Confessions of a Mask delves into the inner turmoil of an individual grappling with societal norms that starkly contrast with his own psychological and sexual identity. The protagonist's struggle is not merely personal but emblematic of the broader theme of an individual's conflict with society at large. As the narrative unfolds, readers are invited to interpret the protagonist’s story through different lenses. For those who perceive the character’s eccentricities as alienating or perplexing, the novel takes on an ironic tone. However, for readers who empathize with his predicament and his futile attempts to align himself with societal expectations, the novel reveals its tragic undertones. This tragedy is rooted in circumstances beyond the protagonist's control, be it genetics or fate, suggesting a profound inevitability to his situation.

Yukio Mishima, in crafting this narrative, subtly underscores these tragic elements by incorporating an epigram from Fyodor Dostoevsky's The Brothers Karamazov. The selected quote captures a paradox of human ambition and desire, as the character Dmitri Karamazov tells his brother Alyosha, “Beauty is a terrible thing!... A man of noble heart and lofty mind sets out with the ideal of the Madonna and ends with the ideal of Sodom....” This allusion to Dostoevsky’s work enriches the thematic complexity of Mishima’s novel, highlighting the tension between ideals and reality, and the inherent conflict between individual identity and societal expectations.

Yukio Mishima's novel employs a unique narrative strategy, weaving its story through a series of vivid and potent images rather than adhering to a straightforward chronological progression. The author crafts a tapestry of symbolic moments, each resonating with deeper implications that elevate the narrative. Among these, the recurring motif of spilled liquids emerges as a significant symbol. The novel opens with the image of the narrator's postpartum bath, setting the stage for the exploration of identity and self-awareness. This image finds an echo in the narrator's first onanistic experience, marked by the bespattering of his desk and books, which underscores themes of solitude and introspection. These moments are further mirrored by the imagery of spilled drinks in the novel’s closing pages, forming a symbolic continuum that ties the narrative's beginning and end, reflecting on the cyclical nature of the protagonist's journey and the complex emotions associated with his inner world.