Beyond the Critique of Imagination: The Journey of AI-Assisted Psychological Counseling for a University Student with Body Image Distress

This study details a psychological counseling process for a university student presenting with body image distress and relational anxiety. The client held a strong conviction that they emitted an unpleasant odor and had a squinting gaze, leading to persistent feelings of being disliked and discussed by others — subjective experiences that sharply contradicted objective observations. Building upon a supportive therapeutic relationship, the counselor integrated Cognitive Behavioral Therapy (CBT) with various expressive arts therapies (sandplay, house-tree-person drawings). Additionally, a digital tool (DeepSeek AI) was incorporated into the intervention framework as an auxiliary resource for self-exploration. By guiding the client to externalize and concretize abstract distress, and collaboratively examining the discrepancy between their beliefs and reality, the intervention successfully helped significantly reduce anxiety levels, loosen fixed erroneous beliefs, and enhance reality-testing abilities and social functioning. This case suggests that for such complex issues involving deep perceptual distortions and social fears, a multimodal approach combining talk therapy, experiential activities, and artistic expression can more effectively access and transform core psychological conflicts.