MIFF 2024 | ‘The Substance’ review: A grotesque dissection of female self-hatred

Demi Moore and Margaret Qualley bring their A-game to Coralie Fargeat’s visionary new entry to the body-horror canon.

Margaret Qualley and Demi Moore in “The Substance.” Photo courtesy of Madman Entertainment.


Seven years after her explosive debut “Revenge,” French provocateuse Coralie Fargeat has returned to the silver screen with a film that not only cements her as a visionary in the genre but also pushes the boundaries of what body horror can achieve. More Cronenbergian than David Cronenberg’s own headliner at MIFF, “The Substance” is, from the get-go, an all-out, balls-to-the-wall — or, should I say, breasts-to-the-wall? — nightmare that dives headfirst into the grotesque extremes of female beauty standards and the self-hatred they breed. A disgustingly cerebral Frankenstein-esque monstrosity, “The Substance” is best described a tapestry of horror homages stapled together in the mad-scientist lab of Fargeat’s mind — a retelling of “The Picture of Dorian Gray,” crossed over with the slime-streaked body horror and practical effects from Brian Yuzna’s “Society,” all wrapped up in a skintight leotard and leg-warmers, with a high ponytail and Botox facelift to boot.

“The Substance” begins with a deliciously-framed overhead timelapse of an iconic pink star on Hollywood’s Walk of Fame — an indication of much greater things to come from cinematographer Benjamin Kracun — charting its journey from creation to disrepair. The woman it celebrates is ageing it-girl Elisabeth Sparkle (Demi Moore), whose fading career as the lead instructor on a daytime fitness program is cut short by scheming TV executive Harvey (Dennis Quaid) the minute her 50th birthday rolls around. Despondent at her lack of remaining options in showbusiness and desperate to maintain her stardom, Elisabeth opts to begin using the titular “Substance,” an experimental cell-replicating drug that promises to create a “better version of herself — younger. More beautiful. More perfect.”

And just like that, Sue (Margaret Qualley) is born; an unblemished and demonically flawless younger doppelganger of Elisabeth who emerges from her split-open spine in a monstrous perversion of Zeus birthing Athena. The mythological comparisons are apt — Sue’s chemically-created beauty does indeed give her a face that could launch a thousand ships, or in this case, a face that increases Harvey’s network ratings thousandfold. Not only does her bright-eyed, bushy-tailed enthusiasm and girl-next-door chic immediately land her a role as Elisabeth’s replacement, it also launches her own career to stratospheric new heights; the likes of which Elisabeth herself only fleetingly caught glimpses of during her own youth.

As if this wasn’t already an intolerably ego-bruising new state of affairs for Elisabeth to acclimate to, more problems begin presenting themselves. Use of The Substance comes with conditions; its one, non-negotiable rule is that Elisabeth and Sue must take turns being conscious, and swap over every seven days. But Elisabeth has nothing else to do during her week of living except to languish in her own despair and obsolescence, and Sue is beginning to overestimate her own importance in the fragile, codependent biological matrix that The Substance has created for them. Of course, rules only exist in films to be broken… and the consequences of both women’s actions lead to a bizarre and increasingly blood-spattered series of events that may ultimately lead to their own self-destruction.

Unlike the bleak, dusty mise-en-scene of Fargeat’s first feature, “The Substance” is set in a world that feels at once familiar and disturbingly alien. On the surface, the film seems rooted in the present day, but everything — from the wardrobe choices to the set design to even the film’s colour-grading choices — screams 1980s excess. Elisabeth’s apartment, with its plush pink carpeting and gaudy decor, feels more suited to a “Miami Vice” speed dealer than a modern-day protagonist. This anachronistic backdrop is jarring at first, especially when we watch Elisabeth take calls on her iPhone in a living room that shouldn’t even have seen the dawn of instant messaging. But once you get used to the cognitive dissonance, the film’s nostalgia-oriented bent comes together as a smart visual metaphor for the film industry’s obsession with an era when beauty was everything, and ageing was a fate worse than death — outdated standards that have, of course, carried over to our present reality. Her apartment is not the only thing stuck in the past — Elisabeth is both victim and perpetrator of the standards that have locked her out of the industry; her inability to see past her own self-hatred drives her to bend over backwards to meet these standards through Sue, instead of taking a stand and subverting them herself.

In that vein, there is certainly something praiseworthy about how “The Substance” is not content with simply pointing fingers at a vague caricature of the patriarchy and calling it a day. While the profiteering men lurking in the shadows are indeed culpable for much of the suffering endured by women both onscreen and off, Fargeat’s screenplay dares to dig deeper; exploring our innate fears of ageing and the terrifying inevitability of mortality that drives our own unavoidable, human instinct to despise our older selves. There is something profoundly unsettling about the way Fargeat forces us to confront these fears head-on with Elisabeth as our vessel; as her body decays and grows in frailty with each passing day, and the mirror becomes a cruel reminder of time’s relentless march.

A sudden mood switch in the third act ensures that such subject matter, especially when told through the mediums of viscerally nauseating practical effects and gut-churning new frontiers of body horror, does not become too maudlin. Both lead performers Moore and Qualley bring their A-game to each moment, injecting plenty of humour into the film’s more farcical elements, and cementing their status as horror’s newest scream queens in every other scene. Moore, in particular, is electric onscreen; the role of Elisabeth and her embattled, objectified body seemingly tailor-made as a semi-autobiographical outlet for the actress’s own past struggles and frustration over predatory media practices. And, for the cherry atop the cake, the strength of these performances is elevated to transcendent new heights of horror cinema thanks to an effervescent EDM score by British composer Raffertie, whose throbbing drum-n-bass backbeats could very well challenge Trent Reznor and Atticus Ross’s “Challengers” score for the year’s best film soundtrack.

Bold and provocative, “The Substance” is a cinematic work that defies easy categorisation. Fargeat has crafted a film that, much like its characters, is obsessed with surface appearances… but don’t be fooled. Beneath its polished exterior; past all that style and silliness, is a dark, festering core of unforgiving feminist truths that demands to be seen, dissected, and perhaps most disturbingly, understood.

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