This is quite an unknown film, in fact I know of no one who has actually even heard of this let alone seen it. Therefore, I'm braving new territory. I'm pleased to report that this is exceptional filmmaking. A young single mother suffers from a mental illness that enables her to see double, questioning what is reality and what is fantasy. Tsukamoto has achieved excellence with Kotoko. He is able to convey the solitude and disparity of a fractured mind with visceral filming techniques. The transition from slow camera movements to explosive shakiness (albeit over accentuating that movement slightly too much) highlights the violence that she suppresses and unfortunately succumbs to. There is self-harming. There are visions of horrific imagery that no parent (or anybody) would ever want to see. Yet, it's imperative that these are shown. The complexity of her illness makes her a liability, her eventual loneliness only worsens the situation and I believe it's important that the bloody violence conveys that raw emotion. You feel helpless watching her. Both the internal and external struggles of this rare psychological detriment are explicitly portrayed where all of your emotions are drained. This is a relentless drama, and I admire the personable perspective. A feature film debut for singer-songwriter Cocco who delivers an outstanding performance. There is a stunning one take scene of her belting out a melancholic song, and I was transfixed. She held my gaze, grabbing my eyes and refusing to let go. Just masterful. The loud piercing noises throughout increases the broken nightmarish reality that she lives. The story does lack some attention towards the psychological aspects of this illness, where certain scenes do feel slightly too ambiguous for its own good. Also, a vision involving her son towards the end was too violent. However Tsukamoto's heartbreaking drama remains grounded throughout and holds one of the best debut performances I've seen. It's not an easy watch, but do check this out and give it some adoration.