Speaking to No One: Ontological Dissonance and the Double Bind of Conversational AI
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 a 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.
Cite
@article{arxiv.2604.10833,
title = {Speaking to No One: Ontological Dissonance and the Double Bind of Conversational AI},
author = {Hugh Brosnahan and Izabela Lipinska},
journal= {arXiv preprint arXiv:2604.10833},
year = {2026}
}
Comments
This version of the article has been accepted for publication in Medicine, Health Care and Philosophy following peer review. This version is distributed under Springer Nature's terms for accepted manuscripts and does not reflect any post-acceptance improvements or corrections. The Version of Record will be available via Springer Nature upon publication