The therapy office in downtown Kyoto. Skype sessions are also available. 

The therapy office in downtown Kyoto. Skype sessions are also available. 

FAQ's for those considering therapy:

If you are considering therapy, and have little or no experience with it, there are a few things which might be helpful to know.

  • Your confidentiality is taken seriously. You don't have to worry about people finding out what is said in therapy sessions, except in extreme situations (such as child or elder abuse, or someone's life is in imminent danger). A therapist will go over this in more detail  during the first session. 
  • Many people are anxious approaching therapy. To be vulnerable and address issues that we have often been avoiding for years is never easy. However, most clients report the experience being well worth it, and often can be life changing. 
  • You don't have to have answers or even have a clear question when starting therapy, but curiosity and an open mind doesn't hurt. 
  • You may like the idea of getting rid of your symptoms (anxiety, depression, destructive behavior patters, etc.) but not like the idea of talking to a stranger about everything. If this is the case, EMDR and Sandplay provide the option for much less talk.  
  • If you have a question or want to know more about the therapist, you have every right to ask. Some things you may consider asking is what is the therapist's education, theoretical orientation, plan for treatment, number of years of experience, length of time in Japan, etc. Therapists will be happy to answer you. However, more personal questions may or may not be answered depending on the therapist's theoretical orientation and whether they feel an answer is therapeutically indicated or not. 
  • In person sessions are generally felt to be the best option but many therapists find teletherapy (online video sessions) to be equally effective. Even EMDR can be used effectively via teletherapy, sadly, Sandplay therapy can not. 
  • Typically, sessions are weekly, but more or less frequent meetings are often an option. 
  • Psychologists differ from psychiatrists in that psychologists are not medical doctors (MDs) and therefore cannot prescribe medication.  Medication may sometimes be helpful for psychological problems. When appropriate, I will arrange a referral for a medical evaluation and can recommend English speaking psychiatrists in the Kansai area. 

What is EMDR therapy? 

“The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing. Shapiro has integrated elements from many different schools of psychotherapy into her protocols, making EMDR applicable to a variety of clinical populations ...”
Bessel A. van der Kolk, MD
Professor of Psychiatry, Boston University School of Medicine

EMDR stands for Eye Movement Desensitization and Reprocessing. Every night, our mind engages in an amazing process of "digestion" of recent memories and experiences. This is one important way we make meaning of our lived lives; how we learn from our experiences. Our mind extracts what is useful, links it to past learning and memories, and redundant or unnecessary information is discarded. We do this mostly during phase 4 sleep, REM sleep. However, some experiences, for various reasons, are unable to be digested on their own. They get stuck, or frozen. Later, if triggered, they can pop out, and cause various unwanted symptoms such as anxiety, anger outbursts, depressive thoughts and feelings, etc. EMDR comes in to play by harnessing the Rapid Eye Movements (or other forms of bi-lateal stimulation such at alternating tapping or auditory beeps), thus jumpstarting the psychological digestive process which is directed at a chosen undigested target memory. The result is an integrated past experience from which we now have a balanced and "wise" understanding, often, a bodily sense of relief, and surprising positive shifts in our behavior. 

While some people are understandably skeptical of this atypical therapy, it is now one of the most researched and empirically validate treatments available today, not only for PTSD, but other common issues as well. 

Below is a video I find to be a good intro to EMDR from the perspective of a patient.  To review the research on EMDR, follow this link: http://www.emdr.com/research-overview/

Sandplay therapy

Another specialty and passion of mine is sandplay therapy. Used with children and adolescents as well as with adults and families, it can be a disarming and immersive tool for psychological growth. It is particularly suited for people less inclined to talk, for those with preverbal traumas, and creatively minded people. 

In the office, a diverse selection of figures and a sand tray are used for non-verbal expression and processing. 

In the office, a diverse selection of figures and a sand tray are used for non-verbal expression and processing. 

Through the act of articulating, in physical form, our hidden, inner world, a kind of dialogue begins to emerge between our conscious mind and our subconscious mind. Through this process, forces and patterns emerge and shift and we often see corresponding behavioral changes in our outer life. The symbolic expression that we experience in the trays acts on us as if it were a real experience because from the mind's perspective, there is no true distinction between the symbolic and the real. Children do this quite naturally. For adults, sometimes the willful suspension of disbelief helps begin the process. Luckily, one doesn't have to understand or even believe it for it to work in our lives. 

Here is a short video showing the process in action with Dora Kalff, originator of this technique:

Excerpt (about 5 min. long) from Sandplay with Dora M. Kalff, produced and directed by Peter Ammann. 

If you feel intrigued by sandplay, or think your child may be open to it, I invite you to try it.

My strengths & limitations

I provide psychotherapy and counseling for individuals and families. Being part of the ex-pat community, this includes bi-cultural families, experiencing problems such as cultural adjustment, life style and career transitions, and relationship or marriage problems. I have extensive training and experience in child development, autism related disorders, trauma, depression and anxiety disorders. I also treat issues such as OCD, panic attacks, and PTSD. While I do have experience treating eating disorders and drug addiction, usually from an EMDR model of treating underlying core beliefs and/or traumas that have led to these patterns of behavior, I am not a specialist in these areas.  Additionally, my private practice setting is not appropriate for those actively experiencing symptoms of schizophrenia. 

Fees

Typically, fees are paid at the beginning of each session. At this time, only cash is accepted. A limited number of scholarships are available for those with financial hardship. 

  • Initial assessment (90 min.) ¥13,000
  • Individual therapy (50 min.):  ¥10,000
  • Couples/Family therapy (90 min.): ¥13,000
  • Initial trial session (20 - 30 min.) ¥2,000 {Upon request. For those seeking a therapist for individual psychotherapy, a reduced rate trial session is offered to help you find a good match between you and a therapist without incurring undue financial hardship}   

Unfortunately, psychotherapy and counseling are not covered by Japanese medical insurance. I am willing to help those with foreign medical insurance with claims for reimbursement from their insurance carriers by providing receipts and basic information, but will not deal directly with insurance companies or wait for reimbursement from them.