More interestingly, The Substance is an internal character study, existing in an exciting year that's seen a few female and non-binary filmmakers use rich, immersive storytelling to convey complicated relationships to the corporeal self, including Jane Schoenbrun's I Saw the TV Glow and Marielle Heller's forthcoming adaptation of the novel Nightbitch. Fargeat's intention isn't only to call out the external pressure women face to take extreme measures to achieve a constricted definition of desirability; she wishes to plunge the viewer into a vicarious experience of the physical and psychological toll it all wrecks.

Following that initial injection, Sue's violent, terrorizing "birth" from Elisabeth's body is a technical marvel and, like the vast majority of the movie, it's not for the squeamish. (The visual and special effects team is made up of Pierre-Olivier Persin, Bryan Jones, Pierre Procoudine-Gorsky, and Jean Miel. We've come a long, long way since David Cronenberg's The Fly.) New cells are formed, skin rips, blood oozes, and Fargeat takes her time over several excruciating minutes to ensure your senses are tapped and engaged by every mortifying bit of it.

This early scene is barely adequate preparation for what follows for the remainder of the runtime, as Elisabeth/Sue becomes consumed by an existential pestilence. Sue, perky and "perfect," replaces Elisabeth as the new aerobics It-girl during her waking hours, while Elisabeth spends hers resenting her other half's ascendance and her own continued existence as an old has-been. The seven day "balance" of time begins tipping in one direction, and things take a turn for the worse.

This is a towering showcase for Qualley and especially Moore, who might be channeling the abrasive, ever-spiraling spirit of Faye Dunaway in Mommie Dearest and late-period Bette Davis. On paper her character is thinly drawn, no family or friends to speak of, no backstory other than her identity as a faded TV star; Elisabeth and Sue are instead pure id, powerful vessels through which to deliver Fargeat's primal scream.

That primal scream is righteous and effective, to a point. Fargeat keeps upping the ante relentlessly, with Moore and Qualley totally committed to the absurdity and monstrosity of their characters' shared trajectory. Some viewers will indulge this excess wholeheartedly, but during one particularly nasty sequence in the third act, the brilliant motif began to feel like a cudgel wielded with such brute force that my senses were dulled. I found myself both in awe of the audacity and uncertain whether the messaging was losing its bite because it was just so much.

At the same time the over-the-top approach feels like an argument in itself, given how little has actually changed even in the wake of campaigns like the body positive movement. The goal posts have merely moved.