My therapy practice is about 40% Japanese nationals and 60% foreigners, and people are always curious about what Japanese people see me for. I always think this is such a weird question, because people are people everywhere you go. I mean, anyone can get their feelings hurt, have marital issues, feel anxious… and Japanese people are no different. There are some cultural differences but most often those are superficial. For example, my office has traditional straw mats, called tatami mats, and some Japanese people do not wear their slippers into the room and some do. I always follow their lead. I do have the custom of everyone taking their shoes off, which is very much a Japan thing. A lot of businesses require people to remove their shoes. I actually think that is the weirdest thing about my practice is that all of my clients remove their shoes without me asking them to. They just do it.

Other than the taking off of shoes and the tatami mats, my practice is pretty much the same as it was in the US when it comes to client issues. In most ways, Japanese people are just like non-Japanese people. The thing that has increased is how often I see people coping with cultural shock, both Japanese and non-Japanese people. In my experience, Japan can be a fairly rigid place to live. Some people find it very hard. I was surprised that Japanese people who had been born and raised in Japan experience culture shock in Japan. Some call it “reverse culture shock,” but I’ve never cared for the phrase.