This Is the Hill

Here's something I believe completely, without qualification, without softening it for comfort:

We have to do our own work if we are going to do this work.

Not once. Not "I did therapy in grad school and processed some things." Not a weekend intensive five years ago that shifted something important. Ongoing. Current. Ours.

This is the hill. I will die on it.

What "doing our own work" actually means.

It doesn't mean you have to be in therapy every week for the rest of your career, though for many of us, more therapy than we're currently doing would not be a bad idea.

It means that the interior life you bring into the room is being tended to. That there is some honest, regular, non-performative process by which you are looking at your own stuff—your history, your patterns, your triggers, your blind spots—with the same quality of attention you bring to your clients.

It means you are not operating on autopilot with your own material while asking clients to examine theirs.

It means the work you do on yourself is real. Not a checkbox. Not a credential. Real.

What happens when we don't.

This is the part that needs to be said plainly.

When we don't do our own work—when we let our own stuff go unexamined, when we tell ourselves we're fine because we're functioning, when we confuse knowing the theory with having done the thing—it doesn't stay contained.

It leaks.

Sometimes it leaks in small ways. The over-identification with a particular client. The subtle push toward a resolution that is more about our own comfort than theirs. The countertransference we notice but don't take to supervision because we don't want to look at it too closely.

And sometimes it leaks in larger ways.

Boundaries that blur gradually, so slowly you almost don't notice until you're somewhere you didn't intend to be. Dual relationships that started with good intentions—genuine care, genuine connection—and ended somewhere none of us would have signed up for on purpose if we'd seen the whole map at the beginning.

I'm not speaking hypothetically. I've heard enough over the years—in supervision, in consultation, in the quiet conversations that happen when someone is finally ready to name what went wrong—to know that this is not rare. It is more common than our professional culture likes to acknowledge. And it is almost always, underneath the specifics, a story about unexamined material finding its way into the work.

This is not about shame.

I want to be clear about that.

This is not a post about bad clinicians who did bad things. It is a post about what happens to all of us--good clinicians, caring clinicians, clinicians who genuinely love this work--when we stop tending to ourselves.

We are not immune to our own humanity just because we understand it clinically. We are not protected from our own wounds just because we can name them in someone else. The map is not the territory. Knowing how countertransference works does not mean yours isn't working on you right now.

The only thing that actually helps is the work. The ongoing, honest, sometimes uncomfortable work of looking at our own interior with someone who can see what we can't.

What's at stake.

I'll say it directly: when we don't do our own work, we put our clients at risk.

Not always in dramatic ways. Sometimes in the quietest, most incremental ways.  Ways that never make it into an ethics complaint, never result in a licensing board action, never become a story anyone tells. Just the slow, invisible cost of a clinician who is running on unexamined material and calling it fine.

Our clients come to us in vulnerability. They trust us with the parts of themselves they don't show anyone else. They deserve a clinician who is doing the same honest reckoning...not perfectly, not without struggle, but genuinely and consistently.

Doing our own work isn't optional maintenance. It isn't a nice addition for the especially conscientious among us. It is the thing that keeps the work itself safe.

For them. And for us.

So...

If you are not currently in any kind of reflective process—therapy, supervision that goes beyond case consultation, a peer group that actually goes there—I want to ask you directly:

What is it costing you to not be?

And what might it be costing the people sitting across from you?

Dr. Jamie English is a licensed clinical social worker, supervisor, and educator. The DJ English blog explores the inner life of the clinician — the parts of this work we don't always talk about out loud.