Podcast Summary: "The Algorithm Will See You Now – AI and Psychiatry"
Podcast: Click Here
Host: Dina Temple-Ralston (for Recorded Future News)
Guest: Dr. Stephen Xenakis (Psychiatrist, Retired U.S. Army Brigadier General)
Date: December 12, 2025
Episode Overview
This episode explores the intersection of artificial intelligence (AI) and psychiatry, specifically how AI can support the diagnosis and treatment of veterans struggling with mental health issues like PTSD. Host Dina Temple-Ralston interviews Dr. Stephen Xenakis, a psychiatrist and retired Army brigadier general known for his openness to innovative treatments—including AI-driven approaches. The discussion delves into how AI might enhance understanding, personalize treatment, and bridge gaps in mental health services, particularly in underserved areas.
Key Discussion Points & Insights
Dr. Xenakis: Not a Typical Psychiatrist (01:16–02:37)
- Background: Dr. Xenakis spent 28 years in the Army, working with military families, veterans, and detainees at Guantanamo Bay.
- Innovation in Treatment: He is known for championing unconventional therapies like psychedelics for PTSD, and is now investigating AI’s role in mental health care.
The Need for Better Tools in Psychiatry (02:37–05:45)
- Traditional psychiatric assessment tools (questionnaires, mood scales) are seen as too blunt for the nuances of real patients.
- Quote: “I think questionnaires...are too crude. That’s standard in the field. But I don’t think they get the kind of nuanced subtleties that we get just from an interview.”
— Dr. Xenakis (05:45)
How AI Could Help: Raw Interviews and Pattern Recognition (06:04–07:37)
- Dr. Xenakis envisions “raw” patient interviews (not just forms or checklists) being processed by large language models to detect subtleties, patterns, and keywords that might be missed by clinicians.
- Quote: “…because of the way these large language models work, they’re able to find key words and nests of words…so this goes way beyond—it's quantum leaps beyond—a questionnaire.”
— Dr. Xenakis (06:11)
Structuring the Interview for AI Analysis (07:14–07:41)
- Standardizing interviews with key clinical questions (“What is the problem? How serious? For how long?”) helps the AI effectively compare and analyze data across patients.
From Multiple Choice to Real Human Connection (07:48–09:35)
- Using AI to analyze richer, more human conversations could actually make psychiatric care feel less mechanical and more personal—despite the involvement of a machine.
- Dr. Xenakis sees this as letting technology “amplify” what works best in mental healthcare.
AI as a "Force Multiplier" for Underserved Areas (10:15–12:32)
- The shortage of psychiatrists in rural or remote states (e.g., Alaska, Wyoming) makes it difficult to provide timely, expert care to veterans.
- AI could act as a “force multiplier”—a military term—for clinicians, supplementing their expertise and enabling broader, more data-driven diagnosis and treatment.
- Quote: “I think it’d be particularly helpful outside of our urban areas, places where we don’t have a good number of mental health people, and yet we have a number of patients that are really seeking help.”
— Dr. Xenakis (11:07)
Leveraging Large Language Models and Learning Over Time (12:32–13:18)
- AI tools would continually refine recommendations by learning from new patient data and outcomes.
- Quote: “And then it would learn over time. …as we look at those patients who were prescribed [a medication] and look at their interviews, we can get a better idea of who would be a responder. And that’s really important.”
— Dr. Xenakis (12:45)
The Challenge of Self-Reported Data—and the Potential of Wearables (13:18–15:14)
- Self-reported data on sleep, exercise, and symptoms is often inaccurate—not due to dishonesty but forgetfulness or lack of awareness.
- Wearable devices (e.g., Apple Watch, Fitbit) can provide objective, minute-by-minute health data to supplement doctor-patient conversations.
- Quote: “It’s really hard to get good information from your patients about how well they slept or really did they exercise…How well did you sleep? I don’t know.”
— Dr. Xenakis (14:10) - Quote: “So let’s look at that, and then let’s look at what you did, or let’s look at your diet. And the more we have that and we can look at it together, the better decisions we can make…”
— Dr. Xenakis (14:53)
The Art and Limits of AI in Psychiatry (16:15–End)
- While AI and technology can transform psychiatry—making it more personalized and data-driven—the field relies on the art of human connection and judgment.
- Quote: “The rub is that psychiatry isn’t an equation. It isn’t about solving for X. It’s about people. And people can be messy…psychiatry isn’t just science. It’s an art. And AI isn’t an artist. At least not yet.”
— Dina Temple-Ralston (16:15)
Notable Quotes & Timestamps
- “I’ve been for years thinking that we needed to use these AI tools in identifying patients who would best respond to particular treatments.”
— Dr. Xenakis (02:37) - “We’re getting away from questionnaires. That’s what I’m trying not to do…”
— Dr. Xenakis (05:45) - “…It would just be a raw interview that could be uploaded and compared to what we think is our reference interview…”
— Dr. Xenakis (06:11) - “I know that there are many therapists out there that are in communities and may not have had a lot of [experience].”
— Dr. Xenakis (11:40) - “It’s really hard to get good information from your patients about how well they slept or really did they exercise…”
— Dr. Xenakis (14:10) - “...The more we have [objective data] and we can look at it together, the better decisions we can make.”
— Dr. Xenakis (14:53) - “The rub is that psychiatry isn’t an equation. It isn’t about solving for X. It’s about people. And people can be messy...psychiatry isn’t just science. It’s an art. And AI isn’t an artist. At least not yet.”
— Dina Temple-Ralston (16:15)
Key Segments & Timestamps
- Dr. Xenakis’ background and approach: 01:00–02:37
- Limits of psychiatric questionnaires: 05:30–06:04
- Raw interviews and large language models: 06:04–07:37
- AI as rural tool and force multiplier: 11:03–12:32
- Wearable tech and objective data: 14:32–15:14
- Reflections on the art of psychiatry: 16:15–End
Summary
This episode illustrates Dr. Xenakis’ forward-thinking vision of using AI and wearable technologies to supplement—but not replace—the human side of psychiatry. While AI can help identify patterns, personalize treatments, and expand access to care in underserved regions, the conversation ends with a reminder: technology is a tool, not a substitute for empathy, connection, and the nuanced art of healing minds.