Zero (Seishin Zero)
Run Time 128 mins.

In Japan, people with mental illnesses have long been stigmatized, marginalized and isolated from broader society. In 2009, documentary filmmaker Kazuhiro Soda released “Mental,” a film about Masatomo Yamamoto, an elderly psychiatrist in Okayama Prefecture who respected his patients as individuals and built close relationships with them. In the process, he challenged standard psychiatric methods that leaned heavily on medication and institutionalization.

As Soda’s fly-on-the-wall camera makes clear, this was no way to get rich. Yamamoto’s hours were long and his clinic was small and rundown. Meanwhile, his wife, Yoshiko, kept domestic and professional wheels turning smoothly. Theirs was a family enterprise, with the “family” including Yamamoto’s patients.

Soda has now followed up with “Zero,” a film that revisits the now white-haired Yamamoto just as he is about to retire. Premiering at this year’s Berlin International Film Festival, “Zero” is a typical Soda documentary relying on observation and made according to his 10 self-imposed “commandments,” which include “no research” and “no meetings with subjects.”

Soda does not just barge in and record, however. In order to make a film — and not simply shoot footage — these “commandments” require empathy, persistence and an eye for what photojournalist Henri Cartier-Bresson called “the decisive moment.” And Soda has made a revealing, unexpectedly touching film indeed.

In his interactions with patients, we see that Yamamoto is more a patient listener than a godlike authority. Advocating for what he describes to one patient as a “return to zero,” Yamamoto explains: “Once a week, stop wishing for anything. Just be thankful to be alive. … When you are thankful, you feel good.”

In parting from his patients — that is, his life’s work — he is kind but firm. He won’t be a stranger, he tells them, but younger doctors will take over his practice. He also thanks them. “I had so much fun,” he tells one. “My life is richer because of you.”

What’s next for Yamamoto, a lifelong workaholic? Instead of dwelling on this question, which the doctor himself does not answer, the film shifts to his relationship with Yoshiko, her once-sharp mind now ravaged by dementia.

Though still mobile, she is practically helpless — and Yamamoto has become her primary caregiver. When Soda visits their home, Yamamoto makes tea, orders sushi and otherwise does what his wife did for decades. As Soda learns where they met (in junior high school), Yoshiko’s first impressions of her future husband (“His grades were not good,” she says with a smile) and other tidbits of their life together, we see that the bond of affection between them is still strong.

So “Zero” becomes a film about their marriage, with Yoshiko in the foreground, a transition that Soda may not have expected when he started filming, but makes nimbly and smoothly Instead of the usual talking head interviews, he records the Yamamotos’ visit to an old mutual friend, who laughs as she talks about how she and Yoshiko enjoyed kabuki, classical music and playing the stock market. We also see flashbacks to the sharp-witted Yoshiko of a decade before. Meanwhile, the film tracks the adventures of a bedraggled stray cat, the sort of digression that is a Soda trademark.

Most of all, we witness Yamamoto’s tender concern for his wife in the present and his rueful recognition of the sacrifices she made in the past. Through Soda’s lens, we see, without filters, Yamamoto’s thanks for a love that has lasted a lifetime.

“Zero” will be streamed on the “Temporary Cinema” site (www.temporary-cinema.jp/seishin0) from May 2. Half of the ¥1,800 charge will be shared with theaters originally scheduled to screen the film.

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