While the exoticism of cultural otherness certainly adds something to the experience of meeting a lover from another country, differences can also be the source of annoyance and complications.

These frustrations lead many cross-cultural couples to seek psychotherapy. In Tokyo counseling is usually initiated by Westerners and it is most often Western men who wish to start couple therapy sessions with female Japanese partners who are reluctant to see a therapist. This is noteworthy considering that in other areas women tend to seek counseling more than men.

One common source of trouble for Western-Japanese couples is communicating about problems. Westerners, whether male or female, often complain that when they try to raise a concern they do not receive an equal degree of willingness to discuss the problem from their Japanese partner.