English-Speaking Therapist in Tokyo.

The work

The work I do is relational and focused on pattern. I don't run intake checklists. I don't assign homework. I pay attention to what happens in the session. The moments when something shifts or goes flat. The pattern that keeps showing up underneath the problem. Most people already know their own story. They still keep landing in the same place. What's missing is someone watching in real time, someone who can name what you cannot see from inside it. More on how I work, and how I work with couples.

The arrangement

I am a US-trained psychodynamic therapist working online and privately. No Japanese license. No local clinic. No diagnosis on any record. You pay directly, in any currency. The time difference is real, so we find a workable window; many Tokyo clients take an early-morning or late-evening slot. When what you need is prescribing, assessment, or in-person psychiatric care, the Japanese system handles that, and I will say so directly.

What people bring to online therapy

The people I work with in English come for a wide range of reasons: anxiety, depression, stress and burnout, anger management, grief and loss, relationship difficulties, loneliness, self-esteem issues, procrastination, sleep problems, attachment patterns, self-sabotage, perfectionism, identity questions, and existential concerns. Online counseling makes this work possible from wherever you are, whether you need an English-speaking therapist, a virtual counselor, or simply someone who can work in your language at a depth that matters.

How it works

Sessions are online via secure video call. I work with individuals and couples (60 minutes). Before your first session, we have a free 15-minute call to see if this feels like the right fit for you.

What I see from Tokyo

Tokyo is safe, polite, and smooth. For a foreigner, it is also nearly impossible to get inside. That is not about effort. That mix produces a specific kind of distress. The Western finance crowd. The diplomats. The corporate transferee. The academic. All live inside a society that rewards decades of belonging. To the outsider, it offers the permanent, polite status of a guest. The trailing spouse who cannot read the room or the mail and has lost the easy competence she had at home. The marriage that frayed under the move, now carried on in a flat where neither person has anyone else. The high-functioning worker who looks fully fine, performs perfectly, and is quietly coming apart. Inside a life with no one in it who speaks their first language at any depth. It is loneliness with excellent infrastructure.

The foreign city inside the city

Tokyo's foreign population is large and concentrated. The metropolitan government counted 721,223 foreign residents at the start of 2025, about 5 percent of the city. Minato ward, home to 81 embassies, more than half of all the embassies in Japan, runs closer to 8 percent, and holds most of the classic expat map: Azabu and Moto-Azabu, Hiroo, Azabu-Juban, Akasaka, with the younger crowd toward Daikanyama and Nakameguro. The concentration does not translate into belonging. In InterNations' 2022 city survey, Tokyo placed 42nd of 50 cities overall, and last of all 50 for language. A city you can live in comfortably for a decade in English, and still not be inside of.

Why English depth therapy is scarce here

Two things make Tokyo hard. The first is structural: Japanese national insurance covers psychiatry, the consult and the prescription, at a 10 to 30 percent copay, but talk therapy with a psychologist is not covered at all. You pay the full fee out of pocket, and at Tokyo's established English-language services that runs roughly 10,000 to 24,000 yen a session. Even at those prices demand outruns supply: the city's oldest English-language counseling service, running since 1973, keeps a waitlist, and at the larger bilingual clinics waits stretch to four to six weeks in busy periods. Open-ended depth work is a small corner of that small pool. The second is the model itself: the covered system leans medical and brief, medication and short consults, rather than the sustained talk therapy many internationals are looking for. Add real stigma, and a lot of people simply go without. The wider picture is on my Japan page.

Working online with me removes the language problem and the cultural-distance problem in one step, with no Japanese record and no wait.

Questions people ask from Tokyo