CAI Currents is a series exploring the latest news on tech and mental health from a psychoanalytic perspective. It is published by TAP in partnership with the American Psychoanalytic Association President’s Commission on Artificial Intelligence.
CAI Currents, June 9, 2026
What AI Scribes Rehumanize and Dehumanize in Health Care
By Molly Pachan, PhD, and Heather DeCastro, LCSW
There’s a new player in the health care delivery system: AI transcriptions of the appointment are being used to create clinical documentation, so-called “AI scribes.”
Emerging evidence already suggests these scribes are fulfilling some of their promise. One qualitative study of ambient scribes in simulated psychiatric consultations showed effects on both clinicians and patients. Clinicians reported restored presence in comparison to contemporaneous note taking. Simulated patients noticed being noticed: nonverbal cues, fidgeting, picking at clothing, were caught immediately during scribe-assisted sessions but went unnoticed when the clinician was typing.
A quantitative study of AI scribes in 20,000 primary care visits yielded ambiguous results: The presence of an AI scribe resulted in increases in documentation of psychiatric-related symptoms, but less likelihood of interventions like referrals or prescriptions.
Reducing the felt pressure to type while talking creates more space and time to listen. When AI scribes permit clinicians to connect with their patients, attunement and accurate empathy increase. For medical providers increasingly squeezed by documentation requirements, AI scribes promise to restore the healing potential of human presence.
But for providers of depth psychotherapies, practitioners already oriented toward the healing potential of human presence, AI scribes likely exhibit a very different pattern of gains and losses. The very same tool that restores presence in a medical setting can be an intrusive new third presence in the therapy room.
A patient may unconsciously self-censor. Therapists may rush to fill silences, drifting toward the articulable and away from the unformulated. With this new, alien other in the room watching, therapists may be less willing to sit with confusion or register the drowsiness that subtly arrived at the exact moment the patient changed the subject. What happens to the value of reverie when the AI scribe only records what is spoken? With AI scribes in the therapy room, notes may be more complete and easier to produce, but also less alive.
Privacy compounds the risks. Offline AI models can, in principle, keep the session contained. But cloud-based AI scribes (by far the most common) process intimate disclosures through external infrastructure. In whose interest is that data held, protected, and perhaps someday used?
Presence is exactly what AI scribes can restore in medicine, and exactly what depth psychotherapy can least afford to lose. But the very same technology that can help rehumanize medical care also threatens to dehumanize depth psychotherapy.
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