"My Dearest Self with Malice Aforethought" is a psychological thriller manga that explores themes of identity, memory, and morality through a complex narrative structure. The story centers around Eiji Urashima, a college student who experiences frequent blackouts and memory lapses. One day, he wakes up to discover that three days have passed, and during that time, he has been implicated in a series of violent crimes, including murder. Eiji struggles to piece together the events of the missing days, uncovering disturbing truths about himself and those around him.

As the narrative unfolds, it becomes apparent that Eiji may have a dissociative identity disorder, with alternate personalities that act independently of his conscious self. These personalities, particularly one known as "Jack the Ripper," are capable of extreme violence and manipulation. Eiji's journey to understand his condition is fraught with tension, as he grapples with the possibility that he may be responsible for heinous acts. The story delves into his relationships with friends, family, and a mysterious woman named Shiori, who seems to hold key information about his past and his condition.

The plot is driven by a series of twists and revelations, as Eiji uncovers connections between his blackouts, the crimes, and a shadowy organization experimenting with human psychology. The narrative frequently shifts perspectives, offering glimpses into the minds of other characters, including detectives investigating the crimes and individuals linked to Eiji's past. This multi-layered approach creates a sense of ambiguity, leaving readers to question the reliability of each character's memories and motivations.

The manga balances its psychological depth with a fast-paced, suspenseful plot, incorporating elements of mystery, crime, and horror. Eiji's internal conflict and the external investigation into the crimes are interwoven, creating a tense atmosphere where the line between victim and perpetrator is often blurred. The story challenges conventional notions of guilt and innocence, exploring how trauma and manipulation can shape a person's actions and sense of self. Through its intricate storytelling and morally complex characters, "My Dearest Self with Malice Aforethought" offers a gripping exploration of the human psyche and the consequences of buried truths.