Practice Stories
Psychiatrist · The Empathy Clinic · 40 years in practice
A psychiatrist who has practiced for 40 years explains why the tool that changed his practice was never the one he was afraid of.
Dr. Ashok knew he wanted to be a doctor at eight years old, though he could not have told you what kind. What he did know, even then, was that he was drawn to something harder to name than medicine: "I was always interested in empathy. And empathy is the capacity to understand and appreciate the perspective of something else outside of you." He offers a strange, disarming example of what he means — what it might feel like to be a fly, chased around a bathroom by someone with a wet towel. We don't know. That not-knowing, and the discipline of reaching for it anyway, became the spine of his career. Decades later, he would found The Empathy Clinic in Toronto and build a psychiatric practice on the same premise: that understanding someone else's interior life is a skill, not a sentiment, and it can be practiced like one.
He calls himself a boomer without embarrassment. He trained "before we even were using calculators." For most of his 40 years, therapy meant a room, two chairs, and a slow accumulation of trust across sessions that could stretch for years.
Then came March 2020. "My government told me you can't see people in person anymore," he says of Toronto's pandemic shutdown. There was no curriculum for what came next — no course in delivering forty years of clinical instinct through a laptop camera. The government's own telehealth platform was so backlogged it would have taken six weeks to get running. He found a workaround, an American platform called Doxy, and got it working in thirty minutes flat with help from his daughter. "I have a daughter who is really tech-savvy," he says. "That's the coolest thing to have."
He expected the shift to cost him something. Instead, it gave him something he hadn't anticipated. "My fear as an old man, you know, doing therapy in person, was that this is not going to work. My surprise is that it worked better." Patients arrived calmer, freed from parking and traffic and the friction of leaving their own homes. And then there was the detail that still seems to catch him off guard when he tells it: the men. In a room together, men perform a kind of vigilance with each other — "we're basically like warriors," he says. Something about the two-dimensional distance of a screen dissolved that. "I was seeing guy men on on this in this platform, their tears were rolling. I needed my Kleenex." Men being treated for post-traumatic stress, he found, "were getting better twice as fast than in person."
That discovery reordered something in him. A man who had spent four decades believing presence meant a shared room learned that presence could travel through a wire and lose almost nothing — sometimes gain something.
Dr. Ashok's answer to AI is neither alarm nor evangelism. It's closer to a craftsman sizing up a new tool. He is a rock guitarist, and he reaches for his rig to explain it: he used to haul heavy tube amplifiers to gigs; now he carries a lightweight modeling amp with a computer inside it. People tell him his tone sounds amazing. "This is like a little AI amplifier," he tells them. "It sounds like the real thing. It's half the weight." His verdict on resisting new tools is blunt: "if you're threatened by the technology, you're using it the wrong way."
He uses AI himself, mostly for research — asking it to brief him on an unfamiliar diagnosis before a session. He doesn't fight it when clients bring in something an AI told them. But he draws a hard line around what technology should never absorb: the skills a person is supposed to keep for themselves. He worries about a generation that pushes a button and never learns to parallel park, and worries more, by extension, about clinicians who let a tool do what only a trained hand should do. "The problem comes if it's something that you should know how to do... and you never learn the skill, like how to talk to a patient, for example, or how to drill a tooth. I mean, yikes."
For all his comfort with the technology, Dr. Ashok is candid that the central question of his field remains open. Some of his clients now split their care between him and an AI app, and he watches that arrangement with genuine curiosity rather than territorial defensiveness. But he keeps returning to one unanswered question, the one he doesn't pretend to have solved: "Who's observing the emotions? Who's processing the connectivity of that? And does that feel right in the right ways? Does it build trust and reliability or does it build a false sense of trust and false reliability? That's going to be the question we'll find out over the next few years."
It's a rare thing — a clinician forty years into his career, still willing to say he doesn't know, still building his answer in real time rather than reciting one he settled on long ago. He leaves you with the same word he started on. "Empathy is finding out how much you can learn... about somebody. And the more we learn about somebody else, the more capable we are to understand where they're at, to be able to help them meaningfully."
Watch the conversation to hear him work through it — the amplifier, the crying men, the question he still can't fully answer.