Stretching out grasping hands, they lurch towards her baby. She retreats in fear into her cramped apartment, with the baby – two babies – squalling incessantly. In a moment of delirium, she drops one of the babies – the imaginary one, luckily – over a bannister. Later, the real baby is taken away from her and put into the care of her sister, and she spirals into a regime of wrist-cutting until a kindly suitor called Tanaka (played by the director) makes heroic efforts to get her life back in order.
Kotoko is played by Cocco, a popular singer on the Japanese folk rock scene who herself had a well-documented history of self-harm. Members of her family take supporting roles, emphasising the personal, confessional nature of what is being put on screen. For Japanese audiences, it must be quite something to see one of their top celebs baring her soul in this way, but even for Westerners unaware of all the baggage, this is still a very striking piece of work.
It's pretty clear right from the start that the double vision from which Kotoko suffers is simply a projection of her fractured psyche. All the same, Tsukamoto injects these apparitions with such visceral power that it's impossible to respond to them rationally. The camera rarely strays more than a few feet from Kotoko's panic-stricken eyes, so that you almost feel as if you're tied to her in some demonic three-legged race. Moments of violence happen in a sickening blur.
Some of that violence is directed at Kotoko, but a great deal of it comes from her too. In his attempts to wean her off slashing her wrist,s the devoted Tanaka ends up by taking her inner fury upon himself and becoming her swollen-faced, black-eyed punching-bag. At other times, it's hard to know what is going on as the film segues into dream and nightmare, but it's never less than compelling, even when deeply obscure.
It's raw, intense, uncompromising. But the real key to its success is its lack of condescension to its central character. It follows her highs and lows as though they're the triumphs and disasters of some tragic heroine – as when, in what will probably become the film's iconic moment, Kotoko weaves and struts her way through an eerie victory dance in the pouring rain.
As for Cocco's performance, it's less a display of acting skill than an act of catharsis. Entering into the world of a disturbed mind hardly makes for easy viewing, but putting that world on screen with such fidelity is a remarkable achievement.