Elisabeth refuses to be put out to pasture. She has a star on the Hollywood Walk of Fame, which, in Fargeat’s bravura opening, we see being implanted, then trampled on across the decades. She even won an Oscar once, though no one remembers which film it was for. Now past 50, she’s let go by a sulphurous TV exec (Dennis Quaid, gleefully horrible) from her dance workout show, Sparkle Your Life, because he wants to reignite the ratings with a fresh face.
Yet that fresh face could be Elisabeth’s own – if she experiments with a hush-hush medical programme, known as The Substance, which has strict rules. Once your younger self pops out, you must share consciousness by turns: one week on, one week off. In the first of many escalatingly outre effects sequences, Qualley’s Sue is born, and rapidly seizes Elisabeth’s spotlight; the thrusting wannabe doesn’t fancy switching back.
The ensuing mano-a-mano between ingenue and hag has all the spite of Death Becomes Her, if the leads were duelling sides of one person. The gross-out levels climb: when Sue steals extra time from poor Elisabeth, the first side-effect is a withered finger, more than horrible enough by itself to make us dread what the rest of her will eventually look like.
Fargeat makes various unmissable homages, to Vertigo and The Shining in particular. It’s the casting of Moore, though, and her willingness to denude herself at 61 – emotionally, as well as physically – that gives The Substance a startling connection with its themes. Not for 30 years has she owned a film with anything like this certitude. Watching her confront the Demi Moore in the mirror, and do it so mercilessly, is extraordinary.