Where Did Psychotherapy Go Wrong? | Ian Cox
3 September 2026
With Ian CoxIan Cox, an Irish psychologist and lecturer, joins Stella O'Malley to examine what has gone wrong inside psychology and counselling. Cox describes the creeping influence of postmodern, activist ideology on training and clinical practice — and the personal cost of speaking out, including complaints, a social-media pile-on and being doxxed. A conversation between two clinicians who have both held the line, and paid for it.
Ian Cox is a psychologist and lecturer working in Ireland who has spent years watching his profession shift in ways that trouble him deeply. In this episode he sits down with Stella O'Malley to explore a question that both of them are well placed to answer: at what point did psychology and counselling stop following the evidence and start following an ideology? The conversation begins with the intellectual roots of the problem. Cox traces the postmodern and activist currents that have moved from the humanities into mental-health training, reshaping what therapists are taught and what they are permitted to question. He and Stella examine how scientific rigour has been steadily eroded in favour of frameworks that treat contested social theory as settled fact — and what this means for clients who arrive in a therapist's office expecting a space free from political pressure. Much of the episode draws on Cox's direct experience as a lecturer. He describes the chilling atmosphere in classrooms where certain ideas cannot be challenged without consequences, and the disorienting experience of watching students act as ideological enforcers rather than developing the kind of critical thinking that therapy fundamentally requires. The consequences for Cox were real: formal complaints filed against him, followed by being doxxed. He also recounts the moment a social-media pile-on made staying private impossible and pushed him toward speaking out publicly. He draws a striking parallel between the social pressure he once faced for criticising the IRA and the dynamics he now encounters when questioning gender-identity ideology — a comparison that reveals something telling about how conformity enforces itself across very different political moments. The episode turns darker when Cox moves to what is happening at the level of professional culture and clinical practice. He recounts an episode in which counsellors appeared to celebrate a death — a moment that, for Cox, illustrated how thoroughly activist ideology can corrode basic professional ethics. He also describes a student effectively exiled from their cohort for holding dissenting views, and discusses how clinics have moved to fully affirmative-only models, framing this not as a clinical development but as the institutional consolidation of the same ideology he has encountered in lecture halls. Stella brings her own clinical experience to the exchange, and the episode benefits from two practitioners who have both paid a professional price for insisting on evidence-based care. What makes this conversation worth returning to is not only the weight of what it documents but the seriousness both speakers bring to asking how intelligent, well-intentioned people helped construct something that has ended up doing harm. The foundations of therapy — curiosity, neutrality, tolerance of uncertainty — are not abstract values. This episode makes the case, compellingly, for why they matter.
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