Where Did Psychotherapy Go Wrong? | Ian Cox
3 September 2026
With Ian Cox
therapy-and-psychology
Ian Cox, an Irish psychologist and university lecturer, traces how postmodern ideology infiltrated counselling and psychology training, displacing scientific reasoning with activist frameworks. His account of complaints, doxxing, and professional retaliation illustrates how institutions built to protect rigorous thinking have become enforcers of ideological conformity. The episode asks a foundational question: when therapy abandons evidence in favour of affirmation, who pays the price?
Therapy has long been understood as a discipline built on careful listening, neutrality, and the slow, honest work of helping someone understand themselves. Ian Cox, an Irish psychologist and university lecturer, argues that this foundation is now under serious threat. In conversation with Stella O'Malley, he describes a profession increasingly shaped not by clinical evidence but by ideological commitments that demand affirmation over exploration. The shift, he suggests, did not happen overnight — it arrived through the gradual capture of training programmes, professional bodies, and the culture of academia itself. Cox traces the roots of what he describes as an assault on science back to the influence of postmodern thought on the social sciences, and its downstream effects on psychology and counselling. Where earlier generations of therapists were trained to hold uncertainty, to ask questions, and to sit with complexity, newer frameworks increasingly treat certain conclusions as settled before the clinical encounter even begins. Gender identity has become one of the areas where ideological positions have most visibly displaced clinical judgement — with affirmation recast not as one option among many but as the only ethical response a therapist can offer. The personal dimension of Cox's account is striking. He describes raising questions in academic and professional settings, only to face formal complaints, a social media pile-on, and being doxxed — his personal information circulated publicly in apparent retaliation. What makes this significant is not just the individual cost but what it reveals about institutional behaviour. Professional communities that once prided themselves on open inquiry have, in some cases, adopted the logic of ideological enforcement. Dissent is not debated; it is punished. Cox also describes specific incidents that illustrate how far the culture has shifted: counsellors who reportedly celebrated the death of a critic of gender ideology, a student socially exiled for holding heterodox views, and gender clinics that have moved to a fully affirmative model — shutting down therapeutic exploration in favour of a pathway that begins and ends with validation. These are not abstract policy disputes. They describe what is happening inside the rooms where vulnerable people seek help. The broader question the episode surfaces is what therapy is fundamentally for. If a profession abandons its commitment to evidence, to the open exploration of a patient's inner life, and to the kind of honest uncertainty that genuine care requires, it risks becoming something else entirely — a mechanism for reinforcing a particular ideological worldview rather than supporting individual wellbeing. Cox's experience as a practitioner and educator who refused to comply offers a close-up account of how cultural capture operates from the inside, and why the integrity of psychology matters well beyond the clinic.
