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Nowadays, patients frequently discuss personal matters with conversational artificial intelligence (CAI) alongside their analytic work. How this affects the analytic process is, in my opinion, one of the most important clinical questions facing the psychoanalytic community at present. I was therefore pleased to see Alessandra Lemma’s article “At the meniscus of self-understanding” (2025) published in the latest issue of the International Journal of Psychoanalysis. In it, the author examines how CAI enters the psychic life of patients, particularly adolescents, reshaping the conditions under which unconscious processes unfold. At the beginning of her text, Lemma poses a question that frames the entire article: What happens to our ability to understand inner life if self-knowledge is increasingly mediated by interfaces that “anticipate and affirm, rather than challenge”? Most CAIs available today do indeed tend to function in this affirmative register, given how they are currently trained and tuned. In my experience, however, some patients use CAI alongside their analytic work to explore dreams, diary entries, and life situations, seeking, at least consciously, to find out something new about themselves. This raises yet another question: What happens to the psychic life of a person whose contact with AI permits the articulation of things about themselves that would otherwise be prevented by the shame accompanying the presence of a living other? In this response, I would like to pursue this dimension a little further. Lemma acknowledges that the clinical manifestation of CAI’s impact varies between patients. While she also notes that CAI may in some instances function as a transitional object, this facilitative dimension is named in passing rather than developed more deeply. The Isobel case study works primarily with the defensive pole, where AI’s role is to reinforce the patient’s psychic adhesion.
In my clinical practice (Kuchař 2026), I have described a use of AI tha