When the initial complaint was made by the informant, Lindsay was made to undergo medical surveillance for two years, while still being allowed to carry passengers for his airline, Cathay Pacific.
But in 2018 the restrictions were upgraded to include the passenger ban.
It is not clear what prompted the upgrade, but Pilditch suggested in his opening statements to Judge Arthur Tompkins that the poor relationship between Lindsay and his neuropsychiatrist during the period of medical surveillance was part of the "rationale".
The physician, Dr Chris Kenedi, today told the court he was concerned by Lindsay's "unusual response during assessment".
"There was such a lack of insight or any sense of other.
"The concern I had was that this otherwise exemplary pilot was showing this pattern of dysregulation that was recurrent, and this it would bleed over into the other side."
Pilditch said there was no evidence the issues had bled over, however.
Kenedi said there was evidence other pilots that had been involved in deliberate crashes had exhibited lack of insight and communication failures, despite their stellar careers.
He was not primarily concerned that Lindsay was a "monster or a psychopath", but that his personal problems would lead to issues on the flight deck.
Kenedi described trying to advocate for Lindsay and help him work through his issues so the conditions on his flying could be removed, but Lindsay's behaviour made it difficult.
"Sometimes he was his own worst enemy."
Lindsay gave evidence yesterday, at one point become emotional and tearful as he spoke about the four-year saga.
"This is about the first time anybody in this process, which has now gone on four years, has actually asked me a serious question about how I do my job professionally ... I'm passionate about it and it's been a very sad way to end my career," he said.
Lindsay said he and Kenedi never discussed how he operated his flight deck or communicated with his crew.
He believed Kenedi had "misreported" some of their sessions.
The hearing will continue tomorrow.