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If you’re afraid to watch ‘The Substance,’ read this

“The Substance” is decidedly not a film for the squeamish.

The gross-out fairy tale is one of the few horror flicks to be recognized by the Academy Awards in categories beyond makeup (though it was deservedly nominated there, too). The excessive gore, much of which occurs while its actresses are nude, may have dissuaded some viewers from checking out the film that could win first-time nominee Demi Moore an Oscar for best actress.

The splatter of “The Substance” is cartoonish and over-the-top. But its grossest scenes don’t register the same as a brutal kill in a typical scary movie because the violence here is so heightened — and has something to say, director Coralie Fargeat hopes.

There are heaps of physical and psychic violence inflicted upon women in this film. The women commit the physical harm against each other, but it’s the emotional damage done by an ageist, misogynistic society that drives our protagonist(s) to harm themselves, Fargeat has said.

“The movie is about women’s bodies, and to me, I couldn’t find a better way than body horror to show the violence that we can do to ourselves,” Fargeat said in an interview with IndieWire.

The penetrating self-hatred that Moore’s protagonist Elisabeth Sparkle feels throughout the film was inspired by Fargeat’s own damaging self-talk as she aged.

“The level of violence I need to put on screen expresses the inner violence that all those issues have created inside of me,” Fargeat told IndieWire. “They are my tool to address it and to say something about it, and make something with it that I hope will hit people’s minds.”

A guide to the gore of ‘The Substance’
Moore plays Elisabeth Sparkle, a fading star who, on her 50th birthday, is ousted from her longtime gig hosting a Jane Fonda-inspired TV workout series. Dejected and overcome with self-loathing, she takes the Substance, a mysterious injection that promises to create a “younger, more beautiful” version of herself.

Elisabeth does not know that the Substance will open up a massive tear in her back from which a nude, slick Margaret Qualley emerges. The pair has to split their time being “awake” — one week “on” for Elisabeth, the other for “Sue,” the name Qualley’s character chooses for herself when she’s “born.” They’re reminded by an ominous voice over the phone to “respect the balance.” That quickly goes sideways — and gets goopy.

For those who want to be warned (or at least know when to look away), here’s a smattering of most of the gore that appears in the first two-thirds of the film (beginning with Dennis Quaid’s skeezy producer Harvey gobbling shrimp cocktail and spitting their heads and entrails inches from Elisabeth’s face):

A car flips over several times in a harrowing accident.

Menacingly long needles are inserted into and withdrawn from veins several times. A woman’s naked back splits open.

A slimy, adult-sized person emerges from the aforementioned back wound.

The slimy, adult-sized person sews up the gaping hole from whence she came.

Loose organs fall out the back of an unzipped jumpsuit.

A full chicken drumstick is pushed up from a butt cheek and out of a belly button.

Demi Moore's Elisabeth Sparkle commits physical and emotional violence against the "younger, more beautiful" version of herself, played by Margaret Qualley.
Demi Moore’s Elisabeth Sparkle commits physical and emotional violence against the “younger, more beautiful” version of herself, played by Margaret Qualley. Christine Tamalet/Universal Studios

Brittle bones are cracked back into place.

A wound at the base of a woman’s spine grows increasingly infected and oozy.

Much of the gore is intermixed with prolonged full-frontal nudity, slo-mo shots of Qualley’s baby-oiled backside or Moore crying in the shower. Fargeat has said that those scenes are commentaries on the way women’s bodies are viewed and scrutinized (though some critics have argued these scenes adopt the sexed-up male gaze that the film aims to critique).

“It’s a way to show our vulnerability with our own bodies, and how much the way we look at the flesh can be so different when you’re alone in your bathroom, or you’re Sue in front of the camera and everyone is looking at your ass,” Fargeat told Vogue last year.

The film saves the goriest set piece for last
The gory pièce de résistance arrives in the last third of the film, when Sue’s forbidden overtime has aged Elisabeth into a stereotypical hag, complete with an extreme hunchback, hooked nose and shriveled skin. Elisabeth prepares to kill Sue for the irreversible damage her younger double has done to her older body but can’t bring herself to finish the job. So Sue wakes up, and the two sides of Elisabeth Sparkle face off in a bloody battle until Sue beats her older self to death.

Without Elisabeth’s genetic material, Sue’s body quickly starts to fall apart: She slowly pulls teeth from her gums. Her ear falls off. Her finger nail breaks and detaches. To protect her gig hosting her network’s coveted New Year’s Eve special, Sue injects herself with the “single-use” activator from Elisabeth’s original Substance kit. It goes poorly.

Margaret Qualley's Sue does a bang-up job stitching her older double back together.
Margaret Qualley’s Sue does a bang-up job stitching her older double back together. Universal/Everett Collection

Out of Sue’s spine emerges a creature with several breasts, toothless gums and maybe a single lock of dark hair. Her title card introduces us to Monstro Elisasue, and here’s where the film really goes for it.

Monstro Elisasue shows up for the live taping and horrifies the audience, who turn on her after she coughs up a loose breast from one of her many orifices. One of her twisted arms is lopped off by an angry audience member and turns into a firehose of blood. (Oh, and Elisabeth’s original, un-Substance-ified face is grafted onto her monster-self’s back, screaming.) If you can’t stomach blood, this may be the most challenging sequence of the film.

And yet, there’s something lovable about Monstro Elisasue, whom Fargeat described to Vulture as “recomposed in a Picasso way with everything at the wrong place.” She’s brimming with confidence when she steps out onstage, which makes it all the more crushing when the audience rejects her for her appearance — an experience new to Sue.

“The monster to me represents who we are for real, our whole humanity with its weakness, its truth and its imperfection,” Fargeat told Vulture.

Eventually, Monstro Elisasue collapses into a pile of blood and guts, and out crawls Elisabeth’s original face. She pulls herself onto her faded star on the Hollywood Walk of Fame and smiles, hallucinating praise and adoration from fans — finally “free from her human body and appearance,” Fargeat explained to Entertainment Weekly. Then she dissolves into goo, all living traces of Elisabeth Sparkle erased.

In a film that’s mostly a blown-up caricature of Hollywood sexism, though, there’s one scene that abandons all artifice. About halfway through, Elisabeth rubs her skin raw as she applies, then removes, then reapplies her makeup as she prepares for and eventually cancels a date. There’s no goop, no prosthetics: It’s just Moore staring at herself in the mirror through the eyes of the TV executives who disposed of her, the audience that tired of her and the Sue version of herself who despises her.

It’s a quietly devastating moment in a film that is almost always “pumped up” to 100. If you can make it through the rest of the bombast, you might just find yourself moved.

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