5.

As mentioned before, Honda had had interest toward human mind and how society worked since he was in primary school, so he began to read introductory books of psychology after entering senior high. And he, whose mind was science-oriented, was attracted by behavioral psychology and cognitive psychology as a natural consequence, but gradually, doubt grew in his mind that human mind couldn’t be explained so easily as to be explained in these studies. Consequently, as a reaction to it, he became absorbed in psychoanalysis, which he had kept away from as something like occult.

The ways seen in case reports of psychoanalyst in which they uncovered neurotics' traumatic experiences in the past and complexes and treat their symptoms provided to Honda the same sense of excitement as he had felt when he read Sherlock Homes stories as a primary school student. It seemed that “the system” with which human mind, which had seemed to be something chaotic to him, could be explained existed in it. To Honda, who had strong interest in human mind and saw himself as “intellectual type,” psychoanalysis seemed to be as fascinating as could be.

Honda started to read psychoanalysis books in the summer in his second year of senior high school, and he became determined to be a psychiatrist, the same occupation as Freud. However, even though he was a student of a prominent senior high, the entrance exam of a medical school, that of a public one especially, wasn’t an easy challenge for him (in Japan, public colleges are better than private ones generally speaking). Since he was fully aware of it, he prepared for the entrance exam throwing everything else aside after he made a vow to be a psychiatrist, and he was able to enter a public medical school in a regional city after spending one year studying as a Rounin (gap year student).　

Even after becoming a medical student, he continued to possess his unwavering passion for psychoanalysis. He finished his six-year school life without any trouble, got his doctor’s license, and finally became a psychiatrist after completing the medical residency program. And then, he started to work at a small-sized clinic in a suburban area, named “Saito Mental Clinic.” In the beginning, (desperately repressing his desire to put into practice his knowledge of psychoanalysis he had hoard through his self-study) he obediently followed advice given by his supervisors including Saito, the director of the clinic, and dealt with daily clinical tasks without troubles. He had generally good reputation from his patients.

However, after some years had passed, he became sick and tired of his days of the same routine work. Honda was a relatively smart man, and didn’t have difficulty in communication, so as long as he faithfully followed advice given by his supervisors, he didn’t have bad reputation from his patients as mentioned before. Still, even such smooth days had bored Honda after he became accustomed to them.

What Honda had expected from a psychiatrist job was stimulating battles of the mind Sherlock Homes and psychoanalysts in books engaged in when Homes led his case to the solution or when they healed complicated trauma their patients had. What he had expected was such experience which seemed to cause abundant dopamine release in his brain as they had when they led highly intricate issues to the solutions under pressure.

Despite his expectation, however, the actual clinical site of psychiatric care he faced wasn’t stimulating at all (at least for him) because all he did was simple routine tasks, such as prescribing pills according to the manuals or rehabilitating his patients in partnership with paramedical staff like clinical psychologists and occupational therapists.

Also, even as a hospital doctor, his salary was far higher than those of ordinary office workers, and he began to feel that living his life where he just dealt with the simple routine tasks was no sweat at all. Becoming arrogant like this while you are young never brings about good results. And although it is taken for granted that men vent such pent-up frustration of theirs through gambling, alcohol, women and so on, in Honda’s case, he didn’t possess so strong desires toward such kinds of things.

Therefore, as a way to vent his frustration accumulated through his daily life, he began to enjoy his “game” in which he tested to what extent he can deviate from his duty without destroying his no-sweat life. The mentality he had then might have been similar to the ones of teenagers who usually behave like model students but actually have emotional problems and sometimes commit evil acts hiding from adults. In the first place, Honda hadn’t undergone a phase which could be called as his rebellious phase, and had easily gotten a position where he could receive a higher salary than ordinary people, so he had become arrogant, and had a deep contempt for others (though he didn’t show his feeling openly, of course). This contempt of his was aimed at the supervisors of his clinic as well, and we may be able to say that he began to perform such deeds because he had entered his humble belated rebellious phase.

6.

Obsessed with his wicked heart, Honda began to play what he recognized as “game,” in which he teased his patients or throw harsh words at them on the borderline of whether he made them really angry or not. Naturally, in front of his supervisors, he continued to behave as a fine young man without showing any sign of his wicked heart. Since Honda had never suffered a setback in particular in his life, he despised his patients with all his heart, thinking “If they were decent people, they wouldn’t have been put in such positions.” Many of the patients he faced in his clinical site couldn’t work for various reasons, and some of them even lived on welfare.

His "game" was like this: for example, on one occasion, a middle-aged schizophrenia patient he saw told him by some chance during a conversation,

“Doctor, renowned celebrity X divorced the other day, didn’t he? It was because of my prayer I offered to the Sun God (he called the object of his worship like this) in order to stop his recent reckless behaviors.”

After Honda listened to it, he made a big show of laughing loudly, and replied, seeming to be fooling around,

“It’s nothing to do with your act. When schizophrenia patients’ brains make up such unrealistic stories, we judge them as ‘in a delusional state.’ Are you OK? Maybe you need more medicine considering you say such a thing without hesitation.”

Hearing this, the patient gazed at Honda with mad eyes, but Honda, entirely indifferent to it, continued to type on a keyboard of a computer in front of himself.

On another occasion, when Honda was asked for advice by a patient with a developmental disorder, the patient saying “I have anxiety for the future,” Honda answered, disregarding his patient’s feeling,

“I’m not a career counselor. You are talking to an inappropriate person. Therefore, people around you say you can’t read between the lines, don’t they?”

When he repeated such deeds, it was natural that he should get a bad reputation as “a problematic doctor.”

However, he cunningly figured out the frequency with which he could deviate from his duty without causing serious troubles, and he showed such deviations when there were no other people around himself and a patient, without exception. Also, whenever his supervisors who heard what his patients had to say about him gave words of caution to him, he explained away pretending that it was his patients who was unreasonable like:

“If my memory is correct, I have never said such a thing. I guess the patient must have gotten some of my words wrong in his own way.”

It seems that there is no denying that psychiatrists and other staff at psychiatric clinical sites in general recognize their patients as problematic people who are beyond the reach of common sense though it isn’t the case with all of them. In Honda’s case especially, he had been keeping pretending to be “a fine young man with honesty” without showing any hint of his wicked heart in front of his supervisors, so they always believed what he had to say rather than what his patients had to say.

Such “game” of Honda’s hadn’t brought about any trouble to him for a while. At one point of time, however, he began to strongly detect hostility his patients felt to him. Actually, it was not certain whether his patients felt such hostility to him, but he grew suspicious of his patients by himself and the doubt began to gnaw at him (though we may be able to say he brought it on himself).

You could be reading stolen content. Head to the original site for the genuine story.

As one of the interesting traits of human mind, we can refer to the fact that even if you have someone hostile toward yourself (or you regard them hostile toward yourself), you don’t feel so much stress as long as you have a feeling that there are other people who are on your side no matter what happens, but provided that you feel that everyone around you has become your enemies, it causes so much stress as to do harm to your body and mind even if the community you are in is a narrow one, and actually there are a lot of others who have different ways of thinking and values outside the community. Because of this trait of human mind, if children are bullied, they suffer so much so that some of them even kill themselves in the end, and schizophrenia patients who are suffering from paranoid are seized by such strong sense of despair as Munch depicted through his prominent work “The Scream.”

Honda had a consciousness of fooling his supervisors, and he began to feel he could trust nobody in his clinic with all his heart. Putting himself in such a setting every day may have gradually taken a toll in both his mind and body.

In that his symptom wasn’t caused by such malfunction of his brain as schizophrenia patients undergo, it isn’t certain whether it could be literally called as “paranoia,” but anyway, in his case, his sense of guilt that he had been doing bad deeds deceiving others led him to be in something like a pathological state of mind.

7.

Sometimes, a chain of pathological mentalities may affect a person successively just like one domino falling after another, so that they drive them to behave abnormally. In Honda’s case especially, (if I dare to use a psychoanalytic expression,) it may have been said that he tried to make atonement out of his sense of guilt unconsciously, and anyway, he gradually began to grow hostile not toward his patients but toward the social system which surrounded psychiatric care.

He may have wanted to say out of his sense of atonement,

“It is not we doctors but society that is tormenting you, patients.”

It was also around this time that he started to write a blog. Taking his patients’ side, he wrote on his blog about such things as lack of manpower at psychiatric clinical sites and how many patients Japan’s welfare system had failed to cover, as if to make accusations. However, page views didn’t increase as much as he had expected. After all, lives of most ordinary people are far from psychiatric care, and however hard he attempted to “make accusations,” these kinds of issues could never move toward resolution unless such things as politicians became involved happened. It was a lost cause even if a mere psychiatrist raised voice.

But then, even though his activity wasn’t influential to the real world at all, his sense of guilt somehow receded through engaging in the activity to support his patients anyway. He suspended his “game,” and started to regain a serious work attitude he had had before.

However, when Honda’s wicked heart was gradually receding, an incident happened: his clinic received a bad online review, which criticized him by name, saying,

“One doctor in this clinic named Honda completely looks down on his patients. He repeatedly said to me, who have been suffering from a developmental disorder, ‘You are surprisingly dull. And that’s why you can’t adapt to society.’ How could he say such a thing? He is a mere young man who has just graduated from a medical school and doesn’t know anything about society outside the medical arena. Furthermore, he is younger than I am.”

Moreover, the account name of the account that left the review was a real name of Honda’s former patient who had just quit coming to the clinic, so it caused a little fuss there.

Human mind has such a wonderous nature that when we are mentally tired, even if we were told harsh things by a person in a higher position, we tend to feel that it was out of their kindness that they said such things, thinking “He said that for my sake” or “It was my fault that I was told such a thing.” We can say that power harassment in companies and domestic violence from husbands to wives and vice versa are so widespread because of this, and some of Honda’s patients thought this way while being treated badly by him. However, as Honda gradually regained his normal work attitude, actually a sense of authority Honda had toward his patients declined, so that some of them left him. And then, one of them left the review out of his unbridled rage which had boiled within himself through objectively thinking back on what he had been told by Honda.

Saito, the director of the clinic, was also aware that some of Honda’s patients had faded away from the clinic at the same period, and now that Honda’s bad deeds had been revealed and left on record though it was on the Internet, even Saito couldn’t keep quiet anymore. One day, Saito couldn’t help calling Honda to question about the review,

“You know about that review, don’t you? Do you have any idea why Mr. Yamanaka (the patient who left the review) suddenly wrote such a thing though he never spoken ill of you while he visited you?”

Honda answered awkwardly, manufacturing an excuse,

“Of course, I never told him such things as was written in the review as if my memory is correct. I might have indicated something like ‘you may sometimes miss contexts because of the characteristics of your disorder. You might as well become more careful about it,’ when I was asked for advice about his inability to hold down a job, though.”

Hearing this, Saito stared Honda in the eye without uttering a word for a while. His stare had sharpness which Saito, a man with a gentle nature, rarely showed. He let out a deep sigh meaningfully and concluded his conversation, saying,

“It seems that Mr. Tanaka and Ms. Okawa also has stopped coming recently. I can’t help feeling it strange that your patients alone left this clinic all at once. I think I know well that you are working hard. Even so, when such things continue to happen, I will have no choice but to take some measure. Dr. Honda, you are already a well-trained and self-sufficient psychiatrist. I hope you will behave in a responsible manner with this in mind.”

8.

Objectively speaking, what Saito said to Honda may not have been so harsh as to be called as “reprimand.” However, Honda had had little experience being scolded by someone superior since he was a student, so this incident left deep scars on him. Be that as it may, now that such things have come to pass, it was out of the question for him to take a hostile attitude toward his patients and all he could do was to continue to work obediently and honestly. This was the incident in September in 2015.

The next month, “Nishida Clinic arson attack” happened. He learned about the incident on the news and felt something like a sense of relief, thinking,

“As I thought, patients with mental illnesses are scum of the earth who resort to such barbaric behavior.”

Also, he came to think that however hard he criticized this guy (Moriyama, who commit the crime), nobody would blame him for that. He felt that his strong hostility and hatred toward psychiatric patients he had been suppressing until then began to well up inside himself irrepressibly.

On finishing his work that day, he went straight home, sat at the computer, and started to write a blog post just following his heart. Here’s the summary of the blog post:

“Naoto Moriyama, the culprit of such a terrible crime should never be forgiven. He deserves to be executed immediately. If this man should be recognized as not guilty, it would mean the death of Japan’s judicial system. I, as a psychiatrist, have been communicating with patients with schizophrenia and/or dissociative disorders. From this experience of mine, I can say that though patients who are suffering from the symptoms of such illnesses sometimes lose themselves as widely believed, so that they behave unreasonably, they can’t act in premeditated ways while they are not of sound mind in most cases. What they do is to brandish a knife which happens to be around themselves, or something like that. On the contrary, at the time of the incident, Moriyama ‘purchased a drum which was easy to carry and a lighter,’ ‘put them into his backpack so that they wouldn’t stand out,’ and ‘chose to commit the crime on the day when he had an appointment most probably to avoid making the staff suspicious.’ Like these, he did several things which couldn’t have been done if he hadn’t been in control of himself. Furthermore, according to a report, as for his schizophrenia, Moriyama received a diagnosis of its having gone into remission two years before. I’ve never seen the case where a schizophrenia patient whose condition had been so stable as to be diagnosed as in remission became in such a confusional state within only two years that he or she committed such a terrible crime. Another report said that he insisted that it was out of his grudge against the director of the clinic caused by being prescribed an ointment with poison that he had committed the crime, but it can be because he has been pretending to be in a confusional state because of his schizophrenia. In addition, if he had complaints against his doctor, (however unreasonable they were,) he should have conveyed his thoughts directly to him. However, he chose not to have a dialogue with his doctor but to resort to the incredible act of violence. After all, all the human relationships he had had by then were improper ones wherein his feelings were hurt: he was abused by his father and bullied by his classmates. And the fact that he didn’t show any resolve to overcome his hardships gives me a glimpse of his weakness. On the other hand, it is reported that the late Dr. Nishida treated Moriyama with utmost courtesy. I’m sure that Moriyama, whose mind bore grave weakness, couldn’t direct his hostile feeling to those who harmed himself because of his fear, and looked down on Dr. Nishida, who was kind to him, on the contrary, so that he ended up venting his vengeance for society on him.”

Though even Honda himself was surprised, his blog got more than one million page views in a week, and many TV stations contacted him through his e-mail address he had put on the blog. He became in great demand afterwards, and was to talk about “Nishida Clinic arson attack from a psychiatrist’s point of view” on TV, day after day.