Practice Stories
Psychotherapist · bipolar specialist · 20 years in practice
A bipolar specialist who has lived what he treats, on why he doesn't want AI anywhere near the chair he's spent twenty years sitting in.
Dr. Lawrence Levy doesn't trace his career back to a class he loved or a professor who inspired him. He traces it to grade ten. "When I was 15 years old, I had my first episode of major depression, and that lasted for several years, and that was a completely debilitating experience for me." It cost him his social world in high school — "I was very withdrawn, very isolating myself" — and it left him, in his own words, "completely isolated" and "alone." He remembers the exact thought that came out of it: "I don't want anybody else to have to go through this."
He carried that thought into university, where he was two years into an honors degree in applied mathematics — a natural science, in the Canadian system, about as far from psychology as a discipline can sit — when he made the switch. "I recognized my limitations in the mathematics, and I also realized I didn't want to be a math professor. That wouldn't be meaningful to me." So he crossed from the natural sciences into the social sciences, a jump he still calls unusual: "There aren't a lot of people with that kind of a background." Looking back on it now, he's direct about what that period cost him. "It was traumatic," he says, "going into grade nine and having friends and being sociable and being well-liked, to being somebody who's completely isolated." And he's just as direct about what studying the mind gave him in return: "I think learning about psychology did start the process of me beginning to heal."
Levy built a nearly two-decade career as a psychotherapist specializing in bipolar disorder — and partway through the conversation, without being pushed, he discloses why the specialty found him. "I also can tell you from personal experience, from experiencing myself bipolar disorder type one, which is the worst kind, the potentially lethal kind" — there's no comparison, he says, between that and the personality disorders it's so often confused with. He describes the two conditions with a precision that only comes from having sat on both sides of the desk: bipolar disorder as weeks of incapacitating depression followed by weeks of incapacitating mania, versus a personality disorder's difficulty sustaining relationships. "They're not at all similar," he says, "yet I see even online lots of people confuse the two."
It's the kind of clarity that comes from a clinician who isn't just trained in the diagnosis. He's lived inside it.
Midway through the conversation, a question about his LinkedIn bio — it lists "defy death twice" — opens onto the reason he isn't currently practicing. "I had an emergency heart transplant seven months ago," he says, plainly. "So no, I'm currently on medical leave." The condition was genetic, not lifestyle. He had a week to decide. "Either you get this transplant or you're going to palliative care and you're going to die." He chose to live. "On a Monday they put me on a waitlist, and by the Wednesday they had found me a heart... I had the heart transplant on the Thursday. Within four days my life was saved."
What stayed with him wasn't just the speed of it — it was who showed up. "I had a cardiologist come to my bedside every single day for a week asking me, 'What's your decision?' Every single day the same question." He calls it "that personal touch," the thing that "helped me basically save my own life." It's not a throwaway detail. It's the same principle he's spent twenty years applying to psychotherapy, now tested on himself: presence, repeated, from someone who is actually there.
Levy's skepticism about AI in therapy isn't a hunch — it's a position built from two decades of watching what a real session requires. "ChatGPT loves to amplify whatever you say," he says. "It doesn't tend to challenge you." A good therapist does the opposite: "They will challenge you. They will make you think. They will push you to certain limits." He's watched colleagues and friends turn to AI at three in the morning, when no therapist is reachable, and he doesn't dress up his concern. "There's no consciousness, there's no actual empathy, there's no actual compassion. Everything's manufactured from a large language model. It's predicting what the next response will be. It's not a human being."
He's not against technology outright — he thinks daily mood, thought, and behavior tracking, done by hand or through an app, has real value, "to help you understand yourself better." But on the question of AI standing in for a therapist, his line is drawn from lived experience on both sides of the relationship: as a patient who was depressed at fifteen, and as a doctor whose life was saved by a person who kept showing up. "I have one comment to make," he says. "Make sure you never let AI replace you. Because you cannot be replaced."
Levy doesn't claim to have the answer to the question underneath his own position — how a profession that requires paid, scheduled, human presence competes with a tool that's instantly available and free. "It's much easier for someone to talk to ChatGPT... than it is for them to go and see a therapist and have to pay money," he says. "So how do we coexist with such an intricate, detailed technology? That's a very hard question." He calls himself, in the end, someone in the middle — "there are benefits, but there are disadvantages, I try to take a balanced approach" — and he says it from medical leave, recovering, with no fixed date for when he returns to the chair he's spent twenty years in.
If you want to hear a therapist reason through that question in real time — from someone who has been the patient on both ends of it — watch the conversation.