Client Authored Case Study Explores Psychotherapy, AI, and the Reclamation of Narrative Agency
New SSRN paper examines collaboration, power, and epistemic risk in psychotherapy
Yorktown Heights, NY, April 01, 2026 --(PR.com)-- A newly released paper on SSRN presents a client authored, autoethnographic case study documenting a ten week course of collaborative psychotherapy that integrated EMDR, creative writing, and AI assisted reflection. The study argues for a model of psychotherapy that emphasizes client agency, transparency, and narrative coherence, while critically examining the promises and limitations of generative artificial intelligence as a therapeutic adjunct.
The paper, Binaries, Multitudes, and Beyond: A Client Authored Case Study in Psychotherapy, Artificial Intelligence, and Narrative Agency, was written by Mark A. Michaels, an independent researcher, and is publicly available on SSRN.
Unlike traditional case reports written from a clinician's perspective, the study is authored by the client himself, who also served as the primary analyst. Drawing on affect theory, attachment theory, mentalization, and Dabrowski's theory of positive disintegration, the paper traces how collaborative therapeutic relationships, attention to rupture and repair processes, and the reclamation of narrative coherence contributed to changes described by the author.
"This paper is not a road map," Michaels said. "It is not a claim about what will work for others. It is an exploration of what may be possible when therapists share power and client agency is centered."
A critique of hierarchy and diagnostic overreach
The case study offers a sustained critique of hierarchical therapeutic structures and what the author describes as diagnostic and interpretive overreach in both psychodynamic and psychotherapy contexts. Michaels documents experiences of self pathologization reinforced by professional authority, contrasting them with later therapeutic encounters characterized by collaboration, psychoeducation, and explicit attention to power dynamics.
The paper argues that such dynamics are not merely interpersonal but are embedded in broader therapeutic cultures and theoretical traditions, and more generally in popular culture, with implications for ethics, accountability, and client care.
AI as adjunct—and as risk
A distinctive feature of the study is its transparent account of using generative AI tools for transcription, reflection, and thematic exploration during therapy and manuscript development. While the paper highlights ways AI supported organization, pattern recognition, and narrative integration, it also documents significant limitations, including tendencies toward superficial affirmation, confirmation bias, and the use of psychologically fraught terminology.
Rather than presenting AI as a solution, the paper frames it as a potentially useful but limited tool whose use raises unresolved questions about epistemic trust, dependency, and the boundaries of algorithmic "empathy."
"The paper documents both the usefulness and the limitations of AI in reflective and writing processes," Michaels said. "It argues that these tools can sometimes aid organization and pattern recognition, but can also introduce bias, redundancy, and misleading interpretations."
Scope and limitations
The author emphasizes that the paper is a single case, client authored study and makes no claims of generalizability or clinical efficacy. No objective outcome measures are presented, and the findings are grounded entirely in subjective experience, narrative analysis, and theoretical interpretation.
The paper is intended as a provocation and a contribution to ongoing discussions about ethics, agency, and methodology in psychotherapy and human–AI collaboration.
The paper, Binaries, Multitudes, and Beyond: A Client Authored Case Study in Psychotherapy, Artificial Intelligence, and Narrative Agency, was written by Mark A. Michaels, an independent researcher, and is publicly available on SSRN.
Unlike traditional case reports written from a clinician's perspective, the study is authored by the client himself, who also served as the primary analyst. Drawing on affect theory, attachment theory, mentalization, and Dabrowski's theory of positive disintegration, the paper traces how collaborative therapeutic relationships, attention to rupture and repair processes, and the reclamation of narrative coherence contributed to changes described by the author.
"This paper is not a road map," Michaels said. "It is not a claim about what will work for others. It is an exploration of what may be possible when therapists share power and client agency is centered."
A critique of hierarchy and diagnostic overreach
The case study offers a sustained critique of hierarchical therapeutic structures and what the author describes as diagnostic and interpretive overreach in both psychodynamic and psychotherapy contexts. Michaels documents experiences of self pathologization reinforced by professional authority, contrasting them with later therapeutic encounters characterized by collaboration, psychoeducation, and explicit attention to power dynamics.
The paper argues that such dynamics are not merely interpersonal but are embedded in broader therapeutic cultures and theoretical traditions, and more generally in popular culture, with implications for ethics, accountability, and client care.
AI as adjunct—and as risk
A distinctive feature of the study is its transparent account of using generative AI tools for transcription, reflection, and thematic exploration during therapy and manuscript development. While the paper highlights ways AI supported organization, pattern recognition, and narrative integration, it also documents significant limitations, including tendencies toward superficial affirmation, confirmation bias, and the use of psychologically fraught terminology.
Rather than presenting AI as a solution, the paper frames it as a potentially useful but limited tool whose use raises unresolved questions about epistemic trust, dependency, and the boundaries of algorithmic "empathy."
"The paper documents both the usefulness and the limitations of AI in reflective and writing processes," Michaels said. "It argues that these tools can sometimes aid organization and pattern recognition, but can also introduce bias, redundancy, and misleading interpretations."
Scope and limitations
The author emphasizes that the paper is a single case, client authored study and makes no claims of generalizability or clinical efficacy. No objective outcome measures are presented, and the findings are grounded entirely in subjective experience, narrative analysis, and theoretical interpretation.
The paper is intended as a provocation and a contribution to ongoing discussions about ethics, agency, and methodology in psychotherapy and human–AI collaboration.
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Mark A. Michaels
347703470
markamichaels.com
347703470
markamichaels.com
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