FAQ's

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

• To use Google Meet all you need to do from your computer is check your email at the time of the session and click on the link that I sent - it will automatically open in your browser. If you are using an iPad or smartphone, you’ll need to first download the app Google Hangouts Meet.

• The office directions are not included on the website. I will send you a PDF of the directions after I receive your contact form or email.

• 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). We will go over this in more detail during the first session.

• Many people are anxious when approaching therapy. You don't have to have answers or even have a clear question when starting. 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.

• Therapy doesn’t mean you have to “spill your heart out” or “rehash everything." In fact, that’s often counterproductive. While I will want to get a sense of where you’ve come from and key experiences and influences, there are several ways of “working through” that are more creative, less linear, and more transformative. This is why IFS, EMDR, and Sandplay therapy have become my primary interventions to achieve the most growth with minimum friction. However, this does not mean that therapy is easy. It does demand a real commitment.

• 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. For example, there is a website you may come across if you google my name that says I am a CIA agent which can be confusing or concerning. Feel free to ask me about this. In a nutshell, I am not nor ever was a CIA agent(!). If you read further on the website, you can see that many foreigners living in Kyoto are accused of being CIA agents. It’s tantalizing to imagine, but I don’t think there’s much truth in it.

• In-person sessions are generally the best option but many clients find video sessions to be equally effective. Even EMDR can be used effectively via video.

• Often, sessions are held weekly or bi-weekly. It is common to have more frequent sessions at the beginning of the therapy process, then fading back as needed.

• There is a difference between psychologists and psychiatrists: psychologists are not medical doctors (MDs) and therefore cannot prescribe medication. Medication may sometimes be helpful for psychological problems. Both can make a diagnosis. When appropriate, I will arrange a referral for a medical evaluation and can recommend English speaking psychiatrists in the Kansai area.

About EMDR (Eye Movement Desensitization and Reprocessing) Therapy

“The speed at which change occurs during EMDR contradicts the traditional notion of time as essential for psychological healing.”
Bessel A. van der Kolk, MD
Professor of Psychiatry, Boston University School of Medicine

This is one therapy approach that I find very useful across a range of issues. It it quite flexible and can be used as the primary intervention or as an accompanying intervention.

Every night, our mind engages in an amazing process of "digestion" of recent memories and experiences. This is one important way we make meaning out of our lived lives; how we learn from our experiences. Our mind extracts what is useful, links it to past learning and memories, while redundant or unnecessary information is discarded. Strangely, we do this mostly during phase 4 (REM) sleep. However, some experiences, for various reasons, are unable to be digested on their own. They get stuck, or frozen. Later, when triggered, they can pop out, and cause various unwanted symptoms such as anxiety, anger outbursts, or depressive thoughts and feelings. These “stuck” areas could be big Traumas, or subtle and small moments that nevertheless cause distress in our inner world.

EMDR utilizes Rapid Eye Movements (or other forms of bi-lateral stimulation such at alternating tapping or auditory beeps) that jumpstart the intrinsic psychological digestive process of our mind. The result is having integrated our experiences, essentially creating a more unified and cohesive sense of self.

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 little introductory video of EMDR.  To review the research on EMDR, follow this link: http://www.emdr.com/research-overview/

IFS (Internal Family Systems) Therapy

This approach is another favorite of mine and dovetails nicely with EMDR. In a nutshell, IFS is a simple yet powerful conceptual model - a map - of how our mind works. It helps us make sense of what often appears to be a tangle of conflicting emotions, desires, and thoughts. IFS is also a method to help untangle our inner experience with a compassionate yet effective approach. A good book to introduce you to this model and even help you begin applying it on your own is “No Bad Parts” by Richard Schwartz.

This video describes in more detail the IFS model:

Sandplay and Sandtray therapy

Both of these therapies use a collection of figures and objects placed within a sand box. Sandplay is specifically a Jungian approach which focuses on facilitating and respecting the full expression of unconscious contents within us. It tends to be more open-ended, evolved over a series of sessions, and is held within an established and strong therapeutic container. Sandtray therapy, on the other hand, is more interactive and structured. In my practice, I often use the tray and figures to help facilitate both EMDR and IFS. Both of these ‘sand’ therapies are well suited for people less inclined to talk, for those with childhood traumas, or simply visual, tactile, and creatively minded people. 

Here is a short video to give you a feel for the Sandplay process in action with Dora Kalff, the originator of Sandplay:

My strengths & limitations

I provide psychotherapy and counseling for individuals and children. I have extensive training and experience in child development, autism related disorders, trauma, depression and anxiety disorders. I also treat issues such as OCD, and panic attacks. Issues such as drug addiction and eating disorders are usually treated with a combination of individual psychotherapy and forms of group support (such as AA), and I can help individuals in this healing process.  Typically, I refer out for couples counseling as this is not my area of expertise. However, I can support individuals within a couples context. Additionally, the private practice setting is not appropriate for those actively experiencing symptoms of schizophrenia or delusional thought processes. 

Fees

Psychotherapy is not inexpensive but is an important investment in one’s future. I strive to keep costs down, while also honoring the “industry standard.” Reach out to me directly to discuss exact fees. A limited number of sliding scale options are available for those who can demonstrate need.

Fees are paid at the beginning of each session, usually in cash if we meet in person. For online video sessions, please pay the fee on the same day as the appointment via either bank transfer (I’ll send you my bank info upon request), Wise (preferred), or PayPal.

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 interact directly with insurance companies.

 About my supervisee Tracy Quayat:

Ms. Quayat is nearing the final stage of acquiring Canadian licensure as a MFT clinician.

She writes, “As an emerging Mental Health Counsellor, now undergoing my Master's practicum, I'm deeply committed to supporting the well-being of all my clients. My studies and training allow me to understand the best ways to address each client's needs. I am flexible in my approach and use collaboration as the basis of my therapy - ensuring a comfortable, safe environment where we can work together on your goals. My training has focused on working with people experiencing anxiety, depression, cross-cultural difficulties, and family and relationship struggles. I have also received additional training for counselling children and teens, using art, play and other creative ways of self-exploration and growth. I look forward to welcoming and working with you.”

You can find her website here: http://www.tracyquayatcounselling.com/

Email her at: t.f.quayat@gmail.com

About Kate Garnett, Ed.D Candidate and recent addition to my Kyoto practice:

Kate has a long history as a passionate educator and learner. She currently teaches at universities in Kyoto and also supports individuals as a life coach. I feel that a life coach can supplement my therapy practice by helping some people prepare for the deeper therapy work by first addressing here-and-now practical concerns. She also specializes in LGBTQ issues and non-transitional relationships, which can be a wonderful help to many in Japan.

It is important to note that Kate is not a mental health counselor nor therapist and understand how a life coach is different from a mental health therapist: Unlike counseling or therapy, coaching assumes a baseline level of emotional wellness, and focuses on the present and the future. An important distinguishing factor between psychotherapists and coaches is that the former are trained to help people who are facing mental illnesses, and the latter do not receive such training.

She writes, “As a doctoral candidate specializing in Transformational Learning and Humane Education, I am committed to supporting clients to deepen their self-reflection and ultimately find solutions to help themselves move forward on their path of transformation, becoming more confident and capable versions of themselves.”

Please reach out to Kate at kate.garnett.lifecoach@gmail.com