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The Silicon Shrink
Cover of The Silicon Shrink
The Silicon Shrink
How Artificial Intelligence Made the World an Asylum
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Why the race to apply AI in psychiatry is so dangerous, and how to understand the new tech-driven psychiatric paradigm.

AI psychiatrists promise to detect mental disorders with superhuman accuracy, provide affordable therapy for those who can’t afford or can’t access treatment, and even invent new psychiatric drugs. But the hype obscures an unnerving reality. In The Silicon Shrink, Daniel Oberhaus tells the inside story of how the quest to use AI in psychiatry has created the conditions to turn the world into an asylum. Most of these systems, he writes, have vanishingly little evidence that they improve patient outcomes, but the risks they pose have less to do with technological shortcomings than the application of deeply flawed psychiatric models of mental disorder at unprecedented scale.

Oberhaus became interested in the subject of mental health after tragically losing his sister to suicide. In the book, he argues that these new, ostensibly therapeutic technologies already pose significant risks to vulnerable people, and they won’t stop there. These new breeds of AI systems are creating a psychiatric surveillance economy in which the emotions, behavior, and cognition of everyday people are subtly manipulated by psychologically savvy algorithms that have escaped the clinic. Oberhaus also introduces readers to the concept of “swipe psychology,” which is quickly establishing itself as the dominant mode of diagnosing and treating mental disorders.
It is not too late to change course, but to do so means we must reckon with the nature of mental illness, the limits of technology, and what it means to be human.
Why the race to apply AI in psychiatry is so dangerous, and how to understand the new tech-driven psychiatric paradigm.

AI psychiatrists promise to detect mental disorders with superhuman accuracy, provide affordable therapy for those who can’t afford or can’t access treatment, and even invent new psychiatric drugs. But the hype obscures an unnerving reality. In The Silicon Shrink, Daniel Oberhaus tells the inside story of how the quest to use AI in psychiatry has created the conditions to turn the world into an asylum. Most of these systems, he writes, have vanishingly little evidence that they improve patient outcomes, but the risks they pose have less to do with technological shortcomings than the application of deeply flawed psychiatric models of mental disorder at unprecedented scale.

Oberhaus became interested in the subject of mental health after tragically losing his sister to suicide. In the book, he argues that these new, ostensibly therapeutic technologies already pose significant risks to vulnerable people, and they won’t stop there. These new breeds of AI systems are creating a psychiatric surveillance economy in which the emotions, behavior, and cognition of everyday people are subtly manipulated by psychologically savvy algorithms that have escaped the clinic. Oberhaus also introduces readers to the concept of “swipe psychology,” which is quickly establishing itself as the dominant mode of diagnosing and treating mental disorders.
It is not too late to change course, but to do so means we must reckon with the nature of mental illness, the limits of technology, and what it means to be human.
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About the Author-
  • Daniel Oberhaus is a science writer based in Brooklyn, New York. He is the founder of the deep tech communications agency HAUS and was previously a staff writer at WIRED. His first book Extraterrestrial Languages (MIT Press) is about the art, science, and philosophy of interstellar communication.
Reviews-
  • Kirkus

    February 1, 2025
    The computer will see you now. Science journalist Oberhaus opens with a tragedy that illuminated a dark corner of medicine: in this case, the suicide of his sister, which prompted him to explore the use of PAI--psychiatric artificial intelligence--in mental health interventions and treatment. This "revolutionary New Thing," as he calls it, has distinct advantages, at least in theory, over human practitioners: It can absorb huge quantities of information, discern patterns of behavior across populations, and perhaps detect when a psychic alarm bell is about to sound. On the other hand, as Oberhaus notes, there are 227 ways to be diagnosed with depression, while there are "more than 600,000 possible symptom combinations that could yield a diagnosis of post-traumatic stress disorder." These are not the hard-and-fast results of scientific discovery, but instead the product of consensus built on "the ability to map these symptoms tointernal dysfunction." Given that AI, so far, has not been a reliable interpreter of emotional states or indeed of the meaning of phrases such as a teenager's saying "I'm going to kill myself" after failing an exam, which may be serious but may also be hyperbole, it has obvious shortcomings. Yet, as Oberhaus observes, given the huge number of people who are suffering from mental disorders, with 20% of Americans experiencing anxiety requiring treatment, PAI is increasingly employed, with all its "potential for harm." Oberhaus examines the history of PAI, with manifestations such as the popular echoic program ELIZA and newer technologies such as Facebook's suicide prevention AI. He doesn't entirely dismiss the possibility of machine intelligence being put to good use in the future, but this extended cautionary tale suggests that there's still much work to be done before hailing PAI as "a new miracle cure." An eye-opening expos� of how machines are replacing people in a sphere they probably shouldn't be.

    COPYRIGHT(2025) Kirkus Reviews, ALL RIGHTS RESERVED.

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How Artificial Intelligence Made the World an Asylum
Daniel Oberhaus
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