Review: What 'The Substance' Gets Wrong About Aging

By Emily Gould, a novelist, critic, and features writer for New York Magazine.  She writes the ‘Going Through It' advice column and is most recently the author of ‘Perfect Tunes.’

The Substance, director Coralie Fargeat’s new body-horror film about the curse of aging in Hollywood, is masterfully well-crafted. Every frame, taken individually, could be installed in a gallery like a work of art. Every editing and sound choice is calculated to extract maximum audience discomfort. Ordinary noises are blasted into our eardrums at high volumes, like reverse ASMR, and there’s never a stationary camera shot when something swooping or low-angled or maximum close-up could exist in its stead. Demi Moore and Margaret Qualley, as two halves of a self divided by the titular Substance, commit to frank unsexual nudity and many varieties of physically and emotionally extreme performance in ways that display both actors working at the top of their game. I’m still dazzled on the level of pure spectacle. Still, there’s something off in its central conceit.

Yes, the movie is clearly using maximalism and shock value to make its points. But the price of being thrilled by The Substance is accepting wholesale that a woman would be willing to give up her life seven days at a time to permit a version of her young, beautiful self to parade around in the world in her stead. The two selves don’t share a mind, so the old self must just sit around and watch TV while the new self paints the town. Why, I wondered, would anyone make that bargain? My inability to suspend my disbelief may be in part because Demi Moore, who plays faded star Elisabeth Sparkle, is one of the most beautiful 62-year-olds on the planet. If you’re already fairly perfect, why sacrifice everything to allow a glistening Margaret Qualley to burst forth from your spinal column every other week?

When we first meet Elisabeth, it’s via symbolism: We see a montage of her Walk of Fame star being scrupulously installed, shiny at first then, over the years, fading and cracking and ignored by the tourists who walk over it, noticing it less and less. We then meet real-life Elisabeth on the set of her long-running aerobics show, sweating it out in a skintight leotard and tights, looking fantastic. But not fantastic enough for Dennis Quaid’s Harvey, the head of the studio and avatar of everything masculine and rapacious in Hollywood. In shiny suits and clanking boots, his face distorted in punishing close-up, he loudly masticates shrimp at lunch in a way that will make you never want to eat shrimp again. As he does so, he fires Elisabeth from her show for being too old. She promptly goes out and crashes her shiny red car because she’s distracted from the road by the sight of her outsize face being peeled off a billboard. At the hospital afterward, she’s pronounced unscathed, but a gleamingly youthful medical assistant slips her a card with a phone number and the words “The Substance” wrapped inside a note that says “It changed my life.”

Alone in her jewel-toned apartment with a punishingly bright full-wall window overlooking the city, Elisabeth smashes the shrines she’s erected to her own beauty, then calls the number, as we know she will. Soon, she receives a numbered pass card in the mail. No money is exchanged, as far as we know. She is only given directions to a mysterious filthy back alley, where at the end of a debris-strewn corridor a blank white room contains lockers. Hers opens to reveal a cardboard box, innocent as an Amazon package, containing the kit that will contaminate her future. She doesn’t hesitate, even momentarily, before using the kit, which comes packaged with a number of scary warnings. Certainly, our culture’s sexism and obsession with beauty makes women desperate for solutions. But … this desperate?

Here are the mechanics of how the Substance works. First, Elisabeth must strip down to harshly lit nudity in her lablike white-tiled bathroom and inspect her aging body. Again I have to stress that she looks great, thin and lithe with preternaturally pert boobs and just the tiniest bit of normal-human ass-sag. Now, she must inject herself with a vial of brat-green liquid, then writhe and groan on the floor as it takes effect. Her greenish pupils cleave in half and sprout blue twins that crowd her eye sockets. A horrific lump distorts the flesh of her back. Then Margaret Qualley’s character, Sue, emerges from a clean line cleaved down her spine. In the aftermath, in a sequence that elicited audible groans from the audience I saw it with, Sue is charged with sewing up the hole she has emerged from with knots of thick black thread. We hear the needle stab and slither as it penetrates a thick wad of skin. The procedure is completed with the insertion of an IV bag of nutrients labeled “FOOD” (an identical bag is marked “FOOD: OTHER SELF”) and Elisabeth’s semi-animate flesh-sack is left on the floor of the bathroom in a puddle of yellow and pink juices to wait out the next week. Oh, one more thing! To keep from getting dizzy and spurting a sudden nosebleed, every day Sue must insert a large hypodermic needle into Elisabeth’s exposed spine and extract a clear fluid that she then injects into her own flank, Ozempic-style. This must be done for seven days in a row, at which point the selves absolutely must, per instructions included with Elisabeth’s first Substance kit, switch.

Sue promptly goes out and gets Elisabeth’s old job. Things go smoothly — the TV audience loves her! She gyrates in a shimmery pink leotard with cutouts under unforgiving lighting, smiling ferociously into the camera. When it’s Elisabeth’s week to exist in the world, things are a bit bleaker. She goes to the trash-strewn alley to pick up more tubes and IV nutrients. After she runs into an acquaintance from high school who remembers her as the prettiest girl in the world, she takes his number, though he’s wholly unappealing, and later arranges a date. Preparing to go out, she doubles back to adjust her outfit and apply more and more makeup, finding herself increasingly unsatisfied with what she sees in the mirror. Finally, she applies a slash of lipstick across her cheek in a gesture of savage disgust. It’s one of the hardest scenes in the movie to watch; she seems about to literally tear her own face off.

The problem is that, while watching Demi Moore as Elisabeth roughly rub more and more concealer and blush into her preternaturally smooth cheeks, I couldn’t help but think about how great she looked. Even as she gave up on the date and crumpled, she still looked, if not 26 and glowing like her other-self version, like a beautiful movie star who’s had expensive and skillful work done on her face that makes her look at least ten years younger than her actual age. For whom exactly would this not be enough? The Substance hinges on the audience taking as a given that nothing but peak, high-assed, smooth-limbed perfection is an acceptable look for any woman, but a few more visible wrinkles or lines of neck flesh would have sold the premise much better.

When Sue inevitably pushes the boundaries of the one-week rule, taking a few more hours than she’s been allotted, the consequences are written on Elisabeth’s body. First, Elisabeth sprouts a monstrous crone finger, desiccated and bony with a long opaque nail. It’s glaringly out of place on her otherwise great body. What if, instead, the change had been more diffuse? A few strands of gray hair, a paunch, a handful of forehead wrinkles, progressing gradually as Sue steals more and more of Elisabeth’s essence? Instead, the film goes for broke. Sue drains Elisabeth’s body to its dregs, stopping only when her spinal fluid dries up entirely, then she’s forced to switch places or, it’s implied, die. Of course, this happens at the most inopportune moment: She’s just dragged a hot motorcyclist back to the apartment for sex. The nightmare-crone version of Elisabeth who emerges from the bathroom and chases that man out of the apartment — all hunched knobby spine and popping varicose veins — is good for a laugh and a shudder, but what exactly is this transformation supposed to mean?

The continued devolution of both Sue and Elisabeth in the last third of the movie is a sustained experience of maximum grotesquerie that I admired on the level of performance and workmanship. Battle lines are drawn and the gleaming apartment is trashed in various hilarious ways. At one point crone-Elisabeth leaves the apartment full of dishes cooked from a classic French cookbook to rot everywhere. The conclusion of Sue’s quest to appear on her TV network’s New Year’s Eve broadcast is best left unspoiled, but I should mention that gallons upon gallons of blood are splattered. It’s hard to imagine a more severe punishment for wanting to unleash a younger self on the world.

My absurd wish for this determinedly unsubtle movie was only for it to have leavened its relentlessness with more moments of precision. What a thoroughly chilling — because familiar — moment it would have been to have Elisabeth notice some minor change in her pristine appearance, a stray, unruly gray chin hair or the shock of a vein protruding on an otherwise smooth thigh? The process of aging naturally is disgusting, this movie seems to be saying, and of course the audience agrees. But pushing that cultural dictate to its most outlandish extremes seems, ultimately, superfluous, when the truth is already horrific enough.