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The Eyes of My Mother contains more grotesque imagery than the average horror film, so there is a temptation to classify it under the “body horror” subgenre. Such a label does the film a disservice, however, since all the transgressive violence deepens a probing, heartfelt psychological study about the effects of profound loneliness. In his directing and writing debut, Nicolas Pesce strikes a grim balance between disgust and sympathy and takes his premise to its inexorable conclusion.

The action largely takes place around a farmhouse, in an unspecified time during the mid-20th century. The titular mother (Diana Agostini) is a Portuguese-American immigrant, as well as a former surgeon, and she uses livestock to give her young daughter Francisca (Olivia Bond) anatomy lessons. The pair receive a visit from Charlie (Will Brill), a man who claims to be a salesman but turns out to be a sadistic killer. Francisca’s father (Paul Nazak) catches Charlie violating his wife’s corpse, and his sense of vengeance is ice-cold: he chains Charlie in a barn, cuts out his eyes and tongue, and keeps him alive for years. This early trauma shapes Francisca’s life—Kika Magalhaes plays her as an adult—so we watch her undergo extreme steps to deal with her sense of isolation.

Pesce and cinematographer Zach Kuperstein use crisp, evocative black and white photography. This gives The Eyes of My Mother a timeless quality and offers the audience a mild reprieve from the gore. In addition to torture, Francisca develops a taste for murder, preferring to commune with bodies rather than people. Like the most memorable movie monsters, however, Pesce makes sure we understand that Francisca is fighting against her dark impulses—a fight she ultimately loses. There is a strange, sad sequence where she picks up a woman at a bar and takes her home. Francisca has the desire for intimacy, yet is so woefully out of practice that when the woman realizes something is wrong, Francisca feels her only recourse is violence. We have no choice but to recognize her perspective better than those of her victims.

In terms of horror, Pesce opts for gnawing dread over “gotcha” scares. He gets a lot of mileage out of filming Charlie, writhing on the floor without the ability to speak or see, as if to invite us to imagine what he could possibly be thinking. The compositions are elegant, with minimal camera movement, a technique that only adds to the dread. A more dynamic, subjective filmmaking style might be more immersive, yet Pesce would rather engage our imagination, not exploit it. The actors are key to this effect. The victims are convincing and ordinary, while Brill’s turn as Charlie is frightening because his self-effacing delivery betrays a deep psychosis. Still, The Eyes of My Mother would fall apart without Magalhaes’ performance. She plays Francisca as a woman who only understands extremes—profoundly lonely, yet without any resources to address her feelings. Despite few lines of dialogue, Magalhaes never takes the easy route, so compassion never veers toward pity.

This film is not a voyeur to Francisca’s crimes because Pesce’s camera is its own form of commentary. There is a long, strange shot where the camera is attached to a tarp that Francisca’s mother drags (young Francisca watches this all unfold, naturally). There are flashes of the outside world and civilization, yet Pesce cuts away from anything reasonable because that would distract from his slow push toward abject madness. The Eyes of My Mother has an ending, as it must, but Pesce prefers no catharsis. He puts Francisca on a disturbing path, and after asking us to share it, he realizes the only way to stop her is cutting her off at the knees. There are no answers, only the demand that we find empathy for someone who perpetrates decades of suffering.

The Eyes of My Mother opens Friday at Landmark’s West End Cinema.