I initially came to Japan to study martial arts, thinking that, after ten years in practice, I' take a break from therapy. I soon discovered that I wasn't going to be able to do that. I was constantly being called upon to use my skills and training. I found that there was a real need here for a quality psychotherapist, so I started a practice. I'm now coming up on my 11th anniversary in Japan.

I wake up around 6 or 6:30am. The early morning is my time with God. I meditate, go for a walk, read and take time to contemplate some of the important questions of life, like why am I here and how can I serve better. I take that time to focus and prepare for the day ahead.

I usually begin seeing clients at am. and I work with clients most of the day, usually ending about 9pm, so I work the whole day, it's usually completely full with clients. It's very exciting, very energizing and very draining all at the same time. I work with people back to back the momentum and the energy builds on itself during the course of the day and so for me it's a very effective way to work and focus. When I'm on, I'm on and when I'm off, I'm off. To maintain a balance I take long weekends--my working week is Wednesday through Saturday--at which time I get away, I travel, I walk, I get out as much as possible. But I do find my work tremendously exhilarating, so that really helps.

Most of the people who seek me out are finding that Tokyo gives them a different picture of themselves. They see some things about themselves, some strengths, some courage they didn't know they had before, and they see some things about themselves that they really don't like. Dealing with the intensity and stress of Tokyo really brings out different aspects of people's characters and that's usually what brings them in. I think a lot of people have very old style notions about what psychotherapy is.

Most people seem to believe you only seek out a psychotherapist if you're mentally ill or in such an absolute crisis that death is the only other alternative. For many therapists though, while we still work with people in severe crisis, our work is focused more and more on helping normal and healthy individuals to really take a look at their lives and the challenges and themes that run through them and finding ways to deepen their experience of life, to understand themselves better.

The atmosphere of the room where I do therapy is absolutely vital. I have a very tranquil office space on the edge of a Japanese garden and the room I have at the moment is the best room I've ever had for working in. It's sunny, it's full of light and flowers and it's very quiet. That makes a tremendous difference because clients can come here and feel that they aren't in Tokyo for a brief period and that allows them to really focus on what they need to work on.

One of the things that I love most about working in Japan is that my clients come from all over the world and they're all ages. I never know what kind of issues and problems will be walking in the door. I have a truly international client base which varies a great deal in composition. There's always a lot of Americans and a fair number of Japanese and then the rest are other Asians, Europeans, Australians, New Zealanders. It's one of the true gifts of working here.

I consider my work with clients to be a sacred trust in that they are inviting me to help examine their lives in depth and that is a courageous and vulnerable invitation. I have entered into . It is a commitment I take very seriously and which I feel very privileged to be a part of.

Ann Spiers spoke with Paul Betney