Modern psychotherapy began to develop in Western Europe in the late 1880s. Around the same time, the Japanese philosopher and Buddhist reformer Inoue Enryō independently crafted a therapeutic system and discipline, calling it shinri ryōhō, now a standard Japanese rendition for the English word “psychotherapy.” This paper delves into Inoue's psychotherapeutic innovations, particularly in his 1914 Psychotherapy, shedding light on their historical significance. Inoue’s interest in psychotherapy stemmed from his dedication to Buddhist reform and public education. In his view, a reformed and modernized psychotherapy could eradicate superstition, further offering Buddhism a renewed role and responsibility in modern society. As an early pioneer of psychosomatic medicine in Japan, his influence reverberates among contemporary Japanese psychotherapists, notably Morita Masatake. Beyond Japan, Inoue was also one of the earliest pioneers in the world of psychosomatic medicine. His religiously inspired conception of psychotherapy reveals the diverse motivations, from scientific aspirations to philosophical and spiritual concerns, that helped give birth to modern psychotherapy. His psychotherapeutic ideas highlight fundamental issues that have shaped and continue to shape modern psychotherapy, including tensions between religion and science, between self-cultivation and therapy, between the mystical and the rational, between intuition and analysis, and between embodiment and discourse.