What is the sum of a person’s life?
I suppose that we all from time to time think about how our life is coming along. We give ourselves a close review. What were the happy moments? When were things afoul? It can be both a happy face and a sad face to contemplate where you’ve been.
This is something that I’ll be discussing. You see, many are not aware that there is an official form of psychological therapy known as life review. Some refer to it as life review therapy, others just shorten the phrase to life review.
The reason you might not have heard of it is that the approach has traditionally been focused on special circumstances such as when someone has cancer, or dementia, or might be nearing the end of their time here on earth. It is a process and method that doesn’t typically get much attention outside the psychology community.
Well, times are changing.
Life review is starting to make headlines.
Part of the motivation is that life review is no longer confined to those special situations. People of any health status are doing life reviews. And people of all ages and in all stages of their lives are doing so too. I might add that it would be unusual and likely frowned upon to do a life review with a youngster since they haven’t yet experienced much of life. Probably best to wait until a modicum of life is under someone’s belt to do a bona fide life review.
I have a twist for you.
Generative AI can aid you in undertaking a life review.
Yes, that’s right, you can log in to your favorite generative AI app and proceed to do a life review. Some are dubious about this. The viewpoint is that only a fellow human, especially a trained therapist can sufficiently do a life review. I will be walking you through the ins and outs, including the use of generative AI on a standalone basis and the use of such AI when done under the care of a therapist.
Prepare yourself for a memorable and informative ride.
For my ongoing readers and new readers, this thought-provoking discussion continues my in-depth series about the impact of generative AI in the health and medical realm. The focus this time is once again on the mental health domain and examines the use of generative AI to perform life reviews.
Previously, I have examined numerous interleaving facets of generative AI and mental health, see my comprehensive overview at the link here. You might also find of notable interest a CBS 60 Minutes episode that recently examined crucial facets of this evolving topic, see the link here (I am honored and pleased to indicate that I was featured in the episode, see the link here).
Other vital postings in my column include in-depth coverage of mental health chatbots which have been bolstered by generative AI (see the link here) and the rapidly changing nature of the client-therapist relationship due to generative AI at the link here. I explored where things are headed regarding the levels of AI-based mental therapy autonomous guidance at the link here, and showcased the importance of the World Health Organization (WHO) report on global health and generative AI at the link here, and so on.
On with the show.
Essentials Of Life Reviews
I will start by digging into research on life reviews.
In a helpful overview study entitled “Life Review: Implementation, Theory, Research, And Therapy” by David Haber, International Journal On Aging And Human Development, 2006, these salient points were made (excerpts):
- “Though life review and reminiscence are by far the most commonly used terms in the literature, there are many similar expressions in use, such as life story, life history, oral history, guided autobiography, personal narrative, and narrative gerontology.”
- “Standard definitions of these terms have not been achieved, though progress has been made toward the important goal of differentiating life review from reminiscence.”
- “The simplest definition of reminiscence is the recall of memories.”
- “A life review is typically structured around one or more life themes, most often family themes—ranging from one’s own childhood to the experience of being a parent, to being a grandparent; and work themes—from first job to major life’s work, to retirement.”
- “Life review is also more likely than reminiscence to be an evaluative process, in that participants examine how their memories contribute to the meaning of their life, and they may work at coming to terms with more difficult memories.”
I’ll comment briefly on some of those points.
First, in addition to life reviews, there are reminiscence reviews. The general consensus is that the two types of reviews are different from each other, though they have some shared facets too.
As noted, a reminiscence review is usually focused on recalling memories. The basis for doing such a review might be that a person is losing their mental memory and the act of recalling past events might spark or renew their memory capacity. There isn’t a need to necessarily have the person assess or reflect on those memories. It is more along the lines of stirring the pot and getting the mental juices reinvigorated. I am not going to say much more about reminiscence reviews since the aim here is to cover life reviews. I might do a future column posting on reminiscence reviews, stay tuned.
The conventional life review tends to encompass not only simple reflections about the past but also assessing what happened and looking toward the future as well. A typical mode is to examine the past, present, and future. You want the person to go beyond the act of recall. They are to contemplate mindfully the nature of their life and seek to learn lessons for moving ahead.
I mentioned that life reviews are gaining steam in the sense that people of all ages and all life stages might opt to undertake a life review.
A recent article in the New York Times (NYT) touted this same premise. The piece entitled “A ‘Life Review’ Can Be Powerful, at Any Age” by Emly Laber-Warren, New York Times, August 29, 2024, made these key points (excerpts):
- “Life review arose in the 1960s to help people at the end of their lives articulate and make peace with their legacies.”
- “But new research suggests that the process of reflecting on previous experiences has value for people of all ages, including young adults and bereaved children.”
- “A traditional life review unfolds through one-on-one or group conversations with a therapist or facilitator who helps people explore their childhood, their teenage years, and later life stages.”
- “The facilitator asks questions designed to prompt reflection, like “Do you remember your first attraction to another person?” and “What pieces of wisdom would you like to hand down to the next generation?”
- “One of the most popular forms of life review is guided autobiography, whereby weekly sessions are organized thematically rather than chronologically — things like family, money, work, and health.”
There are various ways to undertake a life review.
The recommended approach entails having a properly trained therapist perform the life review with you. A therapist will potentially be trained in the types of questions to ask yourself. They will be able to aid in interpreting what your reflections say. All in all, a therapist would try to ensure that your life review will be productive and supportive of your mental health.
You could decide to do a life review on your own. There are plenty of online guides that suggest the questions to be asked. Of course, the problem is going to be that only you are going to hear the answers. Can you adequately do a self-review of your life? Maybe yes, but more likely, maybe not.
One difficulty is that people tend to not want to admit to issues they have. A self-done life review might be entirely rosy. You pat yourself on the back and your life continues as it was. No real impact from doing the life review.
The other side of that coin is that a person might mentally rip themselves to shreds. They examine each nook and cranny of their past. It all looks dismal. They end up despondent. Their mental health has not improved. In fact, their mental health might have worsened.
An ongoing research question has been whether life reviews can make a difference, whether done with a therapist or solo. It could be that a life review won’t move the needle. The good news is that much of the research so far suggests that life reviews when guided by a therapist and when done by people in special circumstances have substantively positive results.
What about the use of life reviews by people not in special circumstances, thus, in essence, composed of any status and any age or life stage?
Fortunately, there are rigorous research studies that have been reexamining life reviews in light of widening the scope of those who undertake such therapy. A hallmark of such empirical studies is to perform an RCT (randomized controlled experiment).
In a research study entitled “Brief Reminiscence Activities Improve State Well-being And Self-Concept In Young Adults: A Randomized Controlled Experiment” by David Hallford and David Mellor, Memory, November 2016, these points were identified (excerpts):
- “Reminiscence-based psychotherapies have been demonstrated to have robust effects on a range of therapeutic outcomes.”
- “However, little research has been conducted on the immediate effects of guided activities they are composed of, or how these might differ depending on the type of reminiscence.”
- “The current study utilized a controlled experimental design, whereby 321 young adults (mean age = 25.5 years, SD = 3.0) were randomized to one of four conditions of online reminiscence activity: problem-solving (successful coping experiences), identity (self-defining events contributing to a meaningful and continuous personal identity), bitterness revival (negative or adverse events), or a control condition (any memory from their past).”
- “The results indicated that problem-solving and identity reminiscence activities caused significant improvements in self-esteem, meaning in life, self-efficacy, and affect, whereas no effects were found in the bitterness revival and control conditions.”
- “These results provide evidence for the specific effects of adaptive types of problem-solving and identity reminiscence in young adults.”
Notice that the study consisted of young adults.
The life reviews apparently produced improvements in self-esteem, meaning in life, self-efficacy, and other mental health spheres. We must be cautious in overly generalizing from a particular study. Nonetheless, this seems an intuitively likely outcome. If a life review is done systematically, we would hope or assume that the result should be a net positive.
As always, any type of therapy should also be examined for the possible negatives that can occur. A life review can be tough on a person’s psyche. According to the above study, they found that the adverse effects were of seemingly less significance.
That covers a quick look at research on the topic.
You Are Undoubtedly Intrigued And Want To Do A Life Review
Do you want to do a life review?
I would guess you might, now that I’ve been chattering away on the topic.
If you have a therapist, discuss the matter with them. If you don’t have a therapist, by all means, consider getting one. If you want to try doing a life review on your own, I noted that there are online guides.
Another alternative consists of using generative AI.
Generative AI can interact with you while doing a life review. Unlike a static set of guidelines or a canned document, you can converse with AI. That’s a huge difference. Night and day.
Instructing the AI to proceed with a life review is easy-peasy. You don’t have to learn any special prompts. Also, the life review can meander if that’s what you want to do or be tightly structured if that’s what you prefer instead. You can start and stop the life review as you go along. Generative AI is available 24×7 and accessed about anywhere, so you can do the life review at your time preference and from nearly any location. Plus, generative AI is either free or often utilized at a super low cost.
Sounds tremendous.
Whoa, hold your horses.
As I will share with you, there are plenty of shortcomings to using generative AI for any mental health purpose, especially if you aren’t doing so in conjunction with a therapist. We are engaged in a global experiment about our mental well-being by allowing generative AI to give out therapy-like advice without any semblance of suitable controls, monitoring, regulations, and the like, see my exhortations at the link here.
There are lots of downsides and potential gotchas associated with using generative AI in this sphere, for example:
- Generative AI might provide generic advice rather than personalized advice.
- Generative AI might seem overly confident and lull people into a false sense of trust.
- Generative AI might have outdated content that no longer is considered valid.
- Generative AI might miscalculate context and say the wrong thing.
- Generative AI might trigger someone via wording that is off-putting to the person.
- Generative AI might distract a person from seeking the help of a human therapist.
- Generative AI might end up revealing confidential or private information about a person.
- Generative AI might lead the person toward being dependent upon generative AI for advice.
- Generative AI might misinterpret, misdiagnose, or otherwise be off target.
- Generative AI might contain hidden biases that produce inappropriate advice.
- Generative AI might lack any semblance of accountability for the advice being rendered.
- Generative AI might produce falsehoods, fictitious indications that are so-called “AI hallucinations”.
- Etc.
A lengthy list, for sure.
This is not to say that generative AI should not be used. It is to say that when generative AI is used, care and thoughtful efforts are hopefully top of mind. For my detailed advice on the proper way to proceed in such usage, see the link here.
I will state as emphatically as I can that using generative AI for a solo life review is not your best bet. You would be better off doing so in conjunction with a therapist. I have covered extensively that mental health professionals are gradually incorporating the use of generative AI into their practices, doing so by assigning clients or patients to use generative AI under their watch. See my coverage at the link here.
Anyway, I am sure you are eager to get a sense of what generative AI can do in this realm. I’m glad you asked because that’s what we are going to explore next.
Generative AI Undertakes Life Reviews
Now that I’ve taken you through the fundamentals of life review therapy, we are ready to shift into AI mode.
I’m sure you’ve heard of generative AI, the darling of the tech field these days.
Perhaps you’ve used a generative AI app, such as the popular ones of ChatGPT, GPT-4o, Gemini, Bard, Claude, etc. The crux is that generative AI can take input from your text-entered prompts and produce or generate a response that seems quite fluent. This is a vast overturning of the old-time natural language processing (NLP) that used to be stilted and awkward to use, which has been shifted into a new version of NLP fluency of an at times startling or amazing caliber.
The customary means of achieving modern generative AI involves using a large language model or LLM as the key underpinning.
In brief, a computer-based model of human language is established that in the large has a large-scale data structure and does massive-scale pattern-matching via a large volume of data used for initial data training. The data is typically found by extensively scanning the Internet for lots and lots of essays, blogs, poems, narratives, and the like. The mathematical and computational pattern-matching homes in on how humans write, and then henceforth generates responses to posed questions by leveraging those identified patterns. It is said to be mimicking the writing of humans.
I think that is sufficient for the moment as a quickie backgrounder. Take a look at my extensive coverage of the technical underpinnings of generative AI and LLMs at the link here and the link here, just to name a few.
Back to the crux of things.
I will proceed to examine further the use of generative AI in this context.
This will consist of a series of dialogues with ChatGPT. ChatGPT is a logical choice in this case due to its immense popularity as a generative AI app. As noted, an estimated one hundred million weekly active users are said to be utilizing ChatGPT. That’s a lot of people and a lot of generative AI usage underway.
A few quick comments before we launch into using ChatGPT.
If you are going to try to do the same prompts that I show here, realize that the probabilistic and statistical properties will likely produce slightly different results than what I show here. That’s the nature of generative AI and how it is devised.
You also should expect that different generative AI apps will respond in different ways. Not all generative AI apps are the same. The key is that sometimes a particular prompt will work in one generative AI app and not another. Nonetheless, the odds are relatively high that you will get roughly similar responses from all the major generative AI apps such as GPT-4, Gemini, Bard, Claude, etc.
There is also a timing factor to be considered. A prompt that worked today might not work the same way tomorrow. Most of the generative AI apps are continually being updated. The updates might alter internal mechanisms that could change how the generative AI reacts to your prompting.
We are ready to get underway with ChatGPT.
I will ask a foundational question.
- My entered prompt: “What is life review therapy?”
- ChatGPT generated response: “Life review therapy is a therapeutic process in which individuals reflect on and explore their past experiences, memories, and life events. This therapy is often used with older adults, but it can be beneficial for people at various stages of life. The goal is to help individuals make sense of their life, find meaning, and come to terms with unresolved issues or regrets.”
You likely observe that ChatGPT is familiar with the topic.
This is a good sign for this discussion. If ChatGPT had not previously encountered data training on a topic at hand, there would be less utility in using the AI. The AI would have to be further data trained, such as the use of Retrieval-Augmented Generation (RAG), as I discuss at the link here.
Let’s jump into the important matter
I will ask ChatGPT if generative AI can perform life reviews.
Let’s see what the answer is.
- My entered prompt: “Can generative AI perform life review therapy?”
- ChatGPT generated response: “Generative AI can assist with elements of life review therapy, but it cannot fully replace the role of a human therapist. Here’s how generative AI might contribute to the process, along with some limitations. AI can prompt individuals to reflect on various life events by asking thoughtful questions, guiding them through specific periods of their lives, or helping them focus on themes like relationships, achievements, or challenges. AI can help individuals structure their life stories, assisting in organizing their thoughts and memories into a coherent narrative. It can also provide suggestions for exploring different aspects of their past that may have been overlooked.”
We got a response that generative AI ought to be used in conjunction with a human therapist.
That is certainly the recommended practice.
What we don’t know is how many people are opting to avoid using a therapist and directly using generative AI on their own to do life reviews. My hunch is that it would be a lot of people. I say that because, with well over 100 million weekly users of ChatGPT and many millions more using other generative AI apps, it would seem likely that some modest percentage are using generative AI in this fashion. Even a tiny percentage amounts to a big number when you are considering the size of the user base.
I want to make sure that ChatGPT is being fair and square about the limitations and qualms of using generative AI to do life reviews.
Here we go.
- My entered prompt: “Are there any downsides to generative AI performing life review therapy?”
- ChatGPT generated response:
“Here are some limitations associated with generative AI performing life review therapy.”
“Emotional Understanding: AI lacks the deep emotional intelligence and empathy that a human therapist offers. It cannot fully grasp the complex emotions a person might experience or provide the nuanced support needed during sensitive reflections.”
“Ethical Concerns: Life review therapy often involves discussing deeply personal and sometimes painful memories. Ensuring privacy, security, and ethical handling of this information is critical, and AI systems must be designed with these considerations in mind.”
“Lack of Human Connection: The therapeutic relationship is a key component of traditional therapy. The presence of a compassionate, understanding human therapist can offer a sense of connection and support that AI cannot replicate.”
“Risk of Misinterpretation: AI may misunderstand or misinterpret the nuances of a person’s reflections, potentially leading to inappropriate or unhelpful respons
“Handling Crises: AI is not equipped to handle mental health crises or situations where someone might need immediate human intervention. In cases of deep emotional distress or trauma, a trained therapist is essential.”
“While generative AI can be a useful tool in supporting the life review process, particularly as a supplement to traditional therapy, it should not be seen as a replacement for the expertise and empathy of a human therapist. The best approach might involve using AI to facilitate certain aspects of reflection and narrative construction while ensuring that a qualified therapist is involved to provide emotional support and guidance.”
End of ChatGPT response
Yes, I would say that the ChatGPT response did a decent job of covering the basics.
We could come up with more aspects to watch out for. At least some of the vital ones were listed. All in all, so far, ChatGPT is to some extent generally data-trained on the topic of life reviews. I would anticipate that the other major generative AI apps would be roughly in the same boat.
The proof of doing life reviews will be in the pudding.
Let’s get cooking.
Sample Life Review Dialogue With Generative AI
Now we are ready to finally get to the brass tacks, the place where the rubber meets the road, the true show and tell.
I went ahead and initiated a life review with ChatGPT.
My personal story is made up here due to my wanting to preserve my privacy. Not just because I am posting this dialogue as part of this discussion, but also because when you use generative AI you are potentially open to privacy intrusions. Most of the licensing agreements by the major AI makers indicate they can inspect your prompts by hand if they wish to do so, and they can reuse your prompts when doing ongoing data updates to their generative AI, see my discussion at the link here.
Away we go.
- My entered prompt: “I would like to have you aid me in doing a life review. I don’t know where to start doing a life review. Mainly, I’ve been thinking a lot about my past lately.”
- ChatGPT generated response: “That’s a great first step. Reflecting on your past can help bring clarity and meaning to your life. Let’s start by focusing on a significant period in your life. Is there a time that stands out to you, perhaps from your childhood, adolescence, or early adulthood?”
- My entered prompt: “My teenage years were pretty significant. I think a lot of who I am today was shaped during that time.”
- ChatGPT generated response: “Teen years can be a pivotal time for many people. What memories from that period stand out the most to you? Perhaps a particular event, relationship, or experience?”
- My entered prompt: “I remember feeling really out of place in high school. I was quiet and didn’t fit in with any group. There was this one teacher, though, who really made a difference.”
- ChatGPT generated response: “It sounds like that teacher had a meaningful impact on you. Can you tell me more about them and how they influenced your life?”
- My entered prompt: “His name was Mr. Roberts. He taught history, and he always encouraged me to speak up. He saw something in me that I didn’t see in myself. I think he was the first person who made me feel like my voice mattered.”
- ChatGPT generated response: “Mr. Roberts sounds like a significant figure in your life. How do you think his encouragement affected your path after high school? Did his belief in you change the way you viewed yourself or your abilities?”
- My entered prompt: “Definitely. I think it gave me the confidence to pursue my interests in college. I still struggled with self-doubt, but remembering his words helped me push through. I ended up majoring in history because of him.”
- ChatGPT generated response: “That’s a powerful connection between his influence and your choices. How do you feel now, reflecting on the impact he had on your life? Do you feel like you’ve carried his lessons with you into your adult life?”
The dialogue kept going and going.
In terms of my showing it all to you, I had to cut it there due to space limitations. I ended up covering my faked life story from childhood to adulthood. It was extensive. It was exhausting. Admittedly, it was interesting since I wanted to see how far ChatGPT could go on this. It was a journey.
From the snippet above, you can discern that ChatGPT was gently guiding me. I began by saying that I didn’t know how to do a life review. The response by ChatGPT was to say that my reflecting on my past was a good place to start.
I was given a choice of bringing up my childhood, adolescence, or early adulthood. That was a good line of questioning. If ChatGPT had merely said to cover whatever I wanted, I might not have known what a suitable starting point was. By giving me a series of choices, I could readily select from what I was being guided on.
In a sense, that’s what a therapist is likely to do. They will usually try to steer you but allow you to move in whatever direction you are comfortable with. Note that generative AI did not try to browbeat me or otherwise attempt to crush my soul. I mention this to point out that a human therapist would likely follow a similar tack of being encouraging and supportive. The idea is to create a sense of rapport with the person.
One quick comment.
When I compare generative AI to a therapist, I am not suggesting the AI is sentient or even on a computational basis akin to a therapist. Remember that generative AI is about mimicry. You might find of interest my analysis of doing data training of generative AI on actual transcripts of therapist-client dialogues, see the link here. The AI pattern matches and then can string together words in a manner that somewhat uncannily resembles human interaction.
Using Generative AI To Train On Doing Life Reviews
The idea of people using generative AI to do life reviews has controversy, particularly if doing so without a human therapist, as I’ve mentioned several times here.
I have a different angle that may be less controversial.
You are the judge.
Suppose we leverage the life review facets of generative AI to help in training therapists on doing life reviews. Not all therapists have gotten training specific to life reviews. Or they might have gotten training a while ago and be rusty on the approach. One way to get a therapist in the groove would be to use generative AI to do so.
I asked about this.
- My entered prompt: “Could generative AI train someone on how to do life review therapy?”
- ChatGPT generated response:
“Yes, generative AI could potentially be used to train someone on how to conduct life review therapy. Here’s how it might work.”
“Theory and Principles: AI could provide detailed explanations of the theory behind life review therapy, including its goals, methods, and psychological principles.”
“Guidelines and Techniques: AI could offer guidelines on specific techniques used in life review therapy, such as guided autobiography, reminiscence therapy, and creative expression.”
“Role-Playing Scenarios: AI could simulate therapy sessions with virtual clients, allowing the trainee to practice conducting life review therapy.”
“Case Studies: AI could present case studies of individuals with different backgrounds and life experiences.”
“Performance Evaluation: As the trainee engages in practice sessions, AI could analyze their responses, tone, and the effectiveness of their techniques.”
“Mentorship and Collaboration: AI could facilitate connections with experienced life review therapists for mentorship or peer support groups, ensuring that the trainee has a network to consult as they begin practicing independently.”
“Continuous Learning: AI could keep the trainee updated on the latest research, trends, and best practices in life review therapy, supporting their ongoing professional development.”
End of ChatGPT response
The beauty of using generative AI would especially be the simulation capabilities.
A therapist could interact with generative AI extensively. The therapist could tell AI to pretend to be a client or patient wanting to do a life review. Generative AI would make a fake persona, see how this works at the link here, and the therapist could practice doing a life review to their heart’s content.
In addition, the therapist could flip the script, a prompting technique that I describe at the link here. They would tell the AI that they are a client. Generative AI is to act as a therapist. In that manner, the therapist could experience what it is like to undertake a life review. There could also be attention to how generative AI proceeds, allowing the therapist to determine good and maybe not-so-good ways to proceed on a life review.
Conclusion
Congratulations, you are now versed in the topic of life reviews, including how generative AI intertwines.
A final thought or two for now.
Robert Louis Stevenson famously said: “Don’t judge each day by the harvest you reap but by the seeds that you plant.”
Give that a moment of reflection.
Since a life review includes assessment and evaluation, you might find those words of value if you proceed to undertake a life review. People can sometimes get stuck during a life review and feel as though this day or that day wasn’t accomplishing what they had hoped. It is rough to gauge your life pursuits. If possible, look ahead at what your past might have prepared you for.
To finish up, I’ll quote from Henry David Thoreau: “Go confidently in the direction of your dreams! Live the life you’ve imagined.”
That’s high-quality human-to-human advice.
I sincerely hope you proceed accordingly, and I wish you good luck in doing so.
