What Does It Actually Mean to “Do the Work” in Therapy?

We hear people talk about “doing the work” all the time. It comes up in conversations about healing, personal growth, relationships, and therapy. We're told that if we want to break old patterns or become healthier versions of ourselves, we need to do the work. But what does that actually mean? What does it look like in everyday life, when nobody is watching and there isn't a therapist sitting across from you asking the right questions?

I think we've turned the phrase into something of a buzzword. We know we're supposed to do the work, but we're not always sure what we're working toward or how to get there. Much of this work happens in ordinary moments: when we catch ourselves falling into an old pattern, have an uncomfortable conversation, or make a different choice than we would have made in the past.

So, what does it really mean to do the work in therapy? Here are some of the things I think matter most.

Being Willing to Choose Your Values Over Your Ego

Doing the work means being willing to look at yourself honestly, even when what you see is uncomfortable. It means considering that you might be wrong, that your perspective might be incomplete, or that the way you've been approaching a situation isn't serving you well.

Our egos can be pretty convincing when they're trying to protect us from feeling embarrassed, rejected, or inadequate. We might defend ourselves instead of listening, justify our behavior instead of acknowledging its impact, or avoid admitting a mistake because we don't want to feel like we've failed.

Personal growth requires a willingness to tolerate some of that discomfort. Sometimes, choosing your values means apologizing when you'd rather defend yourself. It means listening to understand instead of listening for your chance to prove a point. If you value connection, honesty, or integrity, there will be times when living according to those values requires you to set your pride aside.

This doesn't mean abandoning yourself or accepting mistreatment. It means learning to distinguish between protecting your well-being and protecting yourself from the discomfort of being human.

Asking Yourself, “Where Am I Contributing to My Own Suffering?”

When we're hurting, it's natural to focus on what happened to us, what someone else did, or what circumstances have made our lives difficult. Sometimes, those things really are outside our control. Trauma, betrayal, medical invalidation, and other painful experiences deserve to be acknowledged without minimizing their impact.

At the same time, we can become so focused on what has happened to us that we lose sight of the ways we may be perpetuating our own suffering in the present. Maybe we keep saying yes when we want to say no, then feel resentful when people take us up on our offers. Maybe we spend hours replaying conversations, searching for certainty we can't find. Or perhaps we continue pursuing relationships that leave us feeling inadequate because we're afraid of what it would mean to let them go.

These patterns often make sense when we understand where they came from. They may have helped us feel safer, more accepted, or more in control at some point in our lives. But they can still cause us pain today.

This is where accountability becomes important. Accountability isn't about blaming or shaming yourself for what you've experienced. It's about recognizing where you have agency, even when you didn't choose the circumstances you found yourself in. You may not be responsible for what someone did to you, but you can begin to explore how you want to respond now. You may not be able to control another person's behavior, but you can work on your boundaries and decide what kind of access that person has to your life.

We cannot control everything, and pretending otherwise can be harmful. But recognizing what we can influence gives us somewhere to begin. Taking responsibility for our part in a pattern creates opportunities to change it. That's how we begin to take the reins back in our own lives.

Learning to Treat Yourself With More Compassion

Many of us find it easier to extend compassion to other people than to ourselves. We can understand why a friend is struggling or reassure a partner who made a mistake. Then we turn that same attention inward and become our own harshest critics.

We tell ourselves we should be further along by now. We criticize ourselves for feeling overwhelmed or struggling with something that seems easy for everyone else. We might even believe that being hard on ourselves is the only way to stay motivated or avoid making the same mistakes again.

But self-criticism and accountability are different things. You can acknowledge a mistake without turning it into a judgment about your worth. You can recognize that a pattern needs to change while having compassion for the part of you that developed it.

Self-compassion is a skill we can practice. It involves noticing our internal dialogue, questioning the belief that we have to earn our worth, and learning to respond to ourselves with more understanding when life gets difficult. Therapy can help us develop these skills, particularly when years of anxiety, depression, trauma, or chronic stress have shaped the way we relate to ourselves.

Learning to offer yourself the same patience you give everyone else can be an important part of healing.

Learning to Sit With Your Feelings

Most of us have developed ways to avoid uncomfortable feelings. We stay busy, overthink, scroll, people-please, or distract ourselves. Sometimes these strategies are useful, but when avoidance becomes our primary way of coping, we can lose touch with what we're experiencing and what we need.

Doing the work means gradually learning to notice and experience our emotions without immediately trying to fix, suppress, or escape them. This can be especially challenging if you grew up in an environment where your feelings were dismissed, punished, or treated as a problem. You may have learned to disconnect from your emotions to maintain relationships or keep yourself safe. Learning to reconnect can take time and patience.

Our emotions can offer valuable information. Anger may point toward a boundary that has been crossed. Sadness may signal a loss that needs to be acknowledged. Anxiety may reflect uncertainty or a perceived threat. But emotions don't always accurately describe reality, and they don't automatically tell us what to do. Sometimes anxiety shows up when we're doing something meaningful but unfamiliar. Sometimes guilt appears when we set a reasonable boundary because we're accustomed to putting everyone else's needs first.

Part of the work is learning to listen to our emotions without letting them make every decision for us. We can acknowledge that we're afraid and still move forward. We can feel guilty and still say no. We can experience anger without acting in ways that harm others.

In my work with clients, I draw on Acceptance and Commitment Therapy (ACT), somatic-informed approaches, polyvagal-informed work, and Internal Family Systems (IFS)-informed perspectives. These approaches can help us understand our internal experiences, recognize protective patterns, and develop more flexible ways of responding to our thoughts, feelings, and bodily sensations.

We don't have to eliminate every uncomfortable feeling before we can live our lives.

Practicing the Art of Slowing Down

Many of us spend so much of our lives doing that we've forgotten how to simply be. We're moving from one task to the next, thinking about tomorrow while trying to get through today. Even our downtime can become another opportunity to improve ourselves.

Learning to slow down can be particularly helpful for people who live with chronic stress, feel tired but wired, or are accustomed to being on high alert. When your body and mind are used to anticipating the next problem, quiet moments can feel surprisingly uncomfortable. You might notice how exhausted you are or feel an urge to find something productive to do.

Creating more moments of being can take many forms. It might involve gentle yoga, stretching, meditation, breathing exercises, journaling, sound baths, listening to calming music, or simply sitting with a warm cup of tea. These practices aren't one-size-fits-all. The goal is to find what feels supportive rather than turning relaxation into another task to complete.

Sometimes, the work is allowing yourself to rest without feeling guilty or noticing that you're hungry and giving yourself permission to eat before finishing the next ten things on your list. It's learning that you can exist without constantly needing to accomplish something.

Building a Life You Don't Constantly Need to Escape From

We often talk about managing stress, regulating our nervous systems, and learning to cope with difficult circumstances. Those skills matter, but it's also worth examining whether our lives are structured in ways that support our well-being.

If you're constantly overwhelmed by your workload, depleted by your relationships, or spending every evening recovering from the demands of your day, there may be something worth examining beyond your coping skills. Sometimes we need to learn to tolerate discomfort. Other times, we need to recognize that we're tolerating more than is sustainable.

I also recognize that the ability to redesign your life comes with privilege. Not everyone can leave a harmful job, afford to work fewer hours, or move away from an unhealthy environment. Financial responsibilities, caregiving demands, disability, and systemic barriers can significantly limit our options.

Even when our choices are limited, we can explore where small changes might be possible. Perhaps we can protect more time for rest, reconsider a commitment, ask for help, or work toward a longer-term change that would make life more sustainable.

I want people to have tools for managing difficult feelings, but I also want them to feel empowered to examine the lives they're living. Ideally, we're building a life that includes enough connection, meaning, rest, and enjoyment that we don't feel the need to constantly escape from it.

Setting Boundaries While Still Being Part of a Community

Boundaries are an important part of healthy relationships. If you've spent years people-pleasing, overextending yourself, or feeling responsible for everyone else's emotions, saying no can feel uncomfortable or even frightening. You might worry that people will be disappointed or love you less if you stop making yourself so available.

Learning to set boundaries helps us recognize that we can care about others without abandoning ourselves. We can be generous without saying yes to everything, and we can recognize that another person's disappointment doesn't automatically mean we've done something wrong.

But healthy relationships also require some willingness to be inconvenienced by other people. We live in a culture that often prioritizes personal comfort, independence, and convenience. Sometimes, boundaries can become a way of protecting ourselves from anything that asks something of us, even when that something is part of maintaining meaningful relationships.

Being a villager is inconvenient sometimes. It means showing up when someone needs help, making room for the needs of people we care about, and occasionally doing something that isn't our first choice. Relationships involve reciprocity, compromise, and a willingness to give as well as receive.

The work is learning to distinguish between a healthy inconvenience and chronic self-abandonment. You can be there for people without being available all the time. You can say no when you need to while also saying yes when connection matters more than convenience. Both skills are important.

Considering the Physical Side of Mental Health

Mental health doesn't exist separately from the body. Sometimes, doing the work includes becoming curious about physical factors that may contribute to what we're experiencing emotionally. Sleep difficulties, nutritional deficiencies, thyroid dysfunction, medication effects, hormonal changes, gut imbalances, histamine issues, genetic mutations, toxin load, and other medical concerns can influence mood, energy, concentration, and anxiety.

This can be particularly important for people who have spent years feeling anxious, exhausted, or unlike themselves without fully understanding why. When physical symptoms remain unexplained, being told that everything is due to stress becomes incredibly dismissive. The uncertainty itself can also take an emotional toll.

Exploring physical health concerns with an appropriate medical professional is an extremely useful part of the bigger picture. I frequently recommend functional medicine as a complementary avenue for investigating possible contributors to clients' symptoms. It's important to work with qualified professionals who interpret findings in context and understand the body as one whole working unit. It's also extremely important to work with medical professionals who believe you instead of dismiss you.

As a holistic therapist and Certified Integrative Mental Health Professional (CIMHP), I highly value making room for both the psychological and physical aspects of someone's experience. We can work on emotional patterns, boundaries, and nervous system regulation while acknowledging that there may be medical factors worth investigating. Put it this way: I rarely meet a client who is satisfied with their gut health or energy levels. 

Doing the Work Is an Ongoing Practice

Doing the work means becoming more aware of yourself and more intentional about how you live. It involves noticing the patterns that no longer serve you, taking responsibility for what you can change, and developing the skills to respond differently when life gets difficult. It means treating yourself with compassion while remaining willing to grow, and caring for others without losing yourself in the process.

You won't get it right every time. You'll catch yourself reacting defensively, avoiding a difficult feeling, or slipping into a familiar pattern you thought you'd already worked through. That doesn't mean you've failed. Change rarely happens in a straight line.

Progress might look like handling a difficult conversation differently, recovering more quickly after a stressful day, or spending less time criticizing yourself for being imperfect. Some of the most meaningful changes may be visible only to you.

Therapy can be a helpful place to begin, especially when you're trying to understand patterns that have shaped your life for years. A good therapist can help you make sense of where those patterns came from, develop practical skills, and explore new ways of responding. But the work continues outside the therapy room, in the everyday choices that gradually shape how you experience yourself and the world around you.

Over time, you're building a relationship with yourself that allows you to face difficult things with more honesty, compassion, and confidence. You're learning to live according to what matters to you, even when it's uncomfortable, and to make room for a life that feels more aligned with the person you want to be.

If you're an adult in Ohio navigating anxiety, trauma, chronic stress, or the complicated relationship between physical and emotional well-being, therapy can be a space to explore these patterns and develop a more supportive relationship with yourself. At Soma & Soul Mental Health and Trauma Therapy, you don't need to have everything figured out before you start. You just need to be willing to get curious about what might be possible.