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Motifs are recurring structures, contrasts, and narrative devices that can help to develop and inform the text’s major themes.

Body Horror, Transformation, and Decay 

The Substance uses body horror to illustrate identity, aging, and self-destruction. Elisabeth and Sue undergo repeated grotesque physical transformations that reflect their desperation to maintain youth and relevance. The film presents their decaying bodies as consequences of their refusal to accept natural aging, and their pursuit of perfection is a horrifying ordeal. By the end of the movie, Sue is literally doing whatever she can to stop herself from literally falling apart as her teeth and fingernails start to fall off.  

Elisabeth’s first dose of The Substance produces an idealized version of herself in a horrific parody of birth. Sue, at this point a nameless, flawless younger body untouched by time, writhes and wriggles under Elisabeth’s flesh before bursting through the skin of her back. As if its initial violence was not enough, this transformation also requires constant maintenance. The sacrifices Elisabeth makes for her youth and beauty only compound when she begins taking The Substance. When Sue ignores “the balance” and breaks the structured, mandated cycle of switching bodies every seven days, it’s Elisabeth’s body that pays the price, and her rapid decay clearly illustrates the movie’s warning about rejecting natural aging.  

As the film progresses, the body horror escalates. Elisabeth, reduced to a frail shell of herself and almost totally sucked dry of her spinal fluid, tries to reclaim control. She can’t go through with actually killing Sue and terminating the experiment, however, and her refusal to relinquish her younger self (and to recognize that there is value and beauty in her actual self) is the direct cause of her death. When Sue’s body collapses from lack of stabilizer fluid, she injects another dose of The Substance in desperation. It’s an accelerated version of the first time Elisabeth took the drug. Sue cannot see a future in her decomposing body, and so she takes the only opportunity she sees. This only makes things worse, triggering the monstrous fusion of both women into Monstro Elisasue. This final mutation is a deformed nightmare, whose very public death involves soaking an entire theater full of executives in gouts of blood. Elisabeth’s pursuit of perfection does not preserve her—it erases her three times.  

Duality and Reflections 

The Substance uses different kinds of reflections to demonstrate how distorted perspectives can shape people’s lives. Mirrors do not provide clarity for Elisabeth and Sue. Instead, reflections warp and confuse, showing how fractured Elisabeth’s psyche is quickly becoming. The reflections Elisabeth sees aren’t really her, just as any face in the mirror isn’t actually a copy of that person. The fact that Elisabeth hates her reflection is itself a reflection of her body dysmorphia and self-loathing. She’s always two women even before she creates Sue. She’s Elisabeth, and she’s the hypercritical version of herself who loathes and fears Elisabeth. 

Before taking The Substance, Elisabeth studies her reflection in mirrors, spoons, doorknobs and other reflective surfaces. She’s searching for signs of youth that have disappeared or signs of aging she desperately fears. Each glance confirms that time is still passing. She also sees static “reflections” of herself all over Los Angeles, as posters for her fitness program are everywhere and larger-than-life. While preparing to go on a date, she worries that she doesn’t look like her younger self and tries to “fix” her appearance. She applies and reapplies makeup, painfully wiping her face over and over in a tragic set of self-hating snapshots before eventually giving up and bailing on her date.

By contrast, when Elisabeth first transforms into Sue, her reaction to her own body and face in the mirror is delighted and awed. What she sees in the reflection grants her wish—to have a flawless, younger body—but also confronts her with the unsettling truth that this is not a true reversal of time. The reflection belongs to someone else; she is Sue, not Elisabeth. The consciousness hasn’t transferred between them. She may “have” a younger body and all the benefits that come with it, but she doesn’t inhabit that body. 

As Elisabeth’s real body decays, reflections become progressively more ominous. Sue avoids looking at Elisabeth’s body when switching back because her choices are physically reflected in Elisabeth’s ever-worsening appearance. Elisabeth avoids mirrors at all costs. The final use of this motif is the most disturbing: after Sue mutates into Monstro Elisasue, she tries to “solve” the problem of her frightening face by pasting an old one of Elisabeth’s over it. She cuts out a mask made from a poster of Elisabeth and smears it with lipstick, attempting to pass as her ideal self, one last time. The fact that no one stops her from going onto the stage to present the New Year’s Eve Special—when she is clearly not Sue, whom everyone was expecting—is the final nail in the coffin of the film’s message. To people in the entertainment world, it is only the flimsy exterior that counts. No one looks any deeper, even if the surface is a thin paper mask of the wrong beautiful woman.

Overconsumption as Self-Destruction 

The Substance uses overconsumption—drugs, food, fame, alcohol— to illustrate self-destruction. The world that Elisabeth lives in is controlled by a vicious cycle in which individuals and the entertainment industry consume beyond what can be sustained. Elisabeth and Sue experience this through the relationship between their own physical depletion and Hollywood’s relentless demand for new talent. 

The Substance itself is the most bare-faced motif of consumption in the film. While it purports to give the user back their youth and beauty, what it actually does only robs them of their remaining assets far more quickly. Elisabeth injects it to reclaim her youth, but the process requires a constant exchange. Elisabeth exchanges seven days of her life for seven days of Sue’s. While she is unconscious, Sue must extract spinal fluid from Elisabeth’s body to maintain her new body’s integrity. The relationship is parasitic, as one version of Elisabeth constantly drains the other. Sue does not restore the things Elisabeth wants. Instead, she feeds off her ever more greedily, trading Elisabeth’s remaining life for more conscious hours. There’s no increase in any of Elisabeth’s assets: they are just being distributed differently. 

Uncontrolled overconsumption is also literal in this film; as Sue thrives in her new identity, Elisabeth spirals into isolation and depression, using binge eating as a way to cope. The film contrasts Sue’s controlled, highly aestheticized image with Elisabeth’s uncontrolled binges. Elisabeth hates herself for these behaviors, and so Sue hates her too, calling her weak and disgusting when she comes across the evidence of her feasting. Watching Sue live the life she believes she deserves, Elisabeth consumes compulsively and excessively to numb the pain. 

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