Conceptually, a movie has never been more timely. Through an incredible use of body horror, it visualizes an inner reckoning among women, what Demi Moore described in the Q&A following the film’s North American premiere as an “internalized violence against the self.” The Substance takes “we suffer for vanity” to an entirely new level, telling the story of an aging aerobics star, Elizabeth Sparkle (played by Moore) who is presented with a subscription drug that allows her to create a younger, perkier version of herself, Sue (played by Margaret Qualley).

The film attacks, head on, woman’s self-consuming pursuit of beauty, our pitiful attempts to stall time. Elizabeth and Sue belong to different generations, occupy different bodies of different values to the patriarchal industry they operate in, yet both are compelled, at great danger to themselves, to be beautiful. Sue, by staying in her own body. And Elizabeth by forgoing hers. What transpires is a cyclical feast upon the Self, which may just lead to the total destruction of both women, and the terror of the viewer.

What gives me pause about The Substance is where this terror comes from, and what we are to do with it. “Aging” has taken a central focus on the internet, as women tape their mouths before going to sleep and sip from customized straws to avoid the disfigurement of a wrinkle. More than ever, the inevitable, aged female body feels invisible. And thus it’s worth questioning whether body horror is the most productive tool for addressing its absence.

The Substance is a sparse film, with limited dialogue and heavy-handed, almost anime-style editing (not unlike Challengers). It relies on clipped montages that propel the film at breakneck speed, yet by the end of the second act it becomes repetitive, and we’ve learned nothing new about these characters or their motivations. Of course, The Substance is simple because it’s totemic, but its warnings are confused.

On the topic of beauty, vanity and oppression are always undergoing a delicate balancing act. Whether our obsession with the Self is a product of first-world consumerism, or of the cruel, capitalist standards of patriarchy. Whether women are to be shamed and punished for their narcissism, or sympathized for it. The Substance doesn’t seem to know.

In the film’s most powerful scene, Elizabeth manages to lock Sue away in the bathroom, and decides to go on a date, despite her now-deteriorating body. We watch in suspense and frustration as she slowly becomes incapable of leaving the home, returning again and again to the mirror to scrutinize her appearance, until she unravels completely and reanimates Sue - thereby imperilling herself. In this moment, we’re invited to empathize with Elizabeth. Any woman who has exited the bathroom feeling worse than they did when they entered it will understand her, root for her. But by the end of the film, which is undeniably spectacular in its execution and redeems its earlier shortcomings, we are laughing at her. Through the conventions of horror, we are invited more often to cringe away from her rapidly aging, disfigured body than we are to empathize with it.

In the horror genre, the elderly female body has often been used as a tool for terror. Cameras dance across wrinkles, burst blood vessels, sagging breasts, knobbled hands and knees, curved spines, varicose veins, and ask the audience to scream. As I watched Elizabeth’s aged body revealed to the rowdy Midnight Madness audience, and listened to them scream as they were asked to do, I thought of my grandmother, I thought of my mother, and I thought of my own body, and my fears towards it, and I felt very sad. The Substance is an absolute thrill of a movie, and a welcome addition to the body horror genre. But by exchanging much-needed moments of empathy for spectacle, it risks contradicting the desperately important message it wishes to convey.