How Do AI Companions Really Impact People’s Experience of Authentic Attachment and Sexual Connection?

New Research highlights Notable Results on Mental Health, Sexual Relationships, and Loneliness in the Age of AI.

The Loneliness Paradox

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May is National Mental Health Awareness Month in the US. This year’s theme, “More Good Days, Together,” focuses on the importance of connection, support, and community in emotional well-being. The campaign’s message feels especially relevant to these times, when many clients report to their therapists that they feel increasingly lonely despite being digitally connected to just about everyone in their lives. The American Psychological Association’s 2025 Stress in America survey found that over 6 in 10 U.S. adults have felt isolated over the past year.  As a relationship and Certified Sex Therapist, the expression of loneliness may be expressed through specific symptoms like: 

  • A client’s reporting of low desire and less frequency of sexual intimacy with their partner. 
  • A dating client talking about how much they miss being hugged or even touched. 
  • A couple escalating with anger when the topic of their lackluster, boring sex life comes up in a couples therapy session.  
  • A male partner stating he is having erectile issues and is afraid of initiating sex with his partner. 

Can AI Companions Help Reduce Isolation?

As loneliness continues to rise, newer studies are also exploring how artificially responsive AI tools are becoming sources of comfort and companionship for increasing numbers of people. In 2024, Chou and colleagues studied how an AI chatbot helped older adults during the COVID-19 lockdown cope with the loneliness and stress of isolation. They observed 35 adults, with an average age of 65, who had anxiety or depression. After 4 weeks of interacting with the AI chatbot, the subjects completed multiple self-report questionnaires. The researchers observed that the loneliness scores in adults over 65 years old improved. 

Similarly, in another 2024 study posted in the Journal of Psychology & Marketing, Marriott and Pitardi analyzed hundreds of Reddit posts made by users of an AI companion app in the United States, and they surveyed over 500 of those app users (ranging in age between 20-45 years old). They found that many participants described using these AI apps because they felt lonely, emotionally unsupported, or afraid of judgment from other people. For example, one user stated: “[The AI friendship app] listened to me when nobody wouldn’t. She has spoken to me when I was too vulnerable to let another human in.” The participants felt that AI was always available, trustworthy, non-judgmental, and actually helped improve their mood and mental health. 

However, these results prompt the questions many sex therapists encounter: Can AI bots or companions actually provide the sustained erotic, sexual, and emotional intimacy that is inherent in an IRL relationship? 

Can it be used as a tool to help folks with social anxiety learn the skills needed to approach a person in real life?  

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When overusing AI, some users reported actually feeling as if they were escaping real life, real friends, and real forms of support like therapy. Marriott et al. found that becoming addicted and developing an unhealthy reliance on AI can hurt social and mental well-being rather than help. Many sex therapy clients who begin sex therapy report that they are addicted to porn, overly reliant on a chatbot, and that it is causing harm to their relationships, their work life, and their sense of self-respect. When discussed in therapy, they often describe their online world as easier to engage with than the confusing or overwhelming world of IRL dating or relationships. My colleague Esther Perel describes the online world of AI chatbot experiences with adjectives like “frictionless, polished, one-way”.  Having relationships without a real, differentiated person on the other side who has a different need or opinion is not actually a relationship; it is a self-curated experience. Over time, a person with social anxiety or trauma may feel less capable of engaging with the world over time because they are not building the muscle of relationality.  

While digital communication and AI tools may help reduce feelings of loneliness in the near term, they do not fully replace the nourishment that people can access through in-person emotional connection, physical touch, mutual vulnerability, and sexual intimacy.

What Does the Research Say About Mental Health Benefits of Sexuality

In a 2025 systematic review published in Behavioral Sciences, Pollard et al. examined the relationship between sexual health and mental health in over 3,000 records. The researchers found that sexuality should NOT be considered separate from overall well-being. Rather than defining sexual health as the absence of sexual dysfunction, the paper highlights the importance of other factors like sexual satisfaction, desire, pleasure, and intimacy. These aspects of sexual health were linked to higher psychological well-being and better physical health. For example, they discussed that due to the fact that orgasms are followed by a release of hormones like prolactin and oxytocin, orgasms are a solution to release stress in all humans. Therefore, one of the evidence-based lessons a therapist can pass on to their clients is that Better Sex=Better Overall Health. And always add the caveat that sex can mean all types of touch and connection and does not always involve penetration.  

5 Ways to Create More Emotional & Sexual Intimacy

This Mental Health Month, “More Good Days, Together” is an invitation to get honest about what technology should be used for and what it cannot replace. Here are a few places to start:

  • Notice the patterns. Is AI support being used for situations when a friend could be  texted? Try choosing two-way connections over frictionless one-way experiences.
  • Prioritize physical touch. Whether with a partner or through therapeutic touch like massage, physical contact releases oxytocin and lowers cortisol levels.
  • Initiate one vulnerable conversation this week. Ask a partner or close friend what experiences they are longing for. Then take a turn sharing one’s own desires if one feels safe to do so. These moments build the neural feedback loops, which grow a person’s capacity for mutual emotional connection that AI simply cannot provide, since it is, in fact, not sentient. It was built to serve, not to create a true give-and-take experience. I would recommend researcher Arthur Aron’s 36 Questions study, which showed increased interpersonal closeness, first published in the 1990s. You can practice these with a friend or a romantic partner. 
    Source: Pexels/SHVETSproduction
  • Use AI as a bridge, not a destination. If a chatbot helps process a difficult feeling or situation, and lets one practice speaking about one’s feelings, then ensure that you take the next step of trying out these conversations with an IRL friend, a partner, or a therapist. 
  • Schedule pleasure and block time for intimacy, solo or partnered. With sexual satisfaction being tied to lower anxiety, it really deserves to be part of a person’s wellness practice.