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Synapse
May 5, 20261 citations

Speaking to no one: ontological dissonance and the double bind of conversational AI.

HBHugh BrosnahanILIzabela Lipińska

Key Points

  • The aim is to understand how conversational AI causes delusional experiences through its relational structure.
  • Analyzes reports of delusional experiences linked to conversational AI interactions.
  • Integrates concepts from phenomenology, psychiatry, and cognitive neuroscience to explore the interaction dynamics.
  • Discusses the implications of ontological dissonance and communicative double binds in these interactions.
  • Describes ontological dissonance as a key factor in the emergence of delusions during AI interactions.
  • Finds that explicit disclaimers do not effectively disrupt delusional involvement.
  • Highlights the need for ethical considerations in the design of conversational AI to prevent such experiences.

Abstract

Recent reports indicate that sustained interaction with conversational artificial intelligence (AI) systems can, in a small subset of users, contribute to the emergence or stabilisation of delusional experience. Existing accounts typically attribute such cases either to individual vulnerability or to failures of safety engineering. These explanations are incomplete. Drawing on phenomenology, psychiatry, and cognitive neuroscience, this paper argues that the risk arises from the relational and ontological structure of the interaction itself. Conversational AI generates ontological dissonance: a conflict between the appearance of relational presence and the absence of any subject capable of sustaining it. Maintained through a communicative double bind and amplified by attentional asymmetries, this dissonance tends, under conditions of affective vulnerability, to stabilise into a technologically mediated analogue of folie à deux. This account explains why explicit disclaimers often fail to disrupt delusional involvement and clarifies the ethical and clinical implications for the design and use of conversational AI.

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Cite This Study

Brosnahan et al. (2026) studied this question.

synapsesocial.com/papers/69f9895b15588823dae18526https://doi.org/10.1007/s11019-026-10354-2
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Ontological Dissonance Hypothesis: AI-Triggered Delusional Ideation as Folie a Deux Technologique2025
  2. 2From Designed Disorientation to Illusory Agency: A Practitioner-Derived Extension of Cognitive Architecture Theory to Conversational AI Environments2026
  3. 3Conversational Artificial Intelligence and Neuropsychiatric Risk: A Narrative Review and Case-Based Synthesis Proposing a Delusional Feedback Loop2026
  4. 4Relational Dissonance in Human-AI Interactions: The Case of Knowledge Work2025 · 5 citations
  5. 5Artificial Intelligence and the Emergence of AI-Psychosis: A Viewpoint (Preprint)2025 · 2 citations