Couples therapy in English in Japan is very difficult to find. The mental health infrastructure in Japan is limited even in Japanese; in English, options for real depth work outside Tokyo are almost nonexistent. Online is usually the only practical route.
I work with couples who need to work in English and are living in Japan. The relocation asymmetry: one person with a professional life and social world, one person building from scratch in a country whose language they may not speak. The way that imbalance affects desire, respect, and power over time. The relationship that was holding when everything was familiar and is now under pressure.
Japan has a particular intensity for couples who moved here for one person's career. The country is not easy to enter socially for people who aren't from here. If one person is embedded and the other isn't, that gap is real and it does things.
The work
The work I do is relational and pattern-focused. I don't run through intake checklists or assign exercises between sessions. I pay attention to what happens in the room: what you're saying, what you're not saying, the moments when something shifts or goes flat or speeds up. That's the material we work with.
Most people arrive already knowing the story of their situation. They've told it to themselves a hundred times and always land in the same place. What's missing is a different angle, someone watching in real time who can name what's invisible from inside it. That's what I offer. Not interpretation from a distance, but attention in the room, offered as it happens.
I work with individuals and couples. Individual work is usually about finding the pattern underneath the presenting problem, the thing that keeps recurring in different forms across different circumstances. Couples work is about finding what the argument is really about, which is rarely what it appears to be about. Both come down to the same thing: seeing what you haven't been able to see, and from there, actually being able to do something different.
Being in Japan as a couple
Japan does something specific to relationships across cultures. The slow accumulation of the foreigner experience runs through every couple where one partner is Japanese and one is not, even after decades. For couples where both partners are foreign, the country produces a different version of the same thing: a sense of being permanently at the edge of the social grammar, no matter how good your Japanese has gotten or how long you have lived here.
For the binational couple, the most common pattern involves the language and integration asymmetry. The Japanese partner moves through daily life without translation cost. The foreign partner translates constantly, even after years, and notices a quiet diminishment that comes from never quite being the one with native standing. The Japanese partner often feels accused of not understanding how heavy this is. The foreign partner often feels accused of not appreciating how hard the Japanese partner has worked to make life easier for them. Both feelings are real and they are usually about the same underlying asymmetry.
For two-foreigner couples in Tokyo, Yokohama, or the international school orbit, the pattern is different. The expat social world has a heavy turnover. Friends leave. Your work hours are long and so are your partner's. The relationship ends up carrying more than it was built for, and the slow erosion is hard to notice in the moment.
What couples bring
The recurring arguments rarely turn out to be about what they look like. The fight about whether to visit one set of family or the other this New Year is usually about a longer conversation that never quite finishes about whose country this actually is. The argument about the kids' schooling is usually about a deeper question about whose cultural future the family is moving toward.
The standard material shows up too: recurring conflict, emotional distance, infidelity and broken trust, sexlessness, the question of whether to stay together. The work is psychodynamic and pattern-focused, not communication-skills training.
How couples therapy in English works in Japan
Sessions are online via secure video, 60 minutes, usually weekly. Both partners can be on the same screen, or in separate locations across Tokyo, Yokohama, Osaka, Kyoto, Fukuoka, or anywhere else. There is a free 15-minute introductory call.
The work is depth-oriented and entirely outside the Japanese clinical system. No Japanese health insurance code is generated. No record enters the Japanese system. For couples whose work or visa situation makes that separation matter, it is part of the structure.
Fees are in USD by card or bank transfer.