Practice Stories
Licensed marriage & family therapist · San Francisco
A San Francisco marriage and family therapist on twenty years of repair work, why AI can source an answer but never sit in the room, and the one door she still won't let it open.
Andrea Dendinger says she was "born a therapist." She means it literally. At seven years old, she sat down with her grandparents and asked them, plainly, why they slept in separate bedrooms. She didn't understand it, and she wasn't going to let it go unasked. That instinct — to name the thing everyone else is quietly stepping around — never left her.
It found its subject young. Her parents divorced when she was in middle school. Years later, so did she, at 25, ending six years after it began. "Which both my parents' divorce and my own divorce really just were really really painful for me," she says, "and really kind of broke something in me." She was, in her own telling, in recovery from her own life when the answer to what came next arrived somewhere she wasn't looking for it.
Andrea was at a silent meditation retreat, still sorting through what her life would be after the divorce, when the direction landed. "It was literally felt like a transmission from God or whoever," she says, "but it was like, go back to grad school and become a therapist." She didn't argue with it. She enrolled. Twenty-plus years later, she still describes the decision the same way: "It's been my life's passion ever since, and it's been the most amazing career I could have ever dreamed of having."
Today her practice is built around couples — helping them, in her words, "navigate conflict and get out of those looping patterns that every couple gets into." She sees people in her San Francisco office, over video, and, since a pandemic-era habit stuck, on foot: she and her clients walk a set path together, talking as they go. "It's actually one of the most profound things that has come out of COVID for my practice," she says.
Andrea calls what she does being "a doctor of the heart and the mind and the body" — not because it sounds nice, but because that's genuinely the terrain: childhood trauma, communication breakdowns, the unconscious patterns that keep a marriage circling the same fight. Her favorite case is one she returns to often: a husband who'd had an affair, a wife who wanted answers, and a slow, deliberate process of getting him to actually take ownership of what he'd done — "to authentically apologize to his wife and be kind of open to all of her questions" — until she could trust the ground under her again.
She has a name for the moment where the real healing happens, and it isn't the apology itself. It's what she calls "the secret medicine and sauce": when a client can finally say to her, in the room, the thing they could never have said to the person who actually hurt them. If Andrea misses a session by accident, and an old wound of abandonment flares up in a client, the work isn't pretending it didn't happen — it's the client telling her, directly, "I felt really abandoned when you didn't show up for our session." Being heard and repaired in real time, she says, "creates a different neural pathway in people's brains. And that's where people start living healthier, fuller, more connected lives."
Andrea isn't interested in fighting the tide. "If I'm resisting AI, I'm just making my suffering and pain worse," she says — the same principle she teaches her clients about resistance in general. She uses it in her own life constantly: meal planning, taxes, brainstorming social posts. What she won't do is bring it into the room. She's turned down the note-taking AI her practice software offers, because writing her own notes by hand is how she remembers a detail from ten years ago "so crystal clear" when a client needs her to. And when a developer pitched her an AI tool that would listen in on couples sessions and generate a recap of missed interventions afterward, her answer was no — because therapy's whole foundation is privacy, and "if there's this machine that's in here listening to what you're saying with me, it no longer is private. And that... doesn't feel safe."
Her verdict on AI-as-therapist is just as direct. It can be useful, she says — "it can source all of these different experts and give you this regurgitated really great response." But it falls short at the one thing that actually heals people: "there's not a human there behind it." The hurts that brought her clients into her office happened in relationship, and she believes only relationship — the risky, embodied, accountable kind — can close them back up.
Andrea has watched her own caseload shift since AI chatbots became a daily habit for millions of people — not collapse, but settle into a lighter rhythm, clients coming every other week instead of every one. She doesn't fully know what to make of that yet, or where the line sits between AI easing the load on an overwhelmed mental health system and AI quietly replacing the harder, slower work of sitting with another person's pain. She's not against the technology. She's just watching, closely, to see what it does to the thing she's spent twenty years building — the room where two people, in front of each other, do the work no algorithm can do for them.
If you want to hear how she draws that line in her own words, the conversation is worth your time.