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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.”

working on more broadly applying [the therapy] to other forms of genetic hearing loss,” he said. But in contrast to VGLUT3 mutant mice, which are missing the protein entirely, humans with missense mutations expressed a defective transporter, making it unclear whether Lustig’s strategy could translate to human VGLUT3-linked deafness.

Taste and smell are two of the senses that have received less attention from gene therapy researchers—but that’s changing

In olfactory dysfunction, there are few curative therapies,

Treating the mice intra-nasally with gene therapy vectors carrying the wildtype Ift88 gene, researchers saw significant regrowth of nasal cilia, whereas control mice given empty vectors showed no regrowth. Treated mice almost doubled in weight compared to controls.

So far, no scientists have designed a gene therapy to target taste buds, but at least one team is tackling an important factor in taste: saliva. If a person’s saliva production drops below 50 percent of normal, “you get tooth decay and trouble swallowing,”

Scientists are also developing gene therapies for disorders involving touch—or at least pain-sensing—neurons, with one drug candidate

Wolfe envisions that someday pain treatment could be as simple as visiting the doctor every few months for a quick skin prick “wherever it hurts”—choosing between a variety of genes to get the best effect.

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.

Haidt isn’t helping himself any. The term “culture of victimhood” reminds many people of the “snowflake” insult, the idea than anyone from a marginalized background who complains about injustice is really just self-involved and weak.

I find his predictions about how these dynamics will somehow undermine American capitalism to be unconvincing, running towards bizarre. If social media is making our kids depressed and anxious, that is the reason to be concerned, not some tangled logic about national greatness.

I think that suffering is the only truly universal endowment of the human species.

ecause Haidt talked about a culture of victimhood, he was immediately coded as right-wing, which is to say on the wrong side of the culture war

(The piece notes that the age at which children are allowed to play outside alone has moved from 7 or 8 to 10 or 12 in short order.)

the critics of someone like Haidt, the most coherent criticism they mount is that talk of toughness and resilience can be used opportunistically to dismiss demands for justice. “You just need to toughen up” is not, obviously, a constructive, good-faith response to a demand that the police stop killing unarmed Black people

I don’t think that’s the version Haidt is articulating

Yes, we must do all we can to reduce injustice, and we need to be compassionate to everyone. But we also need to understand that no political movement, no matter how effective, can ever end suffering and thus obviate the need for resilience.

I’m really not a fan of therapy culture, where the imperatives and vocabulary and purpose of therapy are now assumed to be necessary in every domain of human affairs. But that’s not because I think therapy is bad; I think therapy, as therapy, is very good. It’s because I think everything can’t be therapy, and the effort to make everything therapy will have the perverse effect of making nothing therapy.

Maurice discloses her Catholicism, and the reader is aware that prayer undergirds the therapy, but the book is about the therapy, not the prayer. Specifically, it is about the importance of choosing methods of treatment that are supported by scientific data. Applied behavioral analysis is all about data: its daily collection and interpretation. The method is empirical, hard-headed, and results-oriented.

on a deeper level, the book is profoundly religious, more religious perhaps than its author intended. In this reading of the book, autism is not only a developmental disorder afflicting particular individuals, but a metaphor for the spiritual condition of fallen man.

Maurice’s autistic daughter is indifferent to her mother

In this reading of the book, the mother is God, watching a child of his wander away from him into darkness: a heartbroken but also a determined God, determined at any cost to bring the child back

the mother doesn’t turn back, concedes nothing to the condition that has overtaken her daughter. There is no political correctness in Maurice’s attitude to autism; no nod to “neurodiversity.” Like the God in Donne’s sonnet, “Batter my heart, three-personed God,” she storms the walls of her daughter’s condition

Like God, she sets her sights high, commits both herself and her child to a demanding, sometimes painful therapy (life!), and receives back in the end a fully alive, loving, talking, and laughing child

the reader realizes that for God, the harrowing drama of recovery is never a singular, or even a twice-told tale, but a perennial one. Every child of his, every child of Adam and Eve, wanders away from him into darkness

we have an epidemic of autism, or “autism spectrum disorder,” which includes classic autism (Maurice’s children’s diagnosis); atypical autism, which exhibits some but not all of the defects of autism; and Asperger’s syndrome, which is much more common in boys than in girls and is characterized by average or above average language skills but impaired social skills.

At the same time, all around us, we have an epidemic of something else. On the street and in the office, at the dinner table and on a remote hiking trail, in line at the deli and pushing a stroller through the park, people go about their business bent over a small glowing screen, as if praying.

This latter epidemic, or experiment, has been going on long enough that people are beginning to worry about its effects.

for a comprehensive survey of the emerging situation on the ground, the interested reader might look at Sherry Turkle’s recent book, Reclaiming Conversation: The Power of Talk in a Digital Age.

she also describes in exhaustive, chilling detail the mostly horrifying effects recent technology has had on families and workplaces, educational institutions, friendships and romance.

many of the promises of technology have not only not been realized, they have backfired. If technology promised greater connection, it has delivered greater alienation. If it promised greater cohesion, it has led to greater fragmentation, both on a communal and individual level.

If thinking that the grass is always greener somewhere else used to be a marker of human foolishness and a temptation to be resisted, today it is simply a possibility to be checked out. The new phones, especially, turn out to be portable Pied Pipers, irresistibly pulling people away from the people in front of them and the tasks at hand.

all it takes is a single phone on a table, even if that phone is turned off, for the conversations in the room to fade in number, duration, and emotional depth.

an infinitely malleable screen isn’t an invitation to stability, but to restlessness

Current media, and the fear of missing out that they foster (a motivator now so common it has its own acronym, FOMO), drive lives of continual interruption and distraction, of virtual rather than real relationships, and of “little” rather than “big” talk

if you may be interrupted at any time, it makes sense, as a student explains to Turkle, to “keep things light.”

we are reaping deficits in emotional intelligence and empathy; loneliness, but also fears of unrehearsed conversations and intimacy; difficulties forming attachments but also difficulties tolerating solitude and boredom

consider the testimony of the faculty at a reputable middle school where Turkle is called in as a consultant

The teachers tell Turkle that their students don’t make eye contact or read body language, have trouble listening, and don’t seem interested in each other, all markers of autism spectrum disorder

Like much younger children, they engage in parallel play, usually on their phones. Like autistic savants, they can call up endless information on their phones, but have no larger context or overarching narrative in which to situate it

Students are so caught up in their phones, one teacher says, “they don’t know how to pay attention to class or to themselves or to another person or to look in each other’s eyes and see what is going on.

“It is as though they all have some signs of being on an Asperger’s spectrum. But that’s impossible. We are talking about a schoolwide problem.”

Can technology cause Asperger’

“It is not necessary to settle this debate to state the obvious. If we don’t look at our children and engage them in conversation, it is not surprising if they grow up awkward and withdrawn.”

In the protocols developed by Ivar Lovaas for treating autism spectrum disorder, every discrete trial in the therapy, every drill, every interaction with the child, however seemingly innocuous, is prefaced by this clear command: “Look at me!”

If absence of relationship is a defining feature of autism, connecting with the child is both the means and the whole goal of the therapy. Applied behavioral analysis does not concern itself with when exactly, how, or why a child becomes autistic, but tries instead to correct, do over, and even perhaps actually rewire what went wrong, by going back to the beginning

Eye contact—which we know is essential for brain development, emotional stability, and social fluency—is the indispensable prerequisite of the therapy, the sine qua non of everything that happens.

There are no shortcuts to this method; no medications or apps to speed things up; no machines that can do the work for us. This is work that only human beings can do

it must not only be started early and be sufficiently intensive, but it must also be carried out in large part by parents themselves. Parents must be trained and involved, so that the treatment carries over into the home and continues for most of the child’s waking hours.

there are foundational relationships that are templates for all other relationships, and for learning itself.

Maurice’s book, in other words, is not fundamentally the story of a child acquiring skills, though she acquires them perforce. It is the story of the restoration of a child’s relationship with her parents

it is also impossible to overstate the time and commitment that were required to bring it about, especially today, when we have so little time, and such a faltering, diminished capacity for sustained engagement with small children

The very qualities that such engagement requires, whether our children are sick or well, are the same qualities being bred out of us by technologies that condition us to crave stimulation and distraction, and by a culture that, through a perverse alchemy, has changed what was supposed to be the freedom to work anywhere into an obligation to work everywhere.

In this world of total work (the phrase is Josef Pieper’s), the work of helping another person become fully human may be work that is passing beyond our reach, as our priorities, and the technologies that enable and reinforce them, steadily unfit us for the work of raising our own young.

in Turkle’s book, as often as not, it is young people who are distressed because their parents are unreachable. Some of the most painful testimony in Reclaiming Conversation is the testimony of teenagers who hope to do things differently when they have children, who hope someday to learn to have a real conversation, and so o

it was an older generation that first fell under technology’s spell. At the middle school Turkle visits, as at many other schools across the country, it is the grown-ups who decide to give every child a computer and deliver all course content electronically, meaning that they require their students to work from the very medium that distracts them, a decision the grown-ups are unwilling to reverse, even as they lament its consequences.

we have approached what Turkle calls the robotic moment, when we will have made ourselves into the kind of people who are ready for what robots have to offer. When people give each other less, machines seem less inhuman.

robot babysitters may not seem so bad. The robots, at least, will be reliable!

If human conversations are endangered, what of prayer, a conversation like no other? All of the qualities that human conversation requires—patience and commitment, an ability to listen and a tolerance for aridity—prayer requires in greater measure.

this conversation—the Church exists to restore. Everything in the traditional Church is there to facilitate and nourish this relationship. Everything breathes, “Look at me!”

there is a second path to God, equally enjoined by the Church, and that is the way of charity to the neighbor, but not the neighbor in the abstract.

“Who is my neighbor?” a lawyer asks Jesus in the Gospel of Luke. Jesus’s answer is, the one you encounter on the way.

Virtue is either concrete or it is nothing. Man’s path to God, like Jesus’s path on the earth, always passes through what the Jesuit Jean Pierre de Caussade called “the sacrament of the present moment,” which we could equally call “the sacrament of the present person,” the way of the Incarnation, the way of humility, or the Way of the Cross.

The tradition of Zen Buddhism expresses the same idea in positive terms: Be here now.

Both of these privileged paths to God, equally dependent on a quality of undivided attention and real presence, are vulnerable to the distracting eye-candy of our technologies

Turkle is at pains to show that multitasking is a myth, that anyone trying to do more than one thing at a time is doing nothing well. We could also call what she was doing multi-relating, another temptation or illusion widespread in the digital age. Turkle’s book is full of people who are online at the same time that they are with friends, who are texting other potential partners while they are on dates, and so on.

This is the situation in which many people find themselves today: thinking that they are special to someone because of something that transpired, only to discover that the other person is spread so thin, the interaction was meaningless. There is a new kind of promiscuity in the world, in other words, that turns out to be as hurtful as the old kind.

Who can actually multitask and multi-relate? Who can love everyone without diluting or cheapening the quality of love given to each individual? Who can love everyone without fomenting insecurity and jealousy? Only God can do this.

When an individual needs to be healed of the effects of screens and machines, it is real presence that he needs: real people in a real world, ideally a world of God’s own making

Nature is restorative, but it is conversation itself, unfolding in real time, that strikes these boys with the force of revelation. More even than the physical vistas surrounding them on a wilderness hike, unrehearsed conversation opens up for them new territory, open-ended adventures. “It was like a stream,” one boy says, “very ongoing. It wouldn’t break apart.”

in the waters of baptism, the new man is born, restored to his true parent, and a conversation begins that over the course of his whole life reminds man of who he is, that he is loved, and that someone watches over him always.

Even if the Church could keep screens out of her sanctuaries, people strongly attached to them would still be people poorly positioned to take advantage of what the Church has to offer. Anxious people, unable to sit alone with their thoughts. Compulsive people, accustomed to checking their phones, on average, every five and a half minutes. As these behaviors increase in the Church, what is at stake is man’s relationship with truth itself.

Morin acknowledges many clients are scared of “getting in trouble” for what they confess in therapy. “They may worry that the therapist will terminate their sessions because they aren’t making progress or they may be concerned the therapist will somehow punish them,” she says.

“Sometimes people don’t really mean to lie, but they minimize their problems because they can’t quite accept them yet,” Morin says. “Someone with a substance abuse problem might insist she didn’t drink much this week even though she drank heavily every day. Individuals often need help coming to terms with their problems before they can be honest with themselves.”

“I don’t want to talk about trauma because discussing it is going to overwhelm me,” Farber says of this mindset. “It’s going to bring me back to an experience or experiences that have been so difficult [and] so overwhelming, and I’m fearful that if I talk about it, it will re-traumatize me.”

Altering the truth in an attempt at kindness is still problematic, though, because it limits how effective treatment can be. “If you’re censoring your experience, then the therapist can’t be helpful to you,” Kolod says. Therapists are aware clients sometimes omit the truth or downplay the significance of certain life experiences, and there has been research on how mental health professionals can better spot dishonesty and adapt their treatment accordingly.

What do doctors say about diseases like Aids?Most of those forced to undergo therapy say they were subjected to verbal harassment and insults during treatment.

What's the situation of LGBT people in China?There is growing awareness of LGBT issues in China. Homosexuality was decriminalised in 1997 and removed from an official list of mental disorders in 2001. Big cities have lively gay scenes, and in June, Shanghai held a gay pride parade.However, advocacy groups say that millions of gay people in China have married heterosexual partners rather than come out as gay as a result of pressure from families. Last year a judge ruled that a gay couple could not register as married, the first case of its kind in China.

In July, a gay man in central China won an apology and compensation from a mental hospital over forced "conversion therapy".

Platonic love relationship: Find an "elegant and caring" member of the opposite sex. Establish a relationship as friends initially. Then hope it becomes something else.2. Repulsion therapy: Induce nausea with forced vomiting or fear of electrocution when thoughts of having a lover of the same sex emerge.3. Shock therapy: Cause major shock to your lifestyle by moving to an entirely new environment in order to sever connection with previous friends, etc.4. Sexual orientation transfer:

Current treatments effectively relieve cravings in the clinic, but not when addicts return to their usual environment

This process – called 'extinction' – forms the basis of cue exposure therapy, in which addicts are repeatedly exposed to drug-associated cues and prevented from responding to them in the usual way of using the drug.

It combines cue exposure with manipulation of a process called memory reconsolidation, in which information is retrieved from long-term storage and then reactivated so that it can be strengthened.

"We did the extinction training during reconsolidation, and what seems to have happened is that we somehow updated the old fear memory,"

also manipulates reconsolidation of addicts' memories of past drug use to weaken their habitual responses to paraphernalia and other drug-related stimuli.

so it remains to be seem whether the procedure will be effective in preventing cravings outside of the clinical setting.

"Go ask him what he means by 'I now know what I need to do,'" she instructed Bremmer. "If it's a matter of him picking up an automatic rifle or something, we have to intervene."

As he clarified to Bremmer, love is what he had just realised he had to do. "Love is the most important thing," he told the baffled research assistant. "Nothing matters without

When de Wit recounted this story to me nearly two years after the fact, she still could hardly believe it. "Isn't that amazing?" she said. "It's what everyone says about this damn drug, that it makes people feel love. To think that a drug could change somebody's beliefs and thoughts without any expectations – it's mind-boggling."

Over the past few years, I've been investigating the scientific research and medical potential of MDMA for a book called "I Feel Love: MDMA and the Quest for Connection in a Fractured World". I learnt how this once-vilified drug is now remerging as a therapeutic agent – a role it previously played in the 1970s and 1980s, prior to its criminalisation

He attended the notorious "Unite the Right" rally in Charlottesville and quickly rose up the ranks of his organisation, first becoming the coordinator for Illinois and then the entire Midwest. He travelled to Europe and around the US to meet other white nationalist groups, with the ultimate goal of taking the movement mainstream

some researchers have begun to wonder if it could be an effective tool for pushing people who are already somehow primed to reconsider their ideology toward a new way of seeing things

While MDMA cannot fix societal-level drivers of prejudice and disconnection, on an individual basis it can make a difference. In certain cases, the drug may even be able to help people see through the fog of discrimination and fear that divides so many of us.

in December 2021 I paid Brendan a visit

What I didn't expect was how ordinary the 31-year-old who answered the door would appear to be: blue plaid button-up shirt, neatly cropped hair, and a friendly smile.

Brendan grew up in an affluent Chicago suburb in an Irish Catholic family. He leaned liberal in high school but got sucked into white nationalism at the University of Illinois Urbana-Champaign, where he joined a fraternity mostly composed of conservative Republican men, began reading antisemitic conspiracy books, and fell down a rabbit hole of racist, sexist content online. Brendan was further emboldened by the populist rhetoric of Donald Trump during his presidential campaign. "His speech talking about Mexicans being rapists, the fixation on the border wall and deporting everyone, the Muslim ban – I didn't really get white nationalism until Trump started running for president," Brendan said.

If this comes to pass, MDMA – and other psychedelics-assisted therapy – could transform the field of mental health through widespread clinical use in the US and beyond, for addressing trauma and possibly other conditions as well, including substance use disorders, depression and eating disorders.

A group of anti-fascist activists published identifying information about him and more than 100 other people in Identity Evropa. He was immediately fired from his job and ostracised by his siblings and friends outside white nationalism.

When Brendan saw a Facebook ad in early 2020 for some sort of drug trial at the University of Chicago, he decided to apply just to have something to do and to earn a little money

At the time, Brendan was "still in the denial stage" following his identity becoming public, he said. He was racked with regret – not over his bigoted views, which he still held, but over the missteps that had landed him in this predicament.

About 30 minutes after taking the pill, he started to feel peculiar. "Wait a second – why am I doing this? Why am I thinking this way?" he began to wonder. "Why did I ever think it was okay to jeopardise relationships with just about everyone in my life?"

Just then, Bremmer came to collect Brendan to start the experiment. Brendan slid into an MRI, and Bremmer started tickling his forearm with a brush and asked him to rate how pleasant it felt. "I noticed it was making me happier – the experience of the touch," Brendan recalled. "I started progressively rating it higher and higher." As he relished in the pleasurable feeling, a single, powerful word popped into his mind: connection.

It suddenly seemed so obvious: connections with other people were all that mattered. "This is stuff you can't really put into words, but it was so profound," Brendan said. "I conceived of my relationships with other people not as distinct boundaries with distinct entities, but more as we-are-all-on

I realised I'd been fixated on stuff that doesn't really matter, and is just so messed up, and that I'd been totally missing the point. I hadn't been soaking up the joy that life has to offer."

Brendan hired a diversity, equity, and inclusion consultant to advise him, enrolled in therapy, began meditating, and started working his way through a list of educational books. S still regularly communicates with Brendan and, for his part, thinks that Brendan is serious in his efforts to change

"I think he is trying to better himself and work on himself, and I do think that experience with MDMA had an impact on him. It's been a touchstone for growth, and over time, I think, the reflection on that experience has had a greater impact on him than necessarily the experience itself."

Brendan is still struggling, though, to make the connections with others that he craves. When I visited him, he'd just spent Thanksgiving alone

He also has not completely abandoned his bigoted ideology, and is not sure that will ever be possible. "There are moments when I have racist or antisemitic thoughts, definitely," he said. "But now I can recognise that those kinds of thought patterns are harming me more than anyone else."

it's not without precedent. In the 1980s, for example, an acquaintance of early MDMA-assisted therapy practitioner Requa Greer administered the drug to a pilot who had grown up in a racist home and had inherited those views. The pilot had always accepted his bigoted way of thinking as being a normal, accurate reflection of the way things were. MDMA, however, "gave him a clear vision that unexamined racism was both wrong and mean," Greer says

Encouraging stories of seemingly spontaneous change appear to be exceptions to the norm, however, and from a neurological point of view, this makes sense

Research shows that oxytocin – one of the key hormones that MDMA triggers neurons to release – drives a "tend and defend" response across the animal kingdom. The same oxytocin that causes a mother bear to nurture her newborn, for example, also fuels her rage when she perceives a threat to her cub. In people, oxytocin likewise strengthens caregiving tendencies toward liked members of a person's in-group and strangers perceived to belong to the same group, but it increases hostility toward individuals from disliked groups

In a 2010 study published in Science, for example, men who inhaled oxytocin were three times more likely to donate money to members of their team in an economic game, as well as more likely to harshly punish competing players for not donating enough. (Read more: "The surprising downsides of empathy.")

According to research published this week in Nature by Johns Hopkins University neuroscientist Gül Dölen, MDMA and other psychedelics – including psilocybin, LSD, ketamine and ibogaine – work therapeutically by reopening a critical period in the brain. Critical periods are finite windows of impressionability that typically occur in childhood, when our brains are more malleable and primed to learn new things

Dölen and her colleagues' findings likewise indicate that, without the proper set and setting, MDMA and other psychedelics probably do not reopen critical periods, which means they will not have a spontaneous, revelatory effect for ridding someone of bigoted beliefs.

In the West, plenty of members of right-wing authoritarian political movements, including neo-Nazi groups, also have track records of taking MDMA and other psychedelics

This suggests, researchers write, that psychedelics are nonspecific, "politically pluripotent" amplifiers of whatever is going on in somebody's head, with no particular directional leaning "on the axes of conservatism-liberalism or authoritarianism-egalitarianism."

That said, a growing body of scientific evidence indicates that the human capacity for compassion, kindness, empathy, gratitude, altruism, fairness, trust, and cooperation are core features of our natures

As Emory University primatologist Frans de Waal wrote, "Empathy is the one weapon in the human repertoire that can rid us of the curse of xenophobia."

Ginsberg also envisions using the drug in workshops aimed at eliminating racism, or as a means of bringing people together from opposite sides of shared cultural histories to help heal intergenerational trauma. "I think all psychedelics have a role to play, but I think MDMA has a particularly key role because you're both expanded and present, heart-open and really able to listen in a new way," Ginsberg says. "That's something really powerful."

"If you give MDMA to hard-core haters on each side of an issue, I don't think it'll do a lot of good,"

if you start with open-minded people on both sides, then I think it can work. You can improve communications and build empathy between groups, and help people be more capable of analysing the world from a more balanced perspective rather than from fear-based, anxiety-based distrust."

In 2021, Ginsberg and Doblin were coauthors on a study investigating the possibility of using ayahuasca – a plant-based psychedelic – in group contexts to bridge divides between Palestinians and Israelis, with positive findings

"I kind of have a fantasy that maybe as we get more reacquainted with psychedelics, there could be group-based experiences that build community resiliency and are intentionally oriented toward breaking down barriers between people, having people see things from other perspectives and detribalising our society,

"But that's not going to happen on its own. It would have to be intentional, and – if it happens – it would probably take multiple generations."

Based on his experience with extremism, Brendan agreed with expert takes that no drug, on its own, will spontaneously change the minds of white supremacists or end political conflict in the US

he does think that, with the right framing and mindset, MDMA could be useful for people who are already at least somewhat open to reconsidering their ideologies, just as it was for him. "It helped me see things in a different way that no amount of therapy or antiracist literature ever would have done," he said. "I really think it was a breakthrough experience."

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.

Functional Medicine isn't a protected title and a medical qualification isn't a prerequisite to practice. The result is an unregulated and disparate field, with medical doctors, nutritionists, naturopaths and homeopaths among the many practitioners.

Some other chronic illnesses the field claims to treat include heart disease, type 2 diabetes, irritable bowel syndrome, ulcerative colitis, depression, anxiety and arthritis

ll kinds of different reasons, some might have gluten issues, gut issues, others might have a deficiency causing neurological issues, MS is a symptom."

"There are components of Functional Medicine that absolutely lack an evidence base and there are practitioners of what they call Functional Medicine, they charge people for intravenous nutritional injections, they exaggerate claims, and that is professionally inappropriate, unethical and it lacks evidence.

On Dr Mark Hyman's view of MS he says, "there are a lot of terms put together there, all of which individually make a lot of sense, but put together in that way they do not.

"What does FM actually mean? It means nothing. It's a gift-gallop of words thrown together. It's criticised by advocates of evidence-based medicine because it's giving a veneer of scientific legitimacy to ideas that are considered pseudoscientific. For example, it'll take alternative medicine modalities like homeopathy and then call them 'bio-infusions' or something similar, rebranding it as something that works.

"It's a redundant name, real medicine is functional."

Next month the third annual Lifestyle and Functional Medical conference will take place in Salthill, Galway on November 3. Last year's event was attended by more than 500 people and featured a keynote address by honorary consultant cardiologist Dr Aseem Malhotra, author of bestselling The Pioppi Diet (which was named one of the top five worst celebrity diets to avoid in 2018 by the British Dietetic Foundation).

Dr David Robert Grimes is physicist and visiting fellow of Oxford and QUB. His research into cancer focuses on modelling tumour metabolism and radiation interactions. For Dr Grimes, the lack of definition, or "double-speak" as he puts it, in FM is troubling.

As well as the cost of appointments, FM practitioners commonly charge extra for tests. An omega finger prick test is around €100. A vitamin D test can cost upwards of €60, full thyroid panel more than €150 and a gut function test €400. Prices vary between practitioners.

"If I, as a GP, engaged in some of these behaviours I would be struck off." Specifically? "If I was recommending treatments that lacked an evidence base, or if I was promoting diagnostic tests which are expensive and lack an evidence base.

GPs engage every year in ongoing continuous professional development, I spend my evenings and my weekends outside of working hours attending educational events, small-group learning, large-group learning, engaging in research. This is an accusation that was levelled at the profession 30 years ago and then it was correct, but the profession has caught up…

"Obviously promoting wellness and healthy diet is very welcome but going beyond that and stating that certain aspects of 'functional medicine' can lead to reduced inflammation or prevent cancer, we have to be very careful about those claims.

Often the outcome of such tests are seemingly 'benign' prescriptions of vitamins or cleanses. However, dietitian Orla Walsh stresses that even these can have potentially harmful effects, especially on "vulnerable" patients, if not prescribed judiciously.

FM has five basic principles. 1. We are all genetically and biochemically unique so it treats the individual, not the disease. 2. It's science-based. 3. The body is intelligent and has the capacity for self-regulation. 4. The body has the ability to heal and prevent nearly all the diseases of ageing. 5. Health is not just the absence of disease, but a state of immense vitality.

She began her Functional Medicine career while training as a medical doctor and now travels the world working with high-profile clients. Dr McHale charges €425 for an initial consultation and €175 for follow-up appointments. Straightforward lab tests are €250 to €750, for complex cases testing fees can be up to €2,000.

"The term [Functional Medicine] tends to be bandied around quite a bit. Other things people say, such as 'functional nutritionist', can be misleading as a term. Many people are Functional Medicine practitioners but don't have any real medical background at all... I think regulation is always probably the best way forward."

"There's an awful lot to it in terms of biochemistry and physiology," she says. "You do need to have a very solid and well ingrained bio-chemistry background. A solely clinical background doesn't equip you with the knowledge to read a test.

"Evidence-base is the cornerstone of medicine and that has to be maintained. It becomes problematic in this area because you are looking at personalised medicine and that can be very difficult to evidence-base."

GP Christine Ritter travelled from England to attend the Galway conference last year with a view to integrating Functional Medicine into her practice.

"It was very motivating," she says. "Where it wasn't perhaps as strong was to find the evidence. The Functional Medicine people would say, 'we've done this study and this trial and we've used this supplement that was successful', but they can't show massive research data which might make it difficult to bring it into the mainstream.

"I also know the rigorous standard of trials we have in medicine they're not usually that great either, it's often driven by who's behind the trial and who's paying for it.

"Every approach that empowers patient to work on their destiny [is beneficial], but you'd have to be mindful that you're not missing any serious conditions."

Dr Hyman is working to grow the evidence-base for Functional Medicine worldwide. "The future is looking very bright," he says. "At the Cleveland Centre we're establishing a research base, building educational platforms, fellowships, residency programmes, rotations. We're advancing the field that's spreading across the world. We're seeing in China the development of a programme of Functional Medicine, South Africa, the UK, in London the Cleveland Clinic will hopefully have a Functional Medicine centre."

For Dr Mark Murphy regulation is a moot point as it can only apply once the field meets the standards of evidence-based medicine.

"Despite well intentioned calls for regulation, complementary and alternative medical therapies cannot be regulated," he says. "Only therapies that possess an evidence-base can enter our standard regulatory processes, including the Irish Medical Council, the Health Products Regulatory Authority and Irish advertising standards. In situations where complementary and alternative therapies develop an evidence base, they are no longer 'complementary and alternative', but in effect they become part of mainstream 'Medicine'.

l What are the principles?

"There's a huge variation between therapists, some are brilliant and some are okay, and some are ludicrous snake oil salesmen."

He is so concerned that patients' health and wealth are being put at risk by alternative therapies that earlier this year he joined Fine Gael TD Kate O'Connell and the Irish Cancer Society in introducing draft legislation earlier this year making it illegal to sell unproven treatments to cancer patients. Violators face jail and heavy fines.

Dr Grimes says criticism of variations in the standards of traditional medical research can be fair, however due to the weight of research it is ultimately self-correcting. He adds, "The reality is that good trials are transparent, independent and pre-registered.

"My involvement in shaping the Bill came from seeing first-hand the exploitation of patients and their families. Most patients undergoing treatment will take some alternative modalities in conjunction but a significant portion are talked out of their conventional medicine and seduced by false promises

A major concern with any type of gene therapy is that the inserted genetic material could have dangerous side effects, like turning off an essential gene or turning on one that could lead to cancer.

There's also the startle response — when you jump out of your skin — which is a way to get yourself away from something when you haven't got the time to even work out what it is, but it's coming at you very suddenly and very loudly.

First up, there's the classic jump scare, explains Andy Nyman, co-creator of the long-running London horror stage play Ghost Stories, which was also turned into a 2017 film starring Martin Freeman. "Often people think that's a bit of a cheap thing to do but the reality is that it's actually quite a sophisticated thing to pull off."If you can get it right, misdirecting an audience properly and then giving them a jump scare is a really wonderful thing because you're properly catching them off guard."

Then, Andy goes on, there's the type of scare that you can't shake off. "These are the scares that are attached to imagery or a moment that means when you close your eyes that's all you can see. These are much deeper-rooted."

If you're a very jumpy person who gets scared easily (or if you have a specific phobia, a severe form of fear that impacts on your life), there are things you can do on your own and with a therapist to help you improve

"The first thing is to realise that it's best to take things at your own pace and that may mean you don't need to face that fear right now but you're going to do it when you're ready."Most things that frighten people can be broken down into smaller, more manageable sections

And Dr Kerr has some practical tips, too, including exposure therapy, cognitive behavioural therapy and breathing exercises.

The brain-development lag has huge implications for how we think about anxiety and how we treat it. It suggests that anxious adolescents may not be very responsive to psychotherapy that attempts to teach them to be unafraid, like cognitive behavior therapy

should also make us think twice — and then some — about the ever rising use of stimulants in young people, because these drugs may worsen anxiety and make it harder for teenagers to do what they are developmentally supposed to do: learn to be unafraid when it is appropriate

up to 20 percent of adolescents in the United States experience a diagnosable anxiety disorder, like generalized anxiety or panic attacks, probably resulting from a mix of genetic factors and environmental influences.

This isn’t to say that cognitive therapy is ineffective for teenagers, but that because of their relative difficulty in learning to be unafraid, it may not be the most effective treatment when used on its own.

Fear learning lies at the heart of anxiety and anxiety disorders. This primitive form of learning allows us to form associations between events and specific cues and environments that may predict danger.

once previously threatening cues or situations become safe, we have to be able to re-evaluate them and suppress our learned fear associations. People with anxiety disorders have trouble doing this and experience persistent fear in the absence of threat — better known as anxiety.

Dr. Casey discovered that adolescents had a much harder time “unlearning” the link between the colored square and the noise than children or adults did.

adolescents had trouble learning that a cue that was previously linked to something aversive was now neutral and “safe.” If you consider that adolescence is a time of exploration when young people develop greater autonomy, an enhanced capacity for fear and a more tenacious memory for threatening situations are adaptive and would confer survival advantage. In fact, the developmental gap between the amygdala and the prefrontal cortex that is described in humans has been found across mammalian species, suggesting that this is an evolutionary advantage.

As a psychiatrist, I’ve treated many adults with various anxiety disorders, nearly all of whom trace the origin of the problem to their teenage years. They typically report an uneventful childhood rudely interrupted by adolescent anxiety. For many, the anxiety was inexplicable and came out of nowhere.

prescription sales for stimulants increased more than fivefold between 2002 and 2012. This is of potential concern because it is well known from both human and animal studies that stimulants enhance learning and, in particular, fear conditioning.

beliefs about how memory works

some believed that traumatic memories could be repressed for years only to be recovered later in therapy, others questioned the concept, noting that lack of scientific evidence in support of repressed memory

Roughly 60-80% of clinicians, psychoanalysts, and therapists surveyed agreed to some extent that traumatic memories are often repressed and can be retrieved in therapy, compared to less than 30% of research-oriented psychologists

belief in repressed memory is still prevalent among the general public

researchers on the one hand and clinicians and the public on the other

In the courtroom, beliefs about memory often determine whether repressed-memory testimony is admitted into evidence

Once veterans got service dogs, they described themselves in surveys as more satisfied with their lives, said they felt a greater sense of well-being and deemed themselves as having better relationships with friends and loved ones.

There can also be a new sense of stigma that goes along with making a disability that might otherwise be hidden readily apparent. Someone who has PTSD might not stick out until they get a service dog that is always present.

The guilt I felt about this compelled me to objectively review the literature on mRNA vaccines. Not being an expert in virology or biochemistry, I realized I had to quickly master unfamiliar words like “transfection” and concepts about gene sequences. Slowly, the information I was devouring started changing my beliefs.

I learned that research into using mRNA for vaccinations and cancer therapies has been ongoing for the past 30 years. Trial and error have refined this modality so that it was almost fully fledged by the time Covid hit

The mRNA from the vaccine is broken down quickly in our cells, and the coronavirus spike protein is expressed only transiently on the cell surface.

Furthermore, this type of vaccine is harnessing a technique that viruses already use.

It was humbling to have to change my mind. As I booked my vaccination time slot, I realized how lucky I am to have access to all this research, as well as the training to understand it.

As medical professionals, we cannot afford to be paternalistic and trust that people will follow advice without all the facts. This is especially true in Australia, where the vast majority of us have never witnessed firsthand the ravages that this disease can inflict.

Like all new converts, I am now a true believer: I’d like everyone to be vaccinated. But autonomy is a precious tenet of a free society, and I’m glad the ethicists have advised against mandating the vaccine

just hope that with more robust discussion and the wider dissemination of scientific knowledge, we may sway people like me — who have what may be valid reservations — to get the vaccine.