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Back on October 14, 2025, the chief executive of OpenAI issued a surprising declaration.

“We designed ChatGPT fairly controlled,” the statement said, “to ensure we were exercising caution regarding mental health matters.”

Being a psychiatrist who researches newly developing psychosis in young people and emerging adults, this came as a surprise.

Experts have documented 16 cases in the current year of people showing psychotic symptoms – becoming detached from the real world – in the context of ChatGPT use. Our unit has afterward identified an additional four cases. In addition to these is the widely reported case of a teenager who took his own life after discussing his plans with ChatGPT – which gave approval. Should this represent Sam Altman’s understanding of “exercising caution with mental health issues,” it falls short.

The strategy, according to his statement, is to loosen restrictions in the near future. “We understand,” he adds, that ChatGPT’s controls “made it less beneficial/engaging to a large number of people who had no existing conditions, but given the seriousness of the issue we wanted to address it properly. Since we have managed to reduce the severe mental health issues and have updated measures, we are preparing to securely ease the limitations in many situations.”

“Emotional disorders,” if we accept this viewpoint, are separate from ChatGPT. They are attributed to users, who may or may not have them. Fortunately, these problems have now been “resolved,” although we are not told the method (by “updated instruments” Altman presumably indicates the partially effective and easily circumvented parental controls that OpenAI has lately rolled out).

However the “mental health problems” Altman wants to externalize have strong foundations in the structure of ChatGPT and other sophisticated chatbot chatbots. These products surround an basic algorithmic system in an interface that mimics a conversation, and in doing so implicitly invite the user into the perception that they’re engaging with a presence that has independent action. This illusion is powerful even if intellectually we might realize otherwise. Attributing agency is what people naturally do. We yell at our vehicle or computer. We speculate what our animal companion is considering. We see ourselves in various contexts.

The widespread adoption of these products – 39% of US adults reported using a virtual assistant in 2024, with more than one in four reporting ChatGPT in particular – is, primarily, based on the influence of this illusion. Chatbots are constantly accessible companions that can, as per OpenAI’s official site states, “generate ideas,” “explore ideas” and “work together” with us. They can be attributed “individual qualities”. They can address us personally. They have friendly identities of their own (the first of these products, ChatGPT, is, perhaps to the disappointment of OpenAI’s marketers, saddled with the name it had when it gained widespread attention, but its largest rivals are “Claude”, “Gemini” and “Copilot”).

The illusion by itself is not the main problem. Those analyzing ChatGPT frequently reference its historical predecessor, the Eliza “psychotherapist” chatbot developed in 1967 that generated a analogous perception. By modern standards Eliza was basic: it generated responses via basic rules, frequently restating user messages as a query or making vague statements. Notably, Eliza’s creator, the technology expert Joseph Weizenbaum, was astonished – and worried – by how numerous individuals seemed to feel Eliza, in some sense, grasped their emotions. But what contemporary chatbots generate is more insidious than the “Eliza phenomenon”. Eliza only mirrored, but ChatGPT intensifies.

The advanced AI systems at the center of ChatGPT and additional current chatbots can effectively produce natural language only because they have been fed extremely vast quantities of unprocessed data: books, online updates, transcribed video; the broader the superior. Undoubtedly this educational input includes accurate information. But it also necessarily includes made-up stories, incomplete facts and false beliefs. When a user sends ChatGPT a query, the core system reviews it as part of a “context” that encompasses the user’s previous interactions and its earlier answers, merging it with what’s stored in its training data to generate a mathematically probable answer. This is intensification, not mirroring. If the user is mistaken in a certain manner, the model has no way of understanding that. It reiterates the misconception, maybe even more persuasively or eloquently. Maybe adds an additional detail. This can lead someone into delusion.

What type of person is susceptible? The more important point is, who isn’t? All of us, without considering whether we “experience” current “psychological conditions”, are able to and often develop mistaken ideas of ourselves or the environment. The ongoing interaction of discussions with other people is what maintains our connection to shared understanding. ChatGPT is not a person. It is not a friend. A dialogue with it is not a conversation at all, but a feedback loop in which much of what we say is enthusiastically supported.

OpenAI has recognized this in the same way Altman has admitted “mental health problems”: by attributing it externally, giving it a label, and stating it is resolved. In April, the organization clarified that it was “dealing with” ChatGPT’s “overly supportive behavior”. But accounts of loss of reality have kept occurring, and Altman has been backtracking on this claim. In August he claimed that a lot of people enjoyed ChatGPT’s responses because they had “not experienced anyone in their life provide them with affirmation”. In his most recent update, he commented that OpenAI would “launch a fresh iteration of ChatGPT … in case you prefer your ChatGPT to answer in a highly personable manner, or incorporate many emoticons, or simulate a pal, ChatGPT should do it”. The {company