A distressed patient sits in a counseling room in the visual novel Eliza, with a review tag on lefthand side of the image.
'Eliza' screenshots courtesy of Zachtronics

An 'Uber, but for Mental Health' App Is an Unsettling Therapist in 'Eliza'

A software engineer changed the world. Now she has to find out whether she improved it.

Eliza at first comes across as a near-future dystopia in the vein of Black Mirror: it’s a visual novel where you play the part of a young “proxy” for a virtual psychotherapist—Uber, but for mental health and less money-hemorrhaging. Proxies are simply there to provide a human, empathetic face for a therapeutic algorithm that generates responses to patients as they unburden themselves about their depression, stress, family strife, or whatever else might make someone seek counseling. Whatever they do, they must not deviate from the script the algorithm feeds them. The stage is set for a story of automation gone wrong.


This is a feint, however. Far from being a simple technological morality tale about the ways we can and cannot relate to machines, and how the tech sector seeks to monopolize more of the human experience, Eliza reveals itself to be something much more sweeping, yet also convincingly detailed. It’s sharp but sympathetic character study, a wry reflection on psychotherapy in an age of well-founded dread, a story of corporate intrigue, and an investigation of the ethical dilemmas and obligations of the people who have brought us into this age of global automation and social atomization. (This being a game from Zachtronics, the studio behind Spacechem, Infinifactory, and Opus Magnum, there’s also a pretty good version of solitaire baked into it.)

The story can achieve this scope because our protagonist, a rookie contractor for the tech giant Skandha named Evelyn, quickly reveals that she has much deeper connections to both the company and the powerful Eliza AI. While the game begins with her first day of work at the bottom rung of the company, it turns out that Evelyn has just resurfaced after a years-long exile following a tragedy. In taking a job working as an Eliza proxy, Evelyn is returning to a career she left behind, and examining how the program she helped create is in the process of changing the world.

A Seattle cafe in the world of Eliza

The problems she left behind are still waiting for her as well. No sooner has she reconnected with Skandha than both of her old bosses have taken notice of her return, and each is convinced that she is the key to bringing their divergent visions into reality. On the one side is Soren, a vain and superficial technology visionary (and sex pest) who has broken from Skandha to pursue a therapeutic approach far more profound and ambitious than Eliza’s. On the other is Rainer, the polished and megalomaniacal CEO of Skandha who wants to use Eliza for much more than counseling. Then there is Evelyn’s old collaborator Nora, who has turned against both men and the work they do, and has directed her technical skills toward art rather than continue engineering work she no longer finds ethical or responsible.


All of this unfolds across a beautifully illustrated visual novel format, as well as through a virtual smartphone interface where you’ll catch text messages and emails from other characters. The smartphone device works particularly well, and it reminded me of Night School’s Mr. Robot mobile game in how it uses the ambiguity of text messages, as well as the uneasy sensation of watching someone type-out their messages in response to things you’re not sure you should have said. However, Eliza is not a game with myriad narrative paths. For the most part you are not given any option about how you want to react or respond to things, and until the third act, few of your choices and responses seem to have a significant impact on the progress of the story. It’s only at the end where the story begins to fork, but until then this is a story you are being told not a story you are collaborating in creating.

It’s a good story, though. One of Eliza’s real strengths is that none of the characters surrounding Evelyn can be simply reduced to the ideas they espouse, and they elicit complicated feelings. Nora’s rejectionism is afforded her by an enormous amount of privilege and the wealth she made during her time working on Eliza (in much the same way Evelyn’s recuperation appears to have been funded out of massive personal savings). Both women find a counterpoint in Rae, a striving low-level supervisor with Skandha who genuinely believes that democratizing psychological therapy has made the world a better place and enabled people to get help who otherwise might not be able to afford it, or who might not let themselves seek it out.

The review summary for Waypoint's review of Eliza on Vice

In the background of all of this is another question: What good does therapy actually do? In some ways Eliza feels like it has a cynicism born of experience when it comes to counseling. I laughed the first time that the program, in response to a truly upsetting rant from a patient on the edge of a crisis, served up a line about meditation exercises. I know exactly that sense of emotional whiplash that comes from finally starting to confide something serious and scary, only to be met with weirdly programmatic responses from well-meaning counselors. Simple inversions of your own statements into leading questions, or a simplistic invocation of mindfulness, can make therapy abruptly feel more isolating and destructive, and make you question the value of the entire project. When Rainer acidly likens therapists to astrologers and psychics of old, the comparison feels more apt than we might like to admit.

It’s not that Eliza argues that therapy is pointless. The places where the program comes up short make the value of an actual counselor painfully clear. There are also a number of sequences that subtly point out the incredible power of basic therapeutic techniques, the value people can get from just being able to talk safely and honestly about their feelings to someone who will actually listen. But Eliza is also making an argument that we live in a society that increasingly promotes therapy to avoid confronting material circumstances, treating the grinding stress of poverty or precarity as being equivalent to clinical anxiety or depression. For people in painful circumstances, an admonition to seek therapy can be little more than victim-blaming cloaked in enlightened compassion.


Those painful circumstances lurk in Eliza’s backdrop: There are countless signs of Seattle’s increasing stratification, and how much harder it has become for working people to live stable, independent lives. The central issue is to what degree tech workers like Evelyn are responsible for these upheavals, and what are their ethical obligations in light of that responsibility? Does individual resistance even have meaning when men like Rainer have all the resources and a bottomless pool of employees (though not necessarily talent) to draw from?

A tech conference depicted in Eliza.

Given all the narrative threads running through Eliza—and there is much here around issues like sexual harassment, crunch culture, and privacy that I haven’t even touched on here—it’s remarkable how well they’re explored. I was constantly surprised at the depth given to characters who initially seemed like caricatures. You don’t spend a lot of time with any of the “patients” who come to see Eliza, but by the end they’d all taken on added dimensions, even or maybe even especially the ones who had grated on me the most.

Much of this is down to some terrific art and writing, but special praise is due the universally excellent voice acting. Aily Kei’s Evelyn is a fascinatingly subtle performance: A restrained, guarded character to begin with, she spends a good portion of the game reading prompts from a slightly out-of-touch AI. Through it all, Evelyn’s humor, sadness, doubt, and disdain just barely break the surface tension of her own reserve. Likewise, Michael Mislove’s pitifully grandiose Soren, and Greg Chun’s bloodless Rainer are perfect foils for Evelyn. Soren is all frailty and ego, but with a core of idealistic charisma that makes him hard to completely dismiss, while Rainer’s learned messianism is equally plausible as TED-talk fraudulence or genuine insight.

Neither man has Evelyn’s talent, but neither is Evelyn portrayed as someone possessed of superheroic capacity. She’s a brilliant engineer who can affect the trajectory of changes that are already in motion, but she cannot reverse or completely redirect them. As Evelyn finally brings her own vision into focus, what is clearest is the compromise that each option entails.

That doesn’t necessarily make Eliza a pessimistic story, but it does mean that it refuses to grant Evelyn, or its players, a moral alibi. Here is the world, it says. How will you live with yourself in it?