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Pushed over to the brink of despair, Sakusa killed for the very first time, taking down the entirety of Mollusca Famiglia's forces by himself knowing full well that his actions will not be tolerated by the Vindice. His complete shift into a merciless killer came after the Mollusca Famiglia managed to kidnap his wife and children and kill them all in an explosion right before his eyes. At some points, Sakusa temporarily helped Arisa in finding the perpetrators and eventually eliminating them which put him and his family in the Mollusca Famiglia's radar. With the way the said mafia organization kept targeting the armories and casinos of the Cranio Property. During the time, the Cranio Famiglia was in a bit of a scuffle with the Mollusca Famiglia. Arisa is the Head Boss of the Cranio Famiglia Coyotte is an undercover member who infiltrated the Police Department as a Commissioner to avoid any arrests from the Law and him, a low ranking member who is only assigned the most trivial of tasks and office works. The three of them always converse like old friends, which is an odd sight considering their respective positions in the famiglia. Sakusa is often seen drinking in the La Farfalla Bar with Coyotte Schnettin and Nikaido Arisa. He became somewhat of an oddball in the mafia, known as " The Mafia Member who doesn't kill". Even stating that he would quit the Famiglia and find a new and more mundane job to support his family.
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He also strived to be a better person in general: loving his wife and daughter cheering up a child whose parent's forgot his birthday adopting four more kids after one of the conflicts between the Cranio Famiglia and the Giovani Famiglia. "How can one appreciate life, if one keeps taking it?" - Sakusa took these words to heart and has continued to persist being in office work and doing menial tasks despite constantly being pestered by Arisa to join her in the higher ups as one of her Guardians. However his meeting with his future wife, Miyazaki Futaba, changed his world views for the better. He used to be a mere lower grunt who does menial tasks and office work for the higher ups. Even before becoming the Mist Guardian, Higashiyama Sakusa was already a member of the Cranio Famiglia.