Work with people seeking asylum brings unfamiliar experiences, challenges, rewards, and dilemmas. Resonances for the therapist and sharing the client’s pain and hopelessness can be distressing. Power, powerlessness and privilege are common themes. Facing the limits of our own compassion, and of what it is possible to do, can be hard. How can we ‘do differently’ and what new skills are needed? The work can be isolating, and exhaustion, burn out, vicarious traumatisation and other existential reactions can arise.Clinicians face many dilemmas, such as over boundaries, neutrality and self-disclosure, overt political action, and how to deal with different perspectives in the same organisation. What helps clinicians do well is a focus on reflection, and accessing supervision and other reflective spaces, such as Balint groups or solidarity teams. Pitfalls of not attending to our own responses are highlighted, as is the need to protect reflective spaces. Remote meetings make access easier for both training and peer support. Meetings in non-clinical settings with people who have sought asylum can also be enlightening.