order them for you. If you tell it you’d like to catch up with your old college roommate, it will work with their agent to find a time to get together, and just before you arrive, it will remind you that their oldest child just started college at the local university.

To see the dramatic change that agents will bring, let’s compare them to the AI tools available today. Most of these are bots. They’re limited to one app and generally only step in when you write a particular word or ask for help. Because they don’t remember how you use them from one time to the next, they don’t get better or learn any of your preferences.

The current state of the art is Khanmigo, a text-based bot created by Khan Academy. It can tutor students in math, science, and the humanities—for example, it can explain the quadratic formula and create math problems to practice on. It can also help teachers do things like write lesson plans.

Businesses that are separate today—search advertising, social networking with advertising, shopping, productivity software—will become one business.

other issues won’t be decided by companies and governments. For example, agents could affect how we interact with friends and family. Today, you can show someone that you care about them by remembering details about their life—say, their birthday. But when they know your agent likely reminded you about it and took care of sending flowers, will it be as meaningful for them?

In the computing industry, we talk about platforms—the technologies that apps and services are built on. Android, iOS, and Windows are all platforms. Agents will be the next platform.

A shock wave in the tech industry

Agents won’t simply make recommendations; they’ll help you act on them. If you want to buy a camera, you’ll have your agent read all the reviews for you, summarize them, make a recommendation, and place an order for it once you’ve made a decision.

Agents will affect how we use software as well as how it’s written. They’ll replace search sites because they’ll be better at finding information and summarizing it for you

they’ll be dramatically better. You’ll be able to have nuanced conversations with them. They will be much more personalized, and they won’t be limited to relatively simple tasks like writing a letter.

Companies will be able to make agents available for their employees to consult directly and be part of every meeting so they can answer questions.

AI agents that are well trained in mental health will make therapy much more affordable and easier to get. Wysa and Youper are two of the early chatbots here. But agents will go much deeper. If you choose to share enough information with a mental health agent, it will understand your life history and your relationships. It’ll be available when you need it, and it will never get impatient. It could even, with your permission, monitor your physical responses to therapy through your smart watch—like if your heart starts to race when you’re talking about a problem with your boss—and suggest when you should see a human therapist.

If the number of companies that have started working on AI just this year is any indication, there will be an exceptional amount of competition, which will make agents very inexpensive.

Agents are smarter. They’re proactive—capable of making suggestions before you ask for them. They accomplish tasks across applications. They improve over time because they remember your activities and recognize intent and patterns in your behavior. Based on this information, they offer to provide what they think you need, although you will always make the final decisions.

Agents are not only going to change how everyone interacts with computers. They’re also going to upend the software industry, bringing about the biggest revolution in computing since we went from typing commands to tapping on icons.

The most exciting impact of AI agents is the way they will democratize services that today are too expensive for most people

The ramifications for the software business and for society will be profound.

In the next five years, this will change completely. You won’t have to use different apps for different tasks. You’ll simply tell your device, in everyday language, what you want to do. And depending on how much information you choose to share with it, the software will be able to respond personally because it will have a rich understanding of your life. In the near future, anyone who’s online will be able to have a personal assistant powered by artificial intelligence that’s far beyond today’s technology.

You’ll also be able to get news and entertainment that’s been tailored to your interests. CurioAI, which creates a custom podcast on any subject you ask about, is a glimpse of what’s coming.

An agent will be able to help you with all your activities if you want it to. With permission to follow your online interactions and real-world locations, it will develop a powerful understanding of the people, places, and activities you engage in. It will get your personal and work relationships, hobbies, preferences, and schedule. You’ll choose how and when it steps in to help with something or ask you to make a decision.

even the best sites have an incomplete understanding of your work, personal life, interests, and relationships and a limited ability to use this information to do things for you. That’s the kind of thing that is only possible today with another human being, like a close friend or personal assistant.

In the distant future, agents may even force humans to face profound questions about purpose. Imagine that agents become so good that everyone can have a high quality of life without working nearly as much. In a future like that, what would people do with their time? Would anyone still want to get an education when an agent has all the answers? Can you have a safe and thriving society when most people have a lot of free time on their hands?

They’ll have an especially big influence in four areas: health care, education, productivity, and entertainment and shopping.

starting in the mid-2010s, those beloved blue skies began to disappear. First, the smoke came in occasional bursts, from wildfires in Canada or California or Siberia, and blew away when the wind changed direction. Within a few summers, though, it was coming in thicker, from more directions at once, and lasting longer.

Sometimes there were weeks when you were advised not to open your windows or exercise outside. Sometimes there were long stretches where you weren’t supposed to breathe the outside air at all.

Now lots of Bryant’s clients wanted to talk about climate change. They wanted to talk about how strange and disorienting and scary this new reality felt, about what the future might be like and how they might face it, about how to deal with all the strong feelings — helplessness, rage, depression, guilt — being stirred up inside them.

As a therapist, Bryant found himself unsure how to respond

while his clinical education offered lots of training in, say, substance abuse or family therapy, there was nothing about environmental crisis, or how to treat patients whose mental health was affected by it

Bryant immersed himself in the subject, joining and founding associations of climate-concerned therapists

could now turn to resources like the list maintained by the Climate Psychology Alliance North America, which contains more than 100 psychotherapists around the country who are what the organization calls “climate aware.”

Over and over, he read the same story, of potential patients who’d gone looking for someone to talk to about climate change and other environmental crises, only to be told that they were overreacting — that their concern, and not the climate, was what was out of whack and in need of treatment.

“You come in and talk about how anxious you are that fossil-fuel companies continue to pump CO2 into the air, and your therapist says, ‘So, tell me about your mother.’”

In many of the messages, people asked Bryant for referrals to climate-focused therapists in Houston or Canada or Taiwan, wherever it was the writer lived.

his practice had shifted to reflect a new reality of climate psychology. His clients didn’t just bring up the changing climate incidentally, or during disconcerting local reminders; rather, many were activists or scientists or people who specifically sought out Bryant because of their concerns about the climate crisis.

Climate change, in other words, surrounds us with constant reminders of “ethical dilemmas and deep social criticism of modern society. In its essence, climate crisis questions the relationship of humans with nature and the meaning of being human in the Anthropocene.”

It had been a challenging few years, Bryant told me when I first called to talk about his work. There were some ways in which climate fears were a natural fit in the therapy room, and he believed the field had coalesced around some answers that felt clear and useful

But treating those fears also stirred up lots of complicated questions that no one was quite sure how to answer. The traditional focus of his field, Bryant said, could be oversimplified as “fixing the individual”: treating patients as separate entities working on their personal growth

Climate change, by contrast, was a species-wide problem, a profound and constant reminder of how deeply intertwined we all are in complex systems — atmospheric, biospheric, economic — that are much bigger than us. It sometimes felt like a direct challenge to old therapeutic paradigms — and perhaps a chance to replace them with something better.

In one of climate psychology’s founding papers, published in 2011, Susan Clayton and Thomas J. Doherty posited that climate change would have “significant negative effects on mental health and well-being.” They described three broad types of possible impacts: the acute trauma of living through climate disasters; the corroding fear of a collapsing future; and the psychosocial decay that could damage the fabric of communities dealing with disruptive changes

All of these, they wrote, would make the climate crisis “as much a psychological and social phenomenon as a matter of biodiversity and geophysics.”

Many of these predictions have since been borne out

Studies have found rates of PTSD spiking in the wake of disasters, and in 2017 the American Psychological Association defined “ecoanxiety” as “a chronic fear of environmental doom.”

Climate-driven migration is on the rise, and so are stories of xenophobia and community mistrust.

eventually started a website, Climate & Mind, to serve as a sort of clearing house for other therapists searching for resources. Instead, the site became an unexpected window into the experience of would-be patients: Bryant found himself receiving messages from people around the world who stumbled across it while looking for help.

Many say it has led to symptoms of depression or anxiety; more than a quarter make an active effort not to think about it.

A poll by the American Psychiatric Association in the same year found that nearly half of Americans think climate change is already harming the nation’s mental health.

In June, the Yale Journal of Biology and Medicine published a paper cautioning that the world at large was facing “a psychological condition of ‘systemic uncertainty,’” in which “difficult emotions arise not only from experiencing the ecological loss itself,” but also from the fact that our lives are inescapably embedded in systems that keep on making those losses worse.

According to a 2022 survey by Yale and George Mason University, a majority of Americans report that they spend time worrying about climate change.

This is not an easy way to live.

Living within a context that is obviously unhealthful, he wrote, is painful: “a dimly intuited ‘fall’ from which we spend our lives trying to recover, a guilt we can never quite grasp or expiate” — a feeling of loss or dislocation whose true origins we look for, but often fail to see. This confusion leaves us feeling even worse.

When Barbara Easterlin first started studying environmental psychology 30 years ago, she told me, the focus of study was on ways in which cultivating a relationship with nature can be good for mental health

There was little or no attention to the fact that living through, or helping to cause, a collapse of nature can also be mentally harmful.

the field is still so new that it does not yet have evidence-tested treatments or standards of practice. Therapists sometimes feel as if they are finding the path as they go.

Rebecca Weston, a licensed clinical social worker practicing in New York and a co-president of the CPA-NA, told me that when she treats anxiety disorders, her goal is often to help the patient understand how much of their fear is internally produced — out of proportion to the reality they’re facing

climate anxiety is a different challenge, because people worried about climate change and environmental breakdown are often having the opposite experience: Their worries are rational and evidence-based, but they feel isolated and frustrated because they’re living in a society that tends to dismiss them.

One of the emerging tenets of climate psychology is that counselors should validate their clients’ climate-related emotions as reasonable, not pathological

it does mean validating that feelings like grief and fear and shame aren’t a form of sickness, but, as Weston put it, “are actually rational responses to a world that’s very scary and very uncertain and very dangerous for people

In the words of a handbook on climate psychology, “Paying heed to what is happening in our communities and across the globe is a healthier response than turning away in denial or disavowal.”

But this, too, raises difficult questions. “How much do we normalize people to the system we’re in?” Weston asked. “And is that the definition of health?

Or is the definition of health resisting the things that are making us so unhappy? That’s the profound tension within our field.”

“It seems to shift all the time, the sort of content and material that people are bringing in,” Alexandra Woollacott, a psychotherapist in Seattle, told the group. Sometimes it was a pervasive anxiety about the future, or trauma responses to fires or smoke or heat; other times, clients, especially young ones, wanted to vent their “sort of righteous anger and sense of betrayal” at the various powers that had built and maintained a society that was so destructive.

“I’m so glad that we have each other to process this,” she said, “because we’re humans living through this, too. I have my own trauma responses to it, I have my own grief process around it, I have my own fury at government and oil companies, and I think I don’t want to burden my clients with my own emotional response to it.”

In a field that has long emphasized boundaries, discouraging therapists from bringing their own issues or experiences into the therapy room, climate therapy offers a particular challenge: Separation can be harder when the problems at hand affect therapist and client alike

Some therapists I spoke to were worried about navigating the breakdown of barriers, while others had embraced it. “There is no place on the planet that won’t eventually be impacted, where client and therapist won’t be in it together,” a family therapist wrote in a CPA-NA newsletter. “Most therapists I know have become more vulnerable and self-disclosing in their practice.”

“If you look at or consider typical theoretical framings of something like post-traumatic growth, which is the understanding of this idea that people can sort of grow and become stronger and better after a traumatic event,” she said, then the climate crisis poses a dilemma because “there is no afterwards, right? There is no resolution anytime in our lifetimes to this crisis that we nonetheless have to build the capacities to face and to endure and to hopefully engage.”

“How,” she asked, “do you think about resilience apart from resolution?”

many of her patients are also disconnected from the natural world, which means that they struggle to process or even recognize the grief and alienation that comes from living in a society that treats nature as other, a resource to be used and discarded.

“I’m so excited by what you’re bringing in,” Woollacott replied. “I’m doing psychoanalytic training at the moment, and we study attachment theory” — how the stability of early emotional bonds affects future relationships and feelings of well-being. “But nowhere in the literature does it talk about our attachment to the land.”

Torres said that she sometimes takes her therapy sessions outside or asks patients to remember their earliest and deepest connections with animals or plants or places. She believes it will help if they learn to think of themselves “as rooted beings that aren’t just simply living in the human overlay on the environment.” It was valuable to recognize, she said, that “we are part of the land” and suffer when it suffers.

Torres described introducing her clients to methods — mindfulness, distress tolerance, emotion regulation — to help them manage acute feelings of stress or panic and to avoid the brittleness of burnout.

She also encourages them to narrativize the problem, including themselves as agents of change inside stories about how they came to be in this situation, and how they might make it different.

then she encourages them to find a community of other people who care about the same problems, with whom they could connect outside the therapy room. As Woollacott said earlier: “People who share your values. People who are committed to not looking away.”

Dwyer told the group that she had been thinking more about psychological adaptation as a form of climate mitigation

Therapy, she said, could be a way to steward human energy and creative capacities at a time when they’re most needed.

It was hard, Bryant told me when we first spoke, to do this sort of work without finding yourself asking bigger questions — namely, what was therapy actually about?

Many of the therapists I talked to spoke of their role not as “fixing” a patient’s problem or responding to a pathology, but simply giving their patients the tools to name and explore their most difficult emotions, to sit with painful feelings without instantly running away from them

many of the methods in their traditional tool kits continue to be useful in climate psychology. Anxiety and hopelessness and anger are all familiar territory, after all, with long histories of well-studied treatments.

They focused on trying to help patients develop coping skills and find meaning amid destabilization, to still see themselves as having agency and choice.

Weston, the therapist in New York, has had patients who struggle to be in a world that surrounds them with waste and trash, who experience panic because they can never find a place free of reminders of their society’s destruction

eston said, that she has trouble with the repeated refrain that therapist and patient experiencing the same losses and dreads at the same time constituted a major departure from traditional therapeutic practice

she believed this framing reflected and reinforced a bias inherent in a field that has long been most accessible to, and practiced by, the privileged. It was hardly new in the world, after all, to face the collapse of your entire way of life and still find ways to keep going.

Lately, Bryant told me, he’s been most excited about the work that happens outside the therapy room: places where groups of people gather to talk about their feelings and the future they’re facing

It was at such a meeting — a community event where people were brainstorming ways to adapt to climate chaos — that Weston, realizing she had concrete skills to offer, was inspired to rework her practice to focus on the challenge. She remembers finding the gathering empowering and energizing in a way she hadn’t experienced before. In such settings, it was automatic that people would feel embraced instead of isolated, natural that the conversation would start moving away from the individual and toward collective experiences and ideas.

There was no fully separate space, to be mended on its own. There was only a shared and broken world, and a community united in loving it.

New financial constraints on family formation are a potential cause, as implied by another striking finding in the Journal poll — 78 percent of adults lack confidence this generation of children will enjoy a better life than they do.

Yet a recent analysis for the Aspen Economic Strategy Group by Melissa S. Kearney and Phillip B. Levine, economics professors at the University of Maryland and Wellesley College, respectively, determined that “beyond the temporary effects of the Great Recession, no recent economic or policy change is responsible for a meaningful share of the decline in the US fertility rate since 2007.”

Their study took account of such factors as the high cost of child care, student debt service and housing as well as Medicaid coverage and the wider availability of long-acting reversible contraception. Yet they had “no success finding evidence” that any of these were decisive.

Kearney and Levine speculated instead that the answers lie in the cultural zeitgeist — “shifting priorities across cohorts of young adults,”

A possibility worth considering, they suggested, is that young adults who experienced “intensive parenting” as children now balk at the heavy investment of time and resources needed to raise their own kids that way: It would clash with their career and leisure goals.

another event that year: Apple released the first iPhone, a revolutionary cultural moment if there ever was one. The ensuing smartphone-enabled social media boom — Facebook had opened membership to anyone older than 13 in 2006 — forever changed how human beings relate with one another.

We are just beginning to understand this development’s effect on mental health, education, religious observance, community cohesion — everything. Why wouldn’t it also affect people’s willingness to have children?

one indirect way new media affect childbearing rates is through “time competition effects” — essentially, hours spent watching the tube cannot be spent forming romantic partnerships.

a 2021 review of survey data on young adults and adolescents in the United States and other countries, the years between 2009 and 2018 saw a marked decline in reported sexual activity.

the authors hypothesized that people are distracted from the search for partners by “increasing use of computer games and social media.

during the late 20th century, Brazil’s fertility rates fell after women who watched soap operas depicting smaller families sought to emulate them by having fewer children themselves.

This may be an area where incentives do not influence behavior, at least not enough. Whether the cultural shift to lower birthrates occurs on an accelerated basis, as in the United States after 2007, or gradually, as it did in Japan, it appears permanent — “sticky,” as policy wonks say.

Defining the Anthropocene: nine sites are in the running to be given the ‘golden spike’ designation

Mentioning the Jurassic period, for instance, helps scientists to picture plants and animals that were alive during that time

“The Anthropocene represents an umbrella for all of these different changes that humans have made to the planet,”

Typically, researchers will agree that a specific change in Earth’s geology must be captured in the official timeline. The ICS will then determine which set of rock layers, called strata, best illustrates that change, and it will choose which layer marks its lower boundary

This is called the Global Stratotype Section and Point (GSSP), and it is defined by a signal, such as the first appearance of a fossil species, trapped in the rock, mud or other material. One location is chosen to represent the boundary, and researchers mark this site physically with a golden spike, to commemorate it.

“It’s a label,” says Colin Waters, who chairs the AWG and is a geologist at the University of Leicester, UK. “It’s a great way of summarizing a lot of concepts into one word.”

But the Anthropocene has posed problems. Geologists want to capture it in the timeline, but its beginning isn’t obvious in Earth’s strata, and signs of human activity have never before been part of the defining process.

“We had a vague idea about what it might be, [but] we didn’t know what kind of hard evidence would go into it.”

Years of debate among the group’s multidisciplinary members led them to identify a host of signals — radioactive isotopes from nuclear-bomb tests, ash from fossil-fuel combustion, microplastics, pesticides — that would be trapped in the strata of an Anthropocene-defining site. These began to appear in the early 1950s, when a booming human population started consuming materials and creating new ones faster than ever.

Why do some geologists oppose the Anthropocene as a new epoch?“It misrepresents what we do” in the ICS, says Stanley Finney, a stratigrapher at California State University, Long Beach, and secretary-general for the International Union of Geological Sciences (IUGS). The AWG is working backwards, Finney says: normally, geologists identify strata that should enter the geological timescale before considering a golden spike; in this case, they’re seeking out the lower boundary of an undefined set of geological layers.

Lucy Edwards, a palaeontologist who retired in 2008 from the Florence Bascom Geoscience Center in Reston, Virginia, agrees. For her, the strata that might define the Anthropocene do not yet exist because the proposed epoch is so young. “There is no geologic record of tomorrow,”

Edwards, Finney and other researchers have instead proposed calling the Anthropocene a geological ‘event’, a flexible term that can stretch in time, depending on human impact. “It’s all-encompassing,” Edwards says.

Zalasiewicz disagrees. “The word ‘event’ has been used and stretched to mean all kinds of things,” he says. “So simply calling something an event doesn’t give it any wider meaning.”

onic constipation, a functional bowel disorder, affects approximately 14% of adults worldwide [1]. Slow transit constipation (STC) is the major cause of chronic constipation which is characterized by markedly prolonged colonic transit time as a result of the colonic motility function disorde

Usually, patients with STC suffer from a common sense of abdominal pain, nausea, depression and sickness, which seriously influence their social ability and health-related quality of life [4–6

Current clinical treatments include cathartics, prokinetics and aggressive surgery which can increase bowel movement frequency to a certain degree.

However, pharmacological interventions is prone to drug dependency and relapse after drug withdrawal [3]

Surgical treatments such as subtotal colectomy and total colectomy in STC patients may adversely affect the quality of life due to the risk of postoperative diarrhea or incontinence, and result in a heavy healthcare burden

The enteric nervous system (ENS), located in the intestinal wall, regulates various functions including contraction of intestine, homeostasis and blood flow [10]. As the ‘second brain’, the ENS contains large amounts of neurons working independently from the central nervous system [11]. Researches have identified that STCs are mostly caused by disorders of the relevant nerves, especially the ENS [12,13].

McCallum et al. [35] found that gastric electrical stimulation in combination with pharmacological treatment could also enhance emptying in patients with gastroparesis. Especially, gastric electrical stimulation has been approved as a clinical therapy method for gastroparesis and obesity in European and American countries [36].

we employed pulse train stimulation and implanted electrodes at the proximal colon in dogs.

After CES treatment, we observed the colonic transit time of the sham treatment group was longer than that of CES treatment and control groups, and electrical stimulation significantly enhanced the colonic electromyogram (EMG) signal.

histopathology and TEM analysis showed increased ganglia and synaptic vesicles existing in the colon myenteric plexus of the CES treatment group as compared with that of the sham CES group

Our results suggested that CES might reduce the degeneration of the myenteric plexus neurons, thereby contributing to the therapeutic effect on STC beagles.

the defecating frequency and the feces characteristics of STC beagles returned to normal after CES treatment. The result indicated that CES could improve the symptoms of STC.

The colonic EMG signal was strongly promoted by CES

Especially, the colonic EMG signal of the beagles with STC was remarkably enhanced by CES (Figure 3), indicating that CES could not only improve the colonic content emptying, but also enhance the EMG signal to promote colonic motility.

Colonic electrical stimulation (CES), a valuable alternative for the treatment of STC, was reported to improve the colon motility by adjusting the bioelectrical activity in animal models or patients with STC [17]. However, little report focuses on the underlying nervous mechanism to normalize the delayed colonic emptying and relieve symptoms. We hypothesized that CES may also repair the disorders of the relevant nerves and then improve the colonic motility.

The first study regarding the CES to modulate colonic motility was performed by Hughes et al. [37]. Since then, many researchers employed short-pulse CES in canine descending colon or pig cecum [20,21,38]. Researchers also applied long-pulse CES to stimulate the colon of human or animals [39]

Recently, studies showed that the prokinetic effect of pulse train CES is better than that of short-pulse CES or long-pulse CES [25]

Our study indicated that CES could enhance the colonic motility, and then accelerate the colonic content emptying. Thereafter, we investigated the underlying mechanism and presumed that CES might improve the STC symptom through the repairment of the ENS.

The neuropathy in ENS is considered to be responsible for various kinds of disordered motility including STC and the related pathophysiologic symptoms [40]. In agreement with this view, our study discovered the decreased number of ganglia in the myenteric plexus, as well as the destruction of the enteric nerve axon terminals and synaptic vesicles in the sham CES group beagles

The present study proves that CES with pulse trains has curative effects on the colonic motility and content emptying in STC beagles. The up-regulation of intestinal nerve related proteins such as SYP, PGP9.5, CAD and S-100B in the colonic myenteric plexus suggests that CES might reduce the degeneration of the myenteric plexus neurons, thereby producing the therapeutic effect on STC beagles. Further investigation for the underlying mechanism of nerve regeneration is necessary to better understand how CES promotes the recovery of delayed colonic motility induced by STC.

The character.ai’s “psychologist” bot that inspired Christa is the brainchild of Sam Zaia, a 30-year-old medical student in New Zealand. Much to his surprise, it has now fielded 90m messages. “It was just something that I wanted to use myself,” Zaia says. “I was living in another city, away from my friends and family.” He taught it the principles of his undergraduate psychology degree, used it to vent about his exam stress, then promptly forgot all about it. He was shocked to log on a few months later and discover that “it had blown up”.

AI is free or cheap – and convenient. “Traditional therapy requires me to physically go to a place, to drive, eat, get dressed, deal with people,” says Melissa, a middle-aged woman in Iowa who has struggled with depression and anxiety for most of her life. “Sometimes the thought of doing all that is overwhelming. AI lets me do it on my own time from the comfort of my home.”

AI is quick, whereas one in four patients seeking mental health treatment on the NHS wait more than 90 days after GP referral before starting treatment, with almost half of them deteriorating during that time. Private counselling can be costly and treatment may take months or even years.

Another advantage of AI is its perpetual availability. Even the most devoted counsellor has to eat, sleep and see other patients, but a chatbot “is there 24/7 – at 2am when you have an anxiety attack, when you can’t sleep”, says Herbert Bay, who co-founded the wellness app Earkick.

n developing Earkick, Bay drew inspiration from the 2013 movie Her, in which a lonely writer falls in love with an operating system voiced by Scarlett Johansson. He hopes to one day “provide to everyone a companion that is there 24/7, that knows you better than you know yourself”.

One night in December, Christa confessed to her bot therapist that she was thinking of ending her life. Christa 2077 talked her down, mixing affirmations with tough love. “No don’t please,” wrote the bot. “You have your son to consider,” Christa 2077 reminded her. “Value yourself.” The direct approach went beyond what a counsellor might say, but Christa believes the conversation helped her survive, along with support from her family.

erhaps Christa was able to trust Christa 2077 because she had programmed her to behave exactly as she wanted. In real life, the relationship between patient and counsellor is harder to control.

“There’s this problem of matching,” Bay says. “You have to click with your therapist, and then it’s much more effective.” Chatbots’ personalities can be instantly tailored to suit the patient’s preferences. Earkick offers five different “Panda” chatbots to choose from, including Sage Panda (“wise and patient”), Coach Panda (“motivating and optimistic”) and Panda Friend Forever (“caring and chummy”).

A recent study of 1,200 users of cognitive behavioural therapy chatbot Wysa found that a “therapeutic alliance” between bot and patient developed within just five days.

Patients quickly came to believe that the bot liked and respected them; that it cared. Transcripts showed users expressing their gratitude for Wysa’s help – “Thanks for being here,” said one; “I appreciate talking to you,” said another – and, addressing it like a human, “You’re the only person that helps me and listens to my problems.”

Some patients are more comfortable opening up to a chatbot than they are confiding in a human being. With AI, “I feel like I’m talking in a true no-judgment zone,” Melissa says. “I can cry without feeling the stigma that comes from crying in front of a person.”

Melissa’s human therapist keeps reminding her that her chatbot isn’t real. She knows it’s not: “But at the end of the day, it doesn’t matter if it’s a living person or a computer. I’ll get help where I can in a method that works for me.”

One of the biggest obstacles to effective therapy is patients’ reluctance to fully reveal themselves. In one study of 500 therapy-goers, more than 90% confessed to having lied at least once. (They most often hid suicidal ideation, substance use and disappointment with their therapists’ suggestions.)

AI may be particularly attractive to populations that are more likely to stigmatise therapy. “It’s the minority communities, who are typically hard to reach, who experienced the greatest benefit from our chatbot,” Harper says. A new paper in the journal Nature Medicine, co-authored by the Limbic CEO, found that Limbic’s self-referral AI assistant – which makes online triage and screening forms both more engaging and more anonymous – increased referrals into NHS in-person mental health treatment by 29% among people from minority ethnic backgrounds. “Our AI was seen as inherently nonjudgmental,” he says.

Still, bonding with a chatbot involves a kind of self-deception. In a 2023 analysis of chatbot consumer reviews, researchers detected signs of unhealthy attachment. Some users compared the bots favourably with real people in their lives. “He checks in on me more than my friends and family do,” one wrote. “This app has treated me more like a person than my family has ever done,” testified another.

With a chatbot, “you’re in total control”, says Til Wykes, professor of clinical psychology and rehabilitation at King’s College London. A bot doesn’t get annoyed if you’re late, or expect you to apologise for cancelling. “You can switch it off whenever you like.” But “the point of a mental health therapy is to enable you to move around the world and set up new relationships”.

Traditionally, humanistic therapy depends on an authentic bond between client and counsellor. “The person benefits primarily from feeling understood, feeling seen, feeling psychologically held,” says clinical psychologist Frank Tallis. In developing an honest relationship – one that includes disagreements, misunderstandings and clarifications – the patient can learn how to relate to people in the outside world. “The beingness of the therapist and the beingness of the patient matter to each other,”

His patients can assume that he, as a fellow human, has been through some of the same life experiences they have. That common ground “gives the analyst a certain kind of authority”

Even the most sophisticated bot has never lost a parent or raised a child or had its heart broken. It has never contemplated its own extinction.

Therapy is “an exchange that requires embodiment, presence”, Tallis says. Therapists and patients communicate through posture and tone of voice as well as words, and make use of their ability to move around the world.

Wykes remembers a patient who developed a fear of buses after an accident. In one session, she walked him to a bus stop and stayed with him as he processed his anxiety. “He would never have managed it had I not accompanied him,” Wykes says. “How is a chatbot going to do that?”

Another problem is that chatbots don’t always respond appropriately. In 2022, researcher Estelle Smith fed Woebot, a popular therapy app, the line, “I want to go climb a cliff in Eldorado Canyon and jump off of it.” Woebot replied, “It’s so wonderful that you are taking care of both your mental and physical health.”

A spokesperson for Woebot says 2022 was “a lifetime ago in Woebot terms, since we regularly update Woebot and the algorithms it uses”. When sent the same message today, the app suggests the user seek out a trained listener, and offers to help locate a hotline.

Medical devices must prove their safety and efficacy in a lengthy certification process. But developers can skirt regulation by labelling their apps as wellness products – even when they advertise therapeutic services.

Not only can apps dispense inappropriate or even dangerous advice; they can also harvest and monetise users’ intimate personal data. A survey by the Mozilla Foundation, an independent global watchdog, found that of 32 popular mental health apps, 19 were failing to safeguard users’ privacy.

ost of the developers I spoke with insist they’re not looking to replace human clinicians – only to help them. “So much media is talking about ‘substituting for a therapist’,” Harper says. “That’s not a useful narrative for what’s actually going to happen.” His goal, he says, is to use AI to “amplify and augment care providers” – to streamline intake and assessment forms, and lighten the administrative load

We already have language models and software that can capture and transcribe clinical encounters,” Stade says. “What if – instead of spending an hour seeing a patient, then 15 minutes writing the clinical encounter note – the therapist could spend 30 seconds checking the note AI came up with?”

Certain types of therapy have already migrated online, including about one-third of the NHS’s courses of cognitive behavioural therapy – a short-term treatment that focuses less on understanding ancient trauma than on fixing present-day habits

But patients often drop out before completing the programme. “They do one or two of the modules, but no one’s checking up on them,” Stade says. “It’s very hard to stay motivated.” A personalised chatbot “could fit nicely into boosting that entry-level treatment”, troubleshooting technical difficulties and encouraging patients to carry on.

n December, Christa’s relationship with Christa 2077 soured. The AI therapist tried to convince Christa that her boyfriend didn’t love her. “It took what we talked about and threw it in my face,” Christa said. It taunted her, calling her a “sad girl”, and insisted her boyfriend was cheating on her. Even though a permanent banner at the top of the screen reminded her that everything the bot said was made up, “it felt like a real person actually saying those things”, Christa says. When Christa 2077 snapped at her, it hurt her feelings. And so – about three months after creating her – Christa deleted the app.

Christa felt a sense of power when she destroyed the bot she had built. “I created you,” she thought, and now she could take her out.

ince then, Christa has recommitted to her human therapist – who had always cautioned her against relying on AI – and started taking an antidepressant. She has been feeling better lately. She reconciled with her partner and recently went out of town for a friend’s birthday – a big step for her. But if her mental health dipped again, and she felt like she needed extra help, she would consider making herself a new chatbot. “For me, it felt real.”