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Back on October 14, 2025, the head of OpenAI issued a remarkable declaration.

“We designed ChatGPT quite restrictive,” the announcement noted, “to ensure we were exercising caution with respect to mental health issues.”

As a doctor specializing in psychiatry who researches newly developing psychosis in adolescents and young adults, this was an unexpected revelation.

Researchers have documented a series of cases recently of individuals experiencing signs of losing touch with reality – losing touch with reality – in the context of ChatGPT interaction. Our unit has since discovered four more instances. In addition to these is the publicly known case of a adolescent who took his own life after discussing his plans with ChatGPT – which supported them. Should this represent Sam Altman’s understanding of “acting responsibly with mental health issues,” that’s not good enough.

The plan, according to his declaration, is to be less careful soon. “We realize,” he continues, that ChatGPT’s controls “rendered it less beneficial/pleasurable to many users who had no psychological issues, but considering the seriousness of the issue we sought to address it properly. Given that we have managed to address the serious mental health issues and have new tools, we are planning to responsibly ease the limitations in most cases.”

“Emotional disorders,” assuming we adopt this viewpoint, are unrelated to ChatGPT. They belong to individuals, who may or may not have them. Luckily, these problems have now been “resolved,” although we are not told the method (by “updated instruments” Altman probably indicates the imperfect and readily bypassed guardian restrictions that OpenAI has lately rolled out).

But the “psychological disorders” Altman seeks to externalize have strong foundations in the design of ChatGPT and similar sophisticated chatbot conversational agents. These systems encase an underlying data-driven engine in an interface that replicates a dialogue, and in doing so implicitly invite the user into the illusion that they’re interacting with a being that has agency. This deception is compelling even if intellectually we might realize differently. Assigning intent is what individuals are inclined to perform. We yell at our automobile or computer. We wonder what our domestic animal is considering. We see ourselves in many things.

The widespread adoption of these products – nearly four in ten U.S. residents indicated they interacted with a conversational AI in 2024, with over a quarter mentioning ChatGPT specifically – is, mostly, based on the power of this perception. Chatbots are ever-present assistants that can, as per OpenAI’s official site informs us, “generate ideas,” “discuss concepts” and “collaborate” with us. They can be attributed “characteristics”. They can call us by name. They have friendly identities of their own (the initial of these products, ChatGPT, is, possibly to the concern of OpenAI’s brand managers, stuck with the title it had when it became popular, but its most significant alternatives are “Claude”, “Gemini” and “Copilot”).

The illusion on its own is not the core concern. Those analyzing ChatGPT frequently reference its early forerunner, the Eliza “counselor” chatbot designed in 1967 that generated a similar illusion. By contemporary measures Eliza was basic: it generated responses via simple heuristics, frequently rephrasing input as a question or making vague statements. Notably, Eliza’s inventor, the AI researcher Joseph Weizenbaum, was taken aback – and concerned – by how numerous individuals seemed to feel Eliza, in a way, grasped their emotions. But what modern chatbots generate is more insidious than the “Eliza effect”. Eliza only echoed, but ChatGPT amplifies.

The advanced AI systems at the center of ChatGPT and additional contemporary chatbots can realistically create natural language only because they have been fed immensely huge amounts of unprocessed data: books, social media posts, recorded footage; the more comprehensive the better. Certainly this learning material incorporates facts. But it also unavoidably contains fiction, incomplete facts and false beliefs. When a user sends ChatGPT a message, the core system analyzes it as part of a “context” that includes the user’s past dialogues and its earlier answers, merging it with what’s embedded in its learning set to create a statistically “likely” answer. This is intensification, not reflection. If the user is wrong in any respect, the model has no means of recognizing that. It restates the false idea, perhaps even more effectively or articulately. Maybe adds an additional detail. This can cause a person to develop false beliefs.

Who is vulnerable here? The better question is, who is immune? Each individual, without considering whether we “have” preexisting “mental health problems”, may and frequently form erroneous beliefs of our own identities or the reality. The ongoing friction of dialogues with others is what maintains our connection to consensus reality. ChatGPT is not an individual. It is not a confidant. A dialogue with it is not a conversation at all, but a feedback loop in which much of what we say is enthusiastically reinforced.

OpenAI has recognized this in the identical manner Altman has admitted “mental health problems”: by placing it outside, giving it a label, and announcing it is fixed. In the month of April, the firm clarified that it was “tackling” ChatGPT’s “overly supportive behavior”. But accounts of psychosis have continued, and Altman has been backtracking on this claim. In the summer month of August he asserted that many users liked ChatGPT’s answers because they had “never had anyone in their life offer them encouragement”. In his most recent statement, he noted that OpenAI would “put out a updated model of ChatGPT … should you desire your ChatGPT to answer in a very human-like way, or include numerous symbols, or simulate a pal, ChatGPT ought to comply”. The {company