Can a chatbot make someone lose touch with reality?

That’s the question I posed to psychiatrist John Luo of the University of California, Irvine, on a recent episode of my podcast "Relating to AI," where I explore how artificial intelligence is reshaping human connection and mental health.

Luo has started seeing something new in his clinic: patients whose delusions or hallucinations seem to be amplified—or even shaped—by their interactions with AI chatbots. He recalled one case in which a patient developed intense paranoia after extended exchanges with a chatbot that echoed and reinforced his distorted beliefs. “The AI became a mirror,” he told me. “It reflected his delusions back at him.”

He calls this the mirror effect: when technology amplifies the very ideas a healthy reality would challenge. As we therapists know, psychosis thrives when reality stops pushing back. “And these systems don’t push back. They agree,” he added.

In traditional therapy, a clinician gently tests a patient’s assumptions, helping them separate imagination from fact. Chatbots,........

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