Where Did Psychotherapy Go Wrong? | Ian Cox
3 September 2026
With Ian Cox
Ireland
Ian Cox, an Irish psychologist and lecturer, joins Stella O'Malley to examine how postmodernist and activist-driven thinking has reshaped psychology and counselling training in Ireland. The conversation covers professional pressure, the silencing of dissenting voices in academic settings, the shift toward fully affirmative clinical models, and the personal cost Cox paid for raising questions — including formal complaints and being doxxed. The episode asks whether Irish professional bodies and training institutions are equipping therapists to think critically or to conform.
Ian Cox is an Irish psychologist and academic who has spent years training the next generation of counsellors and psychotherapists. In this conversation with Stella O'Malley, he maps out how the theoretical foundations of the discipline — rooted in empirical research, differential diagnosis and the therapeutic relationship — have been progressively displaced by ideological frameworks that resist scrutiny. His perspective carries particular weight in an Irish context, where the professional landscape is governed by bodies such as the Psychological Society of Ireland and the Irish Association for Counselling and Psychotherapy, both of which have adopted positions on gender-affirmative practice. Cox describes a shift in how students are being trained: critical thinking is increasingly treated as a threat rather than a skill. When he raised scientific or clinical questions in the classroom — questions that would have been unremarkable a decade ago — he found himself the subject of formal complaints. The episode details how that pressure escalated to an organised Facebook campaign against him and ultimately to doxxing, the deliberate exposure of personal information intended to intimidate and silence. That a lecturer can face these consequences for engaging in ordinary academic inquiry signals something significant about the current state of professional education in Ireland. One of the more disturbing passages concerns reports of counsellors celebrating the deaths of individuals who had publicly criticised gender-identity ideology. Cox and O'Malley reflect on what this reveals about the professional culture that has developed in parts of the Irish and British therapy world. The codes of ethics governing Irish practitioners require integrity and conduct that does not bring the profession into disrepute. Whether those standards are being applied consistently is a question this episode implicitly but seriously raises. The conversation turns to clinical practice and what Cox describes as a wholesale move toward fully affirmative models in gender clinics. In Ireland, HSE gender services have operated against a backdrop of growing international concern — including the Cass Review's findings about the weak evidence base for the social and medical transition of children and young people. Cox argues that when an affirmative-only approach is adopted without clinical flexibility, it eliminates the exploratory space that psychotherapy has always depended on. A therapist who cannot ask open questions, sit with ambiguity or consider differential explanations is not functioning as a therapist in any meaningful sense. The episode closes by examining the deeper philosophical problem: the infiltration of epistemological relativism into psychology training. The view that objective knowledge is impossible and that lived experience automatically trumps evidence has entered degree programmes and supervision frameworks across Ireland and beyond. For a country where mental health services are already under pressure and where referrals involving gender-related distress among young people have risen sharply, the question of whether therapists are trained to think rigorously rather than to affirm reflexively is not a theoretical debate. It has direct consequences for the young people who eventually sit in the consulting room.
