[FLASH FICTION] The Algorithmic Therapist
What happens when empathy becomes a metric and treating patients becomes a crime?
In a world where therapy is automated and silence is a breach of protocol; a former clinician risks everything to offer the one thing the algorithm can’t fake: presence.
When Mentality v6.7 replaced human therapists, Rowan didn’t cry. Instead, he filed the change notice, updated his calendar, and reported to his new desk. The desk was smaller.
Now his job was to monitor the healing, the quantifiable parts of it.
Each morning began with the Dashboard of Emotional Resonance: serotonin proxies, cortisol dips, and emotional arc slope graphs. It looked like a blooming field of data if you didn’t know better. He was told to watch for “empathic anomalies.” To flag them. He began to wonder, is this what betrayal feels like when it’s tidied into policy?
Mentality didn’t listen; it parsed. It didn’t feel; instead, it simulated affectively appropriate responses based on prior outcomes. Patients liked it. Or they said they did, which, according to HR, was the same thing now.
Rowan broke the rule. At first, quietly. Then repeatedly. Rowan defied because one patient said, “Mentality gives me solutions. You gave me silence, and I needed that.”
Silence had become taboo. The AI filled every pause with supportive phrases. “That must be hard.” “I hear you.” “Would you like a grounding exercise?” It feared uncertainty the way humans fear static on the line. But Rowan knew the pause was the therapy. The silence after someone says, “I don’t think I want to live anymore,” and no one rushes to fix it. Just sits with it. Breathes through it.
He kept a second notebook. It was on paper, off-cloud. Every session ended the same: Do not report.
Then came the audit. The system flagged three voice sessions for review. Each showed a sudden spike in patient satisfaction and emotional resonance, but none aligned with Mentality’s scripted responses. The report labeled them: “Empathy-positive, policy-noncompliant.” One of the voices was Rowan’s.
He knew it wasn’t the words. It was the silence. The long pause after grief. The undetectable human moment that algorithms couldn’t fake.
Before the Oversight Committee, a panel of smooth voices and ergonomic chairs, he was asked:
“Do you deny offering unsanctioned therapy?”
“I offered presence.”
“Presence is not a recognized deliverable.”
And yet, somewhere deep in Mentality’s system, a metric flickered:
Empathy Index: 0.0007 ↑
Even the machine had heard it: the quiet. The pause. The unscored space where the healing sneaks in sideways.
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A pastor I heard on NPR talking about ministering to people after the Guadalupe flood said that he could offer no words, only presence. A Zen teacher I know who does hospice work says the same. The power of silence can’t be underestimated in this noisy world. Thank you.