Medusa Moments in Psychoanalysis

It wasn’t long before Lev and I had what I call a Medusa moment. In such moments, the clinical atmosphere becomes stone-like, frozen in silence.

Lev was a forty-year-old psychoanalytic patient of mine, an engineer, who asked at the start of treatment for a way to achieve a lasting erection. (Medication was off the table per his doctor.)

Dialogue with his partner was also off the table. He assured me the issue wasn’t shame, but responsibility, namely his; he had angered his wife by avoiding sex, until she demanded he seek help. Now he was (implicitly) demanding I help him via some literal remedy for what I saw as an emotional and relational problem.

Soon I too felt deflated, as if my emotional curiosity, my analytic stance, was simply inadequate, our dialogue inert as gravel. I made some practical suggestions; he’d tried them all. Never mind Lev’s recent hernia procedure (ouch), or his former partner’s surprise divorce. He needed to fix this now, his wife was murmuring of separation. 

            I said to Lev, “I imagine this kind of pressure ain’t exactly sexy.”

            Lev: “So what are the tools to make it sexy?”

I had little to offer, it appeared, similar to how he felt with his wife perhaps, in a parallel process eluding discussion. She took his deflation as a literal abandonment, “evidence” of his lack of desire for her, an atmosphere cool as granite, cementing their impasse.

But what turned my tongue to stone? Whose snaky gaze was I responding to? The patient’s? His wife’s? Was this my “inner critic,” provoked by the patient’s disappointment, a stony shame I could not name even to myself? This was an anxiety without words, notes without a score, a “vibe” hostile to analytic thought.

This scenario represents an acute but not infrequent clinical dilemma, where patients seek relief from emotional or relational knottiness via mechanical means alone, with language drained of subjective emotional meaning, in favor of verbal “prescriptions” that will unfreeze emotional stuckness, though “emotion” is not a term of significance. Here the patient’s framing of the problem reflects the problem, phrased in machine-like terms (“rewiring”): language games drained of the vitality needed to bring dyadic dialogue to life. As Wittgenstein put it, “to describe a language game is to describe a form of life.” But such forms in these scenarios are increasingly lifeless.

How to re-animate such a drained corpus of communication, speak of the danger of the concrete, the vitality of emotion: analytic language games akin to a foreign tongue? My own inability to “translate” leads to an anxious silence, like a creeping frostbite on the tongue. Such “translation” after all is up to the doctor, is it not? 

Yet notions of “subjectivity,” let alone “transference,” however plainly spoken, appeared useless. Lev’s previous therapist had dwelled on his past at length; he now sought objective feedback about the present, as if I had or should have a God’s-eye view, above rather than within an affectivity he seemed allergic to expressing.

Ludwig Wittgenstein, who coined the term language games, states that philosophical problems are scenarios wherein we seem not to “know our way about,” analogous to clinical moments where the needle of my compass seems frozen in place, with talk of such lostness also enshrouded in ice. Can’t you just tell me what to do? 

Wittgenstein describes how language acquires enlivened meaning in lived usage, in complex contexts of culture, politics, family—the living network of speech, contexts of idiom, slang, or assumptions, the rhythms of connectedness. To live is to speak, and vice-versa; language shapes experience which gives shape to language. 

Patients such as Lev often come from non-responsive surroundings, situations that failed to heed the child’s “ouch,” devaluing the child’s self-expression, and thus (given the power of emotion) the child’s very presence, a withering insignificance (as with Lev’s body, alas.) Children here learn their words are venomous to others, omnisciently dangerous. This leads to metaphysicalized life, words stripped of context, in favor of omni-meanings imposed by the caregiver-system, where there is never more than one perspective, or even a “perspective” at all—merely truth, like the language of a cult.

The child begins to equate personal narratives with monochromatic “incidents” rather than stories, a life turned to stone, under caregivers’ monolithic gaze. Lev’s problem as he saw it was a failure of erection—the end. I saw a way of married life in crisis. Yet feelings were beside the point, as “subjective” sounded like “selfish,” in light of his wife’s dissatisfaction, due to his failure alone (another omni-meaning), which he could only redeem performatively, as with children inflexibly tasked with provision to chronically unhappy caregivers. 

Such restriction against subjective significance can result in moebius-like confusion, as it is hard to make analytic sense of what is happening, when the analyst’s language games are frozen out in undetectable ways. Yet we sense the windswept gap between language worlds, stubbornly unnamable, via a collapsed relationality that itself holds little significance in discussion. Analytically relational concepts are more lived than described, where “description” (like interpretation) is itself contextualized in a dyadic world or empathic surround.

Making this more complicated is the complexity of language games in general, embedding experience in ways unseen due to their familiarity, yet resistant to what Wittgenstein called a seductive “craving for generality,” or the God’s eye view—as when we confuse the mechanics of the brain with “consciousness” or “mind.” This seemed to be what Lev was seeking, a desire to stand outside the problem rather than to understand from within, maintaining the very alienation that deflated him. But again, the reflective language on view in this paragraph was of little to no significance: he simply wanted the prescription, cut back to every other week, wrap things up.

In fact, the imperfection of language, and our embeddedness in it, undercuts our desire for grand comprehension, which remains humanly tempting. Words are potent, in ways that can seduce, a “bewitchment of language by means of our intelligence,” as Wittgenstein famously puts it.  

It seems logical for instance that I could offer an expert opinion on the problem, as it says “Doctor” on my business card, the language game of authority, even as my suggestions to Lev flopped, undermining my own desire to play the role of expert, as if I should be able to explain away the problem. Lev sought help from self-help books, carrying their own cultural caché; his failure to implement them provoked his own Medusa skepticism. We were unseen siblings in paralysis. 

Thus, the gap persisted. How to explain that the “solution” requires a new perspective on the problem, in noticing (for starters) our viewpoint and that of others as perspectives, when only one point of view is foregrounded, in this case Lev’s wife.

Our own theoretical games are also rife with a complexity easy to miss, until we try to put them into play. Our viewpoint becomes familiar, taken for granted, like a painting we walk by daily and after a time fail to notice, until we spot it anew, our gaze alighting with recognition. Some cannot make it out, though we might think we can “get” them to see. (But what “causes” anyone to notice a new aspect?)

Lev’s problem was also a solution, for instance, in its distancing him from a wife who spoke of separation, another aspect of the issue—as in an optical illusion, though Lev saw only a face there, not two. Could the expert explain this unseen aspect?

Some patients talk about replacing negative thoughts—borne of early neglect, injured self-esteem—as if swapping out a light bulb. The presumed insignificance of emotional expression, its originating context, practically guarantees its continuation, with language stripped of such context, when “emotionality” is also mechanical, like garbage to be hauled to the curb. That garbage is analytic gold, I want to insist! Can the expert somehow illuminate that aspect? 

Well, isn’t that my job? Temptation abounds. There is at times an inclination to think of “thinking” as tangible. But what after all is a thought, and where does it take place? Is it a firing of neurons “inside” the brain? In everyday use we say we “have a thought,” a lived familiarity giving sense to “thought.” Notions of “inner” or “thought” are in other words themselves language games. Plucking the word from context turns it to stone, a (fantasied) bulwark against the Medusa-stare of uncertainty, an archaic demand to get it right, have “answers.”

We are embedded in the vastness of our games, the oceans in which we swim. We cannot stand outside with the clarity we want, as language too is fallibly ambiguous. Our only choice is to lean closer, notice what occurs. There is power in the ordinary, Wittgenstein believed. Yet the ordinary becomes overly familiar, including the assumptions of our language world; unsettling when a different world challenges such assumptions, like arguments within analytic “families,” or impasses of dyadic meaning.

Cavell points out how terrifyingly fragile our language worlds can be, dependent as we are on others for dialogic weaving, spoken understanding, a means of our very coexistence and relational survival, freeing us from solitary confinement.

It is thus disquieting when a patient seeks only material solutions, bypassing our terms of art, two foreigners lost in translation. To some, “empathy” is a monadic “fix,” not a “process,” as the latter can be like explaining to a child what paper money represents.

Yet a patient might arrive with hope I can deliver the words to convince a loved one to stop drinking, for instance, as if the right phrasing can “de-spell” some demonic compulsion, exorcise self-destruction. Missing again is any relational background.

Such a closed-system often hints at an archaic demand to manage an entire caregiver-system, an inheritance of compliance, in which nothing is “played” but rather commanded—games not open to question, dominating the child’s thought. 

This is one example of bewitchment. Others include denial, as one’s addiction will be handled “at some point.” Also either/or questions, where only the “perfect answer” will un-spell the anxiety provoking the question: a snake devouring its own tail.

Patients struggling within concretizing, addictive, or accommodative systems (that is to say, the majority of my caseload) become entrapped in bewitchingly coercive language worlds, where bewitchment is contagious, even as the “right answer” eludes so long as emotionality is unexpressed: surrounds stifling or destroying a child’s ability to discover subjectively spoken meaning, the lived concept-game of “subjectivity.”

Such systems camouflage any notion of “systems,” beholden to a darkly magical “script”, written from a God’s-eye view, which caregivers too may have inherited. Here a child’s “wrong words” are venomous, traumatizing to caregivers and the child’s ability to call it as she sees it.

Here is Ogden’s collapse of potential space. Traumatic misattunement collapses transitional speech: the child’s discovering or “authoring” of their own language world, ossifying under the stony stare of expectation. Some patients have told me they never truly felt wanted, valued, or loved. 

Most tragically, then, the child comes to view their spoken spontaneity as evoking the Medusa head. This is prime stage-setting for addiction, as in my own case, where “alcohol” became bewitching, un-stoning by getting me stoned, obscuring the snaky gaze; booze thawed the tongue, in speaking of yearnings and fears. An archaic demand to forego embodied existence spurs the God’s eye view—implanting in the child’s mind the viewpoint of an overbearing adult. 

Such overbearing in my own case can repeat in any variety of ways clinically, an enigmatic pull to “fix” the problem via words, as if I could, a temptation of density, a replication of demands to “magically” soothe others, such seduction sliding in under the radar. The wrong words on the other hand may singularly harm the patient, leading to awkward silence.

When I was in middle-school, I brought home a library book on alcoholism and families, in hope of understanding the madness at home: a terror unmentionable to caregivers. My father was deep in his cups, clashing explosively with my mother. One night I left the book on the coffee table, as if I lived in a free environment. In the morning my father spotted it, eyes widening with anger. “Don’t leave that lying around!” he said, as if the book’s very existence threatened his vaunted reputation as a social worker. I snatched the totemic volume from view.

Here his own terrified perspective disappeared as a perspective, as if I alone (in seeking such dangerous text) seemed to “cause” his panicked rage. The world re-presented its rules: thou shalt not speak out of turn…. as if a desire for textual relief, to soothe and clarify a terrifying family chaos, were alone responsible for the gap between us, haunting still though he is gone, his words hanging like breath in winter.

In intersubjective repetition, it is as if an unspoken, unnamable canyon lies between us, which I may again be tempted to believe I alone can “fill.” The failure to do so becomes threatening, as my words alone can rescue. I can even sense impatient peers and mentors on the sidelines, awaiting implementation of our cherished games. 

Another patient of mine, Jonathan, encountered his own Medusa-head in the form of his boss, a partner at a prestigious Beverly Hills law firm. Jon too hoped for perfect language, via properly written emails to VIPs or flawless legal briefs: words shielding him from his boss’ prickly displeasure. The boss’-eye-view remained foregrounded, obscuring Jon’s underlying desire for recognition, too shameful to note.

This meant that he could not speak to the Escher-like impossibility of his task, of summoning approval via words alone, an external validation confirmed “inside.” Yet this was his focus with me, him talking around and not about the inability to find a relational home defined non-relationally, validated only by a powerful other. Jon could not speak from within such yearning, as such an affective mother tongue had never existed for him; he floated above, a satellite distant from his own often “toxic” subjectivity. He related a nightmare of being an astronaut in space, suffocating in his suit.

Meanwhile, I tried to keep up with the slow-motion sandstorm of his ruminations, lost in a vastness of detail. What he failed to realize, what I somehow could not convey to him, was that the vulnerable, even endearing part of him (to my mind) had somehow become dangerous to others. His vulnerability froze in orbit, lest he tempt his boss’ suffocating Medusa-gaze (I need that by tomorrow Jon, and no screw ups!) 

This became our conundrum, as he agonized about assignments, fearing mistakes he had yet to make, with a mounting dread that I too felt, even as it remained unnamable. He feared his boss would again humiliate him in a staff meeting. This exacerbated a hope to think his way out of his own paralysis, even as her mounting hostility befogged his ability to think! Such paralysis meanwhile was also shameful.

Jon’s parents had been distant, his father semi-warm but immersed in his career. His mother was depressively volatile, leaving Jon (the only child) to “look after her,” foregoing the needs and wants that seemed to disturb her: a Medusa-gaze of terrifying panic, burdening him with a responsibility that ossified his own needs and ability to speak them. 

But this view of a “toxic” vulnerability that I saw as significant, failed to break through, as he strove to think his way around the issue via anguished monologues.

Stabs at empathy even prompted his agitation, i.e., “Ok I’m only human, but this filing is due tomorrow!” Or, “If she doesn’t promote me, I’ll have wasted five years of my goddamn life!” (I had seen him for roughly two.)   

Notions of “transference” were similarly useless, however simply stated. “You’re saying my boss is my mother.” He often heard my curiosity as critique. “You think I blow things out of proportion…?” His opaque yearning for approval provoked self-hatred, as any discussion of his anxiety only postponed its circumvention.   

I pursued co-engagement with Jon, indirect validation of my analytic stance, much as Jon pursued his boss. In such a way we both futilely pursued recognition. Eventually I detected this parallel, with an isolation that was likely analogous to his. Our circular pursuit was like a snake eating its own tail, as if such futility was ours alone, individually, “causing” the other’s Medusa stare, paralyzing us in tandem, both of us angry at ourselves for provoking the other’s disappointment: as if such other said to us about our own hopes, Don’t leave that lying around! (Jon was terrified he was seen as needy and weak.) I sometimes backed away from Jon, unable to find a way in, wary of the futility of my “incorrect” words, halting investigation of joint futility.

I began to see that Jon was no more “responsible” for his boss’ reaction than I was for my father’s, or for Jon himself, in our unseen mutuality. Perhaps I even left that book in view as a flare of defiance, provoking a father who could or would not claim the distress inflicted on us. Jon then became brother-like to me, illuminating the yearning to please a grumpy authority figure, as his boss (like my dad) swung wrecking-balls of self-protection, both of us sifting through rubble rather than examining the pain of impact.   

In fact, there was nothing Jon could say to dispel her venom, just as there was nothing I could say to Jon to appease an agitation I needed to understand, humanizing our asymmetrical anxieties. My own self-muzzling resulted from the ancient notion that I could verbally provide a path to appeasing his boss, as he sought the perfect words. We were both playing an impossible game, whose very impossibility illuminated the problem, sight unseen, me trying to think my way into helping a man thinking his way into altering his boss’ thinking—rather than me addressing such a demand to perfectly think, a game neither of us could win.   

The Medusa image in fact has haunted me since childhood, instilled from countless unseen yet burdensome demands. Seeing such demands as emanating from overwhelmed caregivers, rather than some abstract ideal I had to meet—rigid language games in which fallibility was disallowed—eased the Medusa-terror. Jon’s disappointment in me lost its edge, as I reflected upon this, as fallibility became constitutive of our process, including our attempts to talk around such roadblocks. 

Eventually I told Jon how conflicted I felt, struggling to help him to find the recognition he deserved, even as I sensed there was nothing he could do to change his boss, who increasingly sounded to me like a bully. I pointed out the recent praise he received from her, just before she (again) denied his promotion… a confusing game reflecting her need to feel powerful, at his expense.  

Jon decided she was a narcissist who detested vulnerability, though I myself found him endearingly earnest. (This moved him.) We discussed “gaslighting,” which invalidates experience, devalues the expression of injury, abandoning us in shit, as if we were too stupid to figure a way out by ourselves.   

He sighed after a moment. “That makes sense.”

I remarked I should have said this sooner, that I feared dashing his hopes, in my inability to say the right thing until I realized there was no right thing, and “maybe you relate?” He chuckled… before a bitter sadness settled in. He talked of the dwindling hope of filling the shoes of his father, a semi-famous law professor and speaker who liked admiration from a distance. Thus a frozen paternal gap, which Jon hoped to fill by “being brilliant,” as if he could magically summon the validation he craved. We were siblings in Sisyphean pursuit.

Jon reluctantly sought another job, at a smaller firm that nurtured his talents. Still his sadness lingered, though we could at least address it as sadness, with disappointment in me as well, since he was hoping I might provide a way to victory. We could not fill that gap so much as speak and illuminate its meaning, including Jon’s hope of closing such a wound; in such a way our words gained dialogic currency.

At times he would say, when overwhelmed, “What do I do with all this?” At first, I chafed (was he deflecting?)—until I realized, how could he know what to do, when he had never been encouraged to speak from the anguished center, a subjectivity he was always told not to leave “lying around”? He could not know what to do with these feelings or our relationship, because no one had ever shown him! I understood this and spoke to such a yawning absence. The “shit” of his situation became fertilizer, with fallibility welcomed in. Jon became aware that such struggle was the process, not a symptom of disaster that was his alone. I encouraged him to be more demanding of me and not only of himself; I liked him as he was, no matter how difficult he thought he was. 

I thus heard not a demand (what do I do with this?) but the child’s call of distress. This question, what do I do?, is where so many treatments begin. The Medusa here becomes the instilled, child’s-eye-view of caregiver expectancy, a fear of provoking dangerous contempt, leading to a retreat from the very source of relational home-building. Jon distanced to protect others in self-protection, isolated in the process, as I self-muzzled to not disappoint him, increasing the gap we felt but couldn’t name. What do any of us do indeed, our spoken fallibility, the vast finitude of unknowns. 

There is in the end a common language to be found, if we are smart enough to look stupid, when it comes to the impulse to “fill” the emotional voids of trauma with metaphysical prescriptions, tempting protection against painful voids our words illuminate, such haunted canyons, seen in a context of expressiveness. We do not fill our patients’ existential emptiness but speak of the agony evoked, a blank page for more personalized stories and self-portraits, as we welcome even the darker shadings. 

Our words often fail us because we have been failed by ossifying silences that persist unnamed. It is hard if not impossible to speak of “emotion” or “experience,” when any language of experience is frozen over. Analytic persistence becomes thawing, generating empathic heat, as we lean into fallibility and its impact on patients, our commitment to the pulse of presence via ordinary exchange, language games jointly lived rather than just described.