Psychological help for foreigners can be tricky

by David Tharp 

The first time one of my therapy clients told me that she was always comparing the content of our therapy sessions with what her astrologer was advising her, I blinked and thinking as nimbly as possible, replied, “Well, why don’t we all get together some day for a cup of tea and compare notes?”

The client probably interpreted this as an indica­tion that at least I either approved of her delving into the occult to gain guidance for her life, or she may have decided that I too, saw both professions on an equal level of expertise, and therefore need not con­tinue with psychotherapy, which she didn’t.

She never showed up for her next therapy session. I still have visions of her happily consulting with her as­trologer on a street corner somewhere outside the East Exit of Shinjuku Station.

While both of us were spared the embarrassment of a nasty confrontation about mixing apples and orang­es, or rather, Freuds and Harry Potters, I also realized from that experience that therapy needs to be more forcefully defended at times, especially in a cross-cul­tural context.

Happily, Tokyo is awash these days in all kinds of alternative therapies, some of which I don’t mind recom­mending to my clients as a supplement to their basic psychotherapy, rather like encouraging people to, by all means, take a variety of vitamins — but, not as an alternative to a good, well-balanced meal.

We may as well face it, sometimes we need to see a therapist for what ails us. Perhaps some folks had these prob­lems before moving to Tokyo. Perhaps life here precipitated some predisposing emotional or psychological condition that was never noticed; and, maybe some people are just not cut out for the crucible of life in the cross-cultural fast lane and will do just fine when they get back to East L.A., Long Island, Piccadil­ly Circus, or the Oslo suburbs.

Just like one of my clients once so simply and insightfully confessed about the problems he was having in Japan after struggling with life here for 20 years, “Well, doctor, all in all, I wish that I had never left Tunbridge Wells.” This came just like a flash of enlightenment to a novice guru immersed in meditation in a cave in the Himalayas.

As an extreme and sad example, last year a West­ern client of mine decided that the clash of the stark interface of Japanese and European business methods between his firm and the firm’s Japanese partner was more than he could bear, so, he slashed his wrists from fatigue, despair, and exasperation.

Not having the insight that no capitalist venture was worth going to that level of extreme action, this unfortunate person lapsed between deep depression and further acts of emotional self-harm, while all the time declaring that if he would only work harder, or like his Japanese colleagues, then all would be well.

Obviously, he was in need of some rest and psychi­atric care. But, there is the rub. In spite of the presence and availability of excellent psychiatrists, psychothera­pists, and counselors — even first-rate astrologers — in Tokyo, there is virtually no organization here that is willing to provide full, in-house, institutional treat­ment for a non-Japanese psychiatric patient.

So with the gentleman mentioned above, I had to find the fastest and most expedient way to get him re­patriated to his own country to be hospitalized to get the kind of psychiatric care and treatment that he so desperately needed. But, there was also the problem of getting an airline that would agree to fly him back to his country.

In the end, his company paid for two medical at­tendants to fly with him, and then only after he was heavily sedated to the point that the airline agreed to give him a seat.

What happens to those non-Japanese who lose the plot here, and cannot afford this kind of medical as­sistance to get home? Well, just like they said in the X-Files — they are here and they are among us. In other words, there are some folks who have been able to get away with their neuroses, or more serious problems because they are a foreigner and the people around them assume that this is ‘normal’ behavior iox gaijin in Japan, or, some have struggled mightily with their demons in a see-saw battle back and forth in their minds that keeps them functioning to some workable degree or the other.

And, there are those who recognize they need a helping hand, and learn how to take advantage of the many fine mental health professionals and organiza­tions available here, Japanese and non-Japanese, and are well along the path of working on their psychologi­cal well-being. It is a good idea not to wait until it is too late to get appropriate help for your own particular mental and emotional issues.

There are even some therapists such as myself who decided to take a crash course in astrology in order to talk intelligently to my clients about this if it comes up in a therapy session. Therapy or astrology anyone?

David Tharp is a psychotherapist who originally trained as a medical doctor. His specialties are couple relation­ship and sexual therapy, intercultural therapy, and dance movement therapy./em