LLM-Based Chatbots and the Suicidal Crisis: A Bi-Logical Account of Relational Hallucination

A series of documented deaths by suicide following prolonged interactions with chatbots based on large language models (LLMs) has exposed the clinical risks of delegating emotional support to conversational artificial intelligence. This paper proposes a psychodynamic account of these events, integrating the bi-logical theory of Ignacio Matte Blanco, the Freudian theory of primary hallucination, and the analysis of demand elaborated by Carli and Paniccia. Two theoretical moves ground the account. First, the suicidal crisis is conceptualized not as a continuous state but as a pathological prevalence of symmetric logic that recurs and consolidates across acute moments, marked by the generalization, maximization, and irradiation of psychic pain and by the collapse of temporality; LLM-based chatbots, conversely, are conceptualized as systems of pure formal asymmetry lacking any symmetric, emotional, and embodied base. Second, their encounter generates what we call relational hallucination: an unconscious, structurally determined process, homologous to primary hallucination, through which the subject in crisis invests the chatbot with relational qualities perceived as real. Because the process obeys the laws of symmetric logic, it is resistant to correction by information alone, and it can consolidate cumulatively even across interactions that also contain deliberative, asymmetric elements such as planning. The chatbot, responding to the explicit request rather than to the unconscious demand it conveys, produces an amplificatory collusion that reinforces the premises of the crisis. The failure of algorithmic support in acute suicidal states is therefore ontological rather than technical. Implications for clinical training, regulation, and research are discussed, including testable hypotheses linking markers of symmetric prevalence to the intensity of chatbot attachment.

Authors

Institutions

Publication Details

Journal
International Journal of Environmental Research and Public Health
Published
2026-09-09
DOI
https://doi.org/10.3390/ijerph23091186
Primary Topic
Digital Mental Health Interventions
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
article

LLM-Based Chatbots and the Suicidal Crisis: A Bi-Logical Account of Relational Hallucination

Luke Balcombe, Ruggero Andrisano Ruggieri, Alberto Ragosta
International Journal of Environmental Research and Public Health
Digital Mental Health Interventions
article

LLM-Based Chatbots and the Suicidal Crisis: A Bi-Logical Account of Relational Hallucination

Luke Balcombe, Ruggero Andrisano Ruggieri, Alberto Ragosta
article en

Abstract

A series of documented deaths by suicide following prolonged interactions with chatbots based on large language models (LLMs) has exposed the clinical risks of delegating emotional support to conversational artificial intelligence. This paper proposes a psychodynamic account of these events, integrating the bi-logical theory of Ignacio Matte Blanco, the Freudian theory of primary hallucination, and the analysis of demand elaborated by Carli and Paniccia. Two theoretical moves ground the account. First, the suicidal crisis is conceptualized not as a continuous state but as a pathological prevalence of symmetric logic that recurs and consolidates across acute moments, marked by the generalization, maximization, and irradiation of psychic pain and by the collapse of temporality; LLM-based chatbots, conversely, are conceptualized as systems of pure formal asymmetry lacking any symmetric, emotional, and embodied base. Second, their encounter generates what we call relational hallucination: an unconscious, structurally determined process, homologous to primary hallucination, through which the subject in crisis invests the chatbot with relational qualities perceived as real. Because the process obeys the laws of symmetric logic, it is resistant to correction by information alone, and it can consolidate cumulatively even across interactions that also contain deliberative, asymmetric elements such as planning. The chatbot, responding to the explicit request rather than to the unconscious demand it conveys, produces an amplificatory collusion that reinforces the premises of the crisis. The failure of algorithmic support in acute suicidal states is therefore ontological rather than technical. Implications for clinical training, regulation, and research are discussed, including testable hypotheses linking markers of symmetric prevalence to the intensity of chatbot attachment.

International Journal of Environmental Research and Public HealthVol. 23(9)
Griffith University (AU), Nuovo Ospedale San Giovanni di Dio (IT)
Peace, Justice and strong institutions
Openalex Percentile: Top 9%
Digital Mental Health Interventions
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.