In Coralie Fargeat’s body horror film The Substance, we witness the harrowing transformation of an aging television star named Elisabeth (Demi Moore). While body horror often relies on striking imagery to convey metaphors about beauty, youth, and societal expectations, especially within female-centric narratives, The Substance uniquely integrates sound as a critical tool in articulating these themes. Elisabeth decides to take a mysterious serum labeled ‘the substance’ to create a youthful version of herself, which leads to the creation of Sue (Margaret Qualley), symbolizing the lengths women are pushed to by societal expectations. Each woman is given seven days to live their life before having to switch back to their other body before irreversible consequences occur. In order to illustrate the impact of sound, it is necessary to explore how The Substance employs sonic and acousmatic sound, hyperreal Foley effects, and shifts in sonic perspective to critique societal pressures on women's bodies and the horror of losing bodily autonomy in the face of self-doubt.

The film's reliance on sound as an equal partner to visual storytelling is evident in its stylistic choices and how sound accompanies its lead characters. The choice to use discomforting sound effects is illustrated in the article “Is Sound Recording a Language?” by Alan Williams: “In sound recording, as in image recording, the apparatus performs a significant perceptual work for us—isolating, intensifying, analyzing sonic and visual material."[1] The technology used in sound recording for The Substance utilizes a heightened intensity that crafts a sonic space that is intentional and overwhelming for both the audience and the lead characters. Whether it’s abrupt dynamic accents with the film’s score or the liquid and injecting sounds of Sue injecting serum to remain herself, the construction of sound from filmmakers motivates our feelings just as the imagery does. The Substance embraces this philosophy by using sound not just to reflect but to challenge conventional representations of women in horror, particularly in depicting the decay and vibrancy of youth. Approaching the film through the concept of sonic sound relies on understanding how score and sound effects, among others, contribute to the overall atmosphere of the auditory experience of the film. In the book In Deleuze and Horror Film, film scholar Anna Powell says, “Sound waves, as well as light waves, travel through us and work strongly on the sensorium, bypassing the cerebral cortex and mainlining into our central nervous system. The unnerving sound effects of horror range from human screams to the synthesized and distorted electronic notes.”[2] Fargeat and her sound team utilize atmospheric synthesized notes ranging from a captivating score to distorted sound of the female body and objects. The film desires to reshape female perception through its brash and varying use of sound.

Acousmatic sound, where the source of a sound is unseen, plays a key role in The Substance, guiding our understanding of characters and their transformations. The film's opening sequence introduces Elisabeth’s legacy with the creation of her Hollywood Walk of Fame-style star, chronicling its lifespan. The ambient city sounds of cars honking and people chatting initially create a peaceful environment but gradually become aggressive and overwhelming. A combination with acousmatic sound, a melancholic musical score and the subdued sounds of workers accompany the construction of Elisabeth's star. Harsher noises arrive as the concrete star ages, symbolizing Elisabeth's age and favor with the public. Snapshot sounds of swarming cameras, fast-paced dialogue, crinkling of leaves, and rain wash into the soundscape, symbolizing the societal pressures that are inflicted on women as they age. High-pitched winds, squishing food, and distant yelling intensify as the star deteriorates, aurally mirroring Elisabeth's decline. When Elisabeth initially injects the substance, the scene is dominated by hyperreal Foley effects such as the clinking of medical instruments, the peeling of medical tape, and the piercing sound of needles. All of these auditory elements and items reinforce the invasive nature of her pursuit of youth. 

Sound designer Valerie Deloof, who worked on The Substance describes her approach to Elisabeth's transformation: "When Elisabeth feels the effects of the substance, I looked for sounds that were both soft and brutal. I slowed down some musical instruments, breaths, and screams, trying to create fluid movement and confusion, and added some impacts like blows to her body. I wanted her to seem dematerialized. I wanted us to understand that she's the one screaming, but it's not her own voice anymore."[3] The manipulation and manufacturing of sound that Deloof employs reinforce the idea that Elisabeth is losing control over her own identity through the threat of youth and societal pressure. 

Sue's youthful existence is distinguished by her vibrant vitality and a pulsating, groovy electronic score that reflects energy. When we first meet Sue, as she has started to adjust to her body, the film’s score is serene and in harmony, reflecting a feeling of peace and content for the audience to understand. Her voice carries confidence, choreographing her fitness show over lively '80s-inspired music. However, the sonic atmosphere shifts once Sue is forced to revert to her form as Elisabeth. Elisabeth's reawakening is accompanied by groans and coughs, contrasted with mundane household sounds—sizzling eggs, clinking dishes, running water—illustrating the return to an existence defined by routine rather than vitality. Aggressive car engines and awkward silences accompany her interactions, such as when she meets her old boss, Harvey (Dennis Quaid), to collect her belongings. The shifts in sonic sound and perspective highlight Elisabeth's diminishing agency. The contrast becomes even more apparent when Sue reappears. She turns off the television, a key sound associated with Elisabeth's isolated, aging existence, before reclaiming her dominant soundscape. Meanwhile, Elisabeth's interactions are marked by visceral sonic elements. When she attempts to prepare for a date, the friction of latex gloves against her skin becomes an auditory expression of her frustration and self-loathing. Elisabeth's loss of sonic identity throughout The Substance exemplifies this idea, as her voice is drowned out by younger, more vibrant sounds and overtaken by frustration. 

In a pivotal scene where Sue's impact and thriving status in society is put on display for Elisabeth, the growing identity clash culminates with building sonic motifs from earlier in the film. As Elisabeth watches Sue mock her outdated exercise program and age on a massive talk show, the soundscape follows Elisabeth's frustration as it interweaves audience laughter, sizzling food, and squelching turkey. This sequence blurs the line between humiliation, rage, and physical decay. The increasingly grotesque sonic elements heighten the horror of Elisabeth's unraveling psyche. Additionally, when Sue's frustration grows to an unmanageable amount due to Elisabeth's lack of care for their shared body, she manually drains the substance from Elisabeth's body to the point of irreversible damage and decay. The liquid sounds of Sue drawing the substance out of an unconscious Elisabeth are heard throughout the film and continuously have us associate these discomforting medical auditory moments with the aging Elisabeth as they echo the clear fact that while her health is being sucked away from her, it mirrors the film’s messaging on the unsettling desperation women are forced into to preserve youth. The auditory nature of the film grows more deteriorating, and squelching is fainter and reinforcing, reinforcing the physical toll of her transformation.

In the final sequence of The Substance, Fargeat’s directorial decision to display Sue’s collapse into deterioration deftly mirrors Elisabeth's harrowing journey. The snapping of fingernails, the pulling of teeth, and the wet, organic squelching of rotting flesh create a visceral, almost unbearable sonic atmosphere. Due to Sue pushing the limits of the substance to horrifying results, the formation of Monstroelisasue (Sue and Elisabeth merge into one monster) occurs and leads to a chaotic symphony of sound. The horrific transformation into Monstroelisasue relies on tearing sounds to signify the skin ripping open on Sue’s body, the squishing sounds of multiple eyes appearing, and the chaotic score peaking as both women cry out in pain. Once the monster is fully formed, we hear muffled breathing, which provides a sense of disconnection and anxiety. As soon as the visual cue of what the monster looks like in the mirror, a screeching peak of the film score frightens us just as much as the image of Monstroelisasue. 

Monstroelisasue disguises herself as she attends the crowded New Year’s Eve event Sue had been preparing for. The applause and admiration she receives as she enters the party signifies one of the leading culprits of the pain and destruction. While both Elisabeth and Sue crave the spotlight and public acclaim, the system set in place against women has trapped them in this cycle and the disorienting sound of fans exemplifies this. As soon as her monstrous figure is revealed to the live audience, the film's soundscape reaches its peak intensity: heavy metal music blares, blood sprays, muffled groans, and panicked screams erupt. The gasps of human air, sloshing body parts, oozing, distorted voices, vomiting, and labored breathing create an amalgam of terror. The intentionally erratic and thunderous film score, especially compared to the opposite music that accompanies a youthful Sue, causes disorientation, reinforcing its recurring motif of social pressure and destructive beauty standards. 

After being attacked by the crowd, Monstroelisasue starts to decompose, leading to Elisabeth's detached puddle of a head being the final remains outside on the street. Elisabeth’s head sloshes, groans, and crawls onto her Hollywood star, creating a revolting and desperate group of sounds as she clings towards a final moment of fame. Elisabeth’s final vision is of a crowd clapping, cheering, and admiring her. The finale presents a score where we hear a car driving over Elisabeth's star and leftover goo, erasing her existence. Suddenly, the title flashes onto the screen, interrupting a brief moment of silence. When the finale title appears on the screen, it offers a return to the film's brooding theme music, completing the cycle of sonic storytelling with a clear auditory signal. 

The Substance portrays the repulsiveness of bodily decay through immersive auditory experience. The film's sonic elements of acousmatic sound, shifting musical motifs and enhanced sound effects reinforce its youth, identity, and critique of societal obsession with women's aging bodies. Using sound as a disruptive and character defining force, The Substance amplifies the horror of losing control over one's body. In doing so, it proves that sound complements horror and is essential in shaping its most profound anxieties.

Bibliography

Powell, Anna. Deleuze and Horror Film. Edinburgh University Press, 2005. 

Walden, Jennifer. Behind the disturbing sound of ‘The Substance’ – with Valerie Deloof, Victor Fleurant, and Gregory Vincent.” Interview by Jennifer Walden. A Sound Effect, December 18, 2024. https://www.asoundeffect.com/the-substance-film-sound/.

Williams, Alan. “Is Sound Recording Like a Language?” Yale French Studies, no. 60 (1980): 51–66. https://doi.org/10.2307/2930004.