Where Did Psychotherapy Go Wrong? | Ian Cox
Irish psychologist Ian Cox joins Stella O'Malley to examine how postmodern ideology and activist pressure have corroded the foundations of counselling and psychology training. His first-hand account of complaints, doxxing and professional silencing holds an uncomfortable mirror up to Britain: the same forces are reshaping BACP guidance, NHS psychological services, and the parliamentary debate over a conversion therapy law that could criminalise the exploratory therapy the Cass Review said gender-questioning children desperately needed.
Ian Cox is a psychologist and academic lecturer in Ireland who found himself at the centre of professional controversy after raising questions about the direction of contemporary psychology. In this conversation with Stella O'Malley, he traces how the discipline he trained in has been progressively reshaped — not by clinical evidence, but by postmodern theory and activist politics that he argues have little grounding in the empirical tradition psychology was built upon. His account of what it now costs to ask the wrong questions is both personal and systemic. Cox describes the sequence of events that followed when he voiced scepticism in professional and academic settings: student complaints, a coordinated social media campaign, and being doxxed. What makes the story more than a tale of personal misfortune is what it reveals about the culture surrounding it — colleagues who should model intellectual courage instead greeting the silencing of dissent with approval, and in one case, counsellors reacting to a critic's death with open satisfaction. These are not isolated incidents of bad behaviour; they are symptoms of a professional environment in which ideological conformity has become a disciplinary expectation. A central concern in the episode is the drift of therapy clinics toward fully affirmative practice — an approach that treats a patient's stated gender identity as the fixed point around which all clinical work must revolve. Cox argues this abandons the foundational therapeutic commitment to open, exploratory conversation, replacing it with a framework that forecloses questions before the session has even begun. When a therapist cannot follow the client's material wherever it leads, they are no longer practising therapy in any meaningful sense. For British listeners, the territory Cox describes will feel familiar. The Cass Review, reporting in 2024, identified a near-total collapse of psychotherapeutic support for gender-questioning young people within NHS services — replaced by pathways that moved rapidly toward medical intervention. The British Association for Counselling and Psychotherapy has faced its own internal tensions over guidance that critics argue effectively prohibits practitioners from exploring the roots of gender distress. The stakes were already high; they rise further as Parliament continues to debate conversion therapy legislation. A badly drawn law could criminalise precisely the exploratory, non-directive work that Cass concluded children needed and were not receiving. What Cox contributes that parliamentary reports and professional guidelines cannot is a view from inside the training rooms — the places where the next generation of British counsellors is being formed. If an ideology is embedded at that level, restoring sound clinical practice requires more than policy revision at the top. It demands a reckoning within professional education itself: who controls the curriculum, which questions are permitted, and whether students can express clinical doubt without fearing for their careers before those careers have begun.
