Horror has taken many twisted detours in its evolution, spawning so many sub-genres it would be a full-time job to keep them straight. Yet, there is a visible, and telling, progression in the early stages of its history. Some of the earliest horror were the classics like Dracula and Frankenstein. One thing they all have in common is they feature “monsters” and are set in foreign countries. In later films, the threat moves onto North American soil but their villains are very much invaders: usually aliens like the strange being in The Blob or some kind of mutation like the giant ants in Them!. And while they all thrilled and frightened in their own way, they never hit too close to home. Then, in 1960, Psycho changed everything.

To begin with, Psycho revolutionized what it meant to go to the movies by requiring theatres to post scheduled start times and enforcing audiences to sit through the film from beginning to end. Because of this Psycho changed the way stories in film were told (and invented the concept of “spoilers”). But more importantly, Psycho features a very different kind of horror, something new and uncomfortable. The threat is not some foreign creature or alien influence, it’s the boy next door. The shy, unassuming, and seemingly harmless boy next door. Evil is no longer “personified” by an immediately terrible looking creature, it’s now invisible: psychological. And although its violence is more suggestive than overt, it’s still more bloody than anything that had come before, and the overhead shot of blood circling around a drain is now a necessity in any horror film that takes itself seriously. Psycho also features a much more intimate horror than its genre predecessors: you’d be hard pressed to find a pre-Psycho Hollywood movie that spends anywhere near as much screen time in the bathroom and it’s actually the very first Hollywood film to feature a toilet being flushed on screen. Marion, the ill-fated shower victim, even finds herself identifying with Norman, feeling he’s a naive, sheltered young man, but a kindred spirit.

After Psycho, the first horror film to permeate the barrier of the mind, horror gets closer and closer. Night of the Living Dead has a mixed group of survivors barricaded in a house which becomes increasingly claustrophobic, they are eventually cornered in a basement as the infection causing corpses to turn into zombies then spreads among them. Horror then invades the very body, as in The Exorcist where a little girl is tortured from the inside out by an unseen possessing entity. The Shining and other “haunted house” films move horror back into the mind, as Stephen King described the book, The Shining is at heart about the fear of bad memories. Not only that, but the fear of the inescapable: family secrets, legacies, and even family ties themselves.

If there is a warning in horror it is certainly that nothing is impermeable. All barricades are eventually torn down, all flesh torn, and all minds infected. There are no safe places; only those which later become traps. The increasing encroachment of horror into the familiar and into the self tends to add fuel to the censorship fire which believes horror films are destroying society. At the heart of this attitude is the belief that the only pleasure horror offers is sadism. Number one on most censor’s list of complaints is the recognition that most of the victims in horror films, particularly in ‘slasher films,’ are women. Men die too, of course, but they are far more likely to be killed quickly and to have their deaths filmed from a distance. By contrast, the deaths of women tend to be filmed very closely, capturing every detail, and women die more slowly, and certainly more painfully. Certainly gender matters in horror, and often, women in slashers are killed because they are women: Marion in Psycho, for example, is killed precisely because she turns Norman on (causing the “Mother” in him to become outraged and even jealous). It was Alfred Hitchcock, after all, who famously said that to make an effective horror film “torture the women!” But to believe horror is therefore misogynist is a myopic attitude. In her landmark book Men, Women, and Chainsaws, author and professor at the University of California at Berkeley, Carol Clover argues that not only is horror not anti-feminist, but believing so actually harms women.

As crucial to the slasher film as a sadistic killer and screaming women is the phenomenon of the ‘Final Girl.’ The Final Girl is essentially the girl who not only survives the killer’s onslaught, but effectively fights back: with force, resourcefulness, and completely without outside help, often even killing the villain. Crucial too, is that while she is feminine, it is never to the same degree as her friends. In fact she’s often downright boyish. To believe horror films are unequivocally “bad” for women is to overlook the agency, intelligence and sheer grit of survival embodied by the Final Girl. It would also be to assume male fans of the slasher film only and exclusively identify with the sadist killer. And of course we all do to a certain extent, part of the fun of horror is indeed teetering on sadistic. Early kills are usually filmed from the point of view of the killer stalking his unsuspecting victims which sutures the viewers to the killer’s position; and I’m sure more than a few people went to see House of Wax exclusively to watch Paris Hilton die. But the Final Girl reveals that there is much more to horror than sadism. The male (and female) fans who early in the film get some pleasure from the violence, later in the film cheer for the survival of the Final Girl, hide in closet with her, are afraid with her and for her, and cheer for her as she attacks the villain. As Carol Clover points out, “conspicuously groups of boys [in the theatre] who cheer the killer on as he assaults his victims, then reverse their sympathies to cheer the survivor on as she attacks the killer.”

Horror, perhaps more completely than any other genre, creates cross-identification (that is, the ability for audiences to identify with characters in the film that may be completely different than they are). For example, even though Carrie is by all accounts about a strictly female experience, Stephen King explicitly says her revenge also stands in for “any student who has ever had his gym shorts pulled down in Phys Ed or his glasses thumb-rubbed in study hall.” There is something about women in fear and pain which men identify with, and don’t just pander to. Perhaps partially because men are socialized to believe showing fear and terror is not “acceptable,” it is easier to have a woman in their place on film. Either way, it is clear that not only women are cheering on the Final Girl in the closing scenes, and more importantly, in the words of Clover, “What filmmakers seem to know better than film critics is that gender is less a wall than a permeable membrane.”

Believing horror is ‘bad’ for women also ignores the real wealth of women in the film industry who gravitate towards horror. There are a lot of female horror directors, writers and producers, and they aren’t in it because they hate women. It is usually because horror offers the opportunity to explore experiences and fears not available in other narrative types. Women are also more likely to be horror fans than men, American Horror Story is the most highly rated TV show among adult women, beating all three of the most popular Real Housewives series – combined. And frankly, the very claim that the only possible relationship a woman can have with an image of another woman in pain and fear is to feel victimized is insulting. It is to assume a woman is incapable of having a sophisticated, meaningful and wholly personal relationship with film images. To assume a woman can only feel victimized by an image is to perpetuate the so-called “culture of victimization” critics of horror claim exists.

Screen violence does not have an equal relationship to real violence. Horror films suggest as much themselves, like the self-referential Scream whose duo of killers claim they learned everything they needed to know about murder and violence from movies, and yet are surprised to discover, when they stab each other to feign innocence, that it actually hurts. Nightmare on Elm Street, which deals with a killer who stalks his victims in their dreams, suggests images can harm when his victims assume that because they’re dreaming, the threat isn’t ‘real.’ It is only Nancy who survives by fortifying the house in her mind with traps and weapons against killer Freddy’s attack, suggesting images in the mind are pliable, and only harmful if they are unexamined.

There is a popular assumption that the violence and gore in horror films are completely without value beyond cheap shocks and thrills. Roger Ebert, for example, quite often screens horror films but then refuses to rate them, most recently Tom Six’s The Human Centipede, and more than a few horror films appear on his list of most hated movies. To be fair, a lot of horror movies are just bad movies, but consider what Ebert said about The Human Centipede: “I am required to award stars to movies I review. This time, I refuse to do it. The star rating system is unsuited to this film. Is the movie good? Is it bad? Does it matter? It is what it is and occupies a world where the stars don’t shine.” The irony is that despite the common opinion that horror films are morally reprehensible, they tend to, surprisingly, be quite conservative. As Randy in Scream makes clear: “There are certain rules that one must abide by in order to successfully survive a horror movie. For instance, number one: you can never have sex. … Sex equals death, okay? Number two: you can never drink or do drugs. The sin factor! It’s a sin. It’s an extension of number one. And number three: never, ever, ever, under any circumstance say, ‘I’ll be right back,’ because you won’t be back.” This scene is effective mostly because the rules are dead-on: Lynda and Bob in Halloween are killed after having sex, as are Jack and his girlfriend in Friday the 13th. Nothing causes more trouble than sex in horror: Michael Myers’s first kill comes after finding his sister in bed with her boyfriend; Mrs. Voorhees in Friday the 13th exacts revenge on horny teenagers for the drowning death of her son, neglected because the lifeguards were too busy with each other to notice; and Norman also becomes disturbed and enraged after finding his mother in bed with a man.

As for something like The Human Centipede, its “villain” Dr. Heiter has more than a little in common with Dr. Frankenstein and is a traditional “mad scientist” par excellence. As Carol Clover makes clear, “the fact is that horror movies look like nothing so much as folk tales – as set of fixed tale types that generate an endless stream of what are in effect variants: sequels, remakes, and rip-offs. … Audiences may thrill to the killer’s particular schtick (his hockey mask or knife fingers or whatever) or to the special effect that shows the bloody stump up close – surface effects are the stuff of fanzines – but the structure, functions or subject positions, and narrative moves are as old as the hills.”

This conservatism is in fact a function of the horror film, as Robin Wood argues in his landmark essay on horror films of the 70s, “The Return of the Repressed.” As the title suggests, Wood sees horror as the embodiment of repressed desires, experiences and fears which have become distorted by the unconscious. Sigmund Freud emphasizes that material in the unconscious is “indestructible” so will always return in some way, either in our consciousness or behaviour, but will be unrecognizable. For Wood, the deranged, disfigured monsters that stalk horror films are the incarnation of these repressed forces, returning to haunt us, and in turn need to be re-repressed in order to restore “normality” and allow life to continue.

The encroaching closeness of horror throughout its history leads us here, to the recognition, in the words of Carol Clover, that the “attacker and attacked are expressions of the same self in nightmares.” To Woods point, the killer is an expression of the rejected desires and fears of the self, returning to haunt the conscious mind. It is not a celebration of sadism and cruelty but rather, as Clover concludes, “the pleasure of looking at others in fear and pain has its origins in one’s own past-but-not-finished fear and pain.” Horror films are, in their quickly beating, blood soaked heart, an expression of the fear of the self, and not just fear of our “real” desires but the vast unknown within. While Clover rightly points out that the progressively graphic nature of the gore in horror films is partially due to the increasing sophistication of special effects, it is also the natural evolution of horror’s slow and bloody invasion into every safe place. Barricades, walls and barred doors are breached, and so too, eventually, is the body – the last barrier to the self.

The increasing amount, and realism, of gore in contemporary horror films, particularly those in the so-called “torture-porn” genre (the Saw and Hostel franchises among others), expresses an equal fascination as well as disgust with the body, even the fear of it. As the physical manifestation of “the return of the repressed,” Carol Clover explains “the slasher evinces a fascination with flesh or meat itself as that which is hidden from view. When the hitchhiker in Texas Chainsaw Massacre slits open his hand for the thrill, the onlookers recoil in horror – all but Franklin, who seems fascinated by the realization that all that lies between the visible, knowable outside of the body and its secret insides is one thin membrane, protected only by a collective taboo against its violation. It is no surprise that the rise of the slasher film is concomitant with the development of special effects that let us see with our own eyes the ‘opened’ body.”

I think a large part of the “recoil” gore creates is that it reminds us of the horror within the body. We are made up of blood and guts and pus, and gore is not the stuff of death: it is the stuff of life. We’d just rather not admit what lurks beneath our skin. In many ways, the discomfort with gore is a rejection of life. As horror writer Clive Barker puts it: “Everybody is a book of blood; whenever we’re opened we’re red.” After all, most of the revulsion inspired by The Human Centipede comes not only from the normal functions of the body but that the film is (although imperfectly) medically accurate.

Personally, gore doesn’t tend to affect me. I blame this on my sister who from the age of 2 wanted to be a doctor. She used to watch a lot of medical shows on TV growing up, and her favourite was Trauma: Life in the ER which aired on TLC and profiled a different Emergency department every episode. It’s burned into my consciousness because it showed everything. During surgeries there was no blurring and no filming from the back corner of the operating room. I can recall episodes profiling a man who was stabbed in the head with a hunting knife (and survived!), another man who had his neck impaled by a tree branch, two girls who crashed their car into a fence and came in attached to the same pole, all sorts of run-ins with lawn mowers, and even someone who had their intestines partially sucked out by a malfunctioning pool filter. TLC also had a habit of airing marathons of Trauma over dinner-time. After all that, a little blood splatter pales in comparison. The only thing that really makes my stomach turn is broken bones – which happens to be my sister’s speciality (she is, as I’m writing, an orthopaedic surgery resident). Fractures probably bother me because bones are the structure of the body, and there’s something desperately vulnerable about a broken bone. For Clive Barker, this is another source of anxiety in horror, which he explains “shows us that the control we believe we have is purely illusory, and that every moment we teeter on chaos and oblivion.”

The mantra of absolute permeability in horror is expressed in easily broken bodies, the fragility of sanity, and the extent to which our own lives are affected by the lives of others – it is, after all, an innocent ‘snap’ in the mind which turns the boy next door into a killer. As Carol Clover suggests, “If mainstream film detains us with niceties of plot, character, motivation, cinematography, pacing, acting, and the like, low or exploitation horror operates at the bottom line, and in so doing reminds us that every movie has a bottom line, no matter how covert or mystified or sublimated it may be.” Horror is the black, hissing heart of every film: the fear that the world is something unfathomably threatening, or an unknowable mystery. Many Oscar-calibre films deal with the burdens and expectations of familial ties, and the complications of inheritance and greed, for instance, but only the horror genre can lay it so bare: as does the grandfather of slasher films Bay of Blood which features a house full of relatives killing each other to be the sole inheritor of a fortune.

And to confront this “bottom line” is perhaps the highest purpose of horror. Part of the thrill of horror is the “dare” to watch, to witness the things in ourselves we reject and push from our own minds. Horror is an invitation to confront the reality of our constant vulnerability. As Clover suggests, “looking [is] the avenue of horror,” and appropriately that “eyes are everywhere in horror cinema.” As one of the first “torture porn” films, Saw even suggests this in its very title, as a pun for the implement of torture in the film as well as the past tense of ‘to see.’ You are dared to keep your eyes open as Dr. Gordon saws off his own foot, and what you saw in Saw matters, as “themes and images of painful looking and pierced eyes have long been a staple of the [horror] tradition.” There is a sense that what you are able to watch in a horror film is the extent to which you are able to confront the fears of your self, and the horror of having a body. It is only by facing the repressed in ourselves that we are freed from its haunting. And this is, ultimately, the lesson the Final Girl must learn to secure her survival: after running, hiding, and screaming, eventually she must accept the need to fight back. And so, the examination of what we would rather reject within us may ultimately be healthy.

Ironically, my sister wouldn’t watch a horror film if her life depended on it. Ironic because, even as the centre piece of horror in Saw is a self-amputated foot, my sister came home one morning lit up like a Christmas tree and told me that while assisting the operation on a motorcycle accident victim, “I got to throw his foot in the garbage!” The truth is that medicine has more in common with horror films than we’d like to realize. If you’ve ever seen the sheer violence of most cosmetic surgeries (no, really) you’ll know what I mean. But here is the kind of thing my sister does all day:

If those metal implants don’t look like they’re the barbaric mutations of a horror film I don’t know what does. My sister often sounds like the deranged doctors from so many of those early horror films, she has also said, regarding the ‘disposed’ foot, “I hope to throw more feet in the garbage in the future!” and then, as an afterthought, “Well, not for the people.” This comes, of course, from her deep curiosity and fascination with the body. It is this fascination which reveals the ‘noble’ profession of the doctor often teeters into the territory of the mad scientist, and that more often than not the line between the two are not at all distinguishable: each permeates the other. And while I hope you never meet my sister in her professional capacity, since it would mean you’re having a very bad day, if you do happen to be in several pieces I do hope your ambulance finds its way to my sister because it is her mad and delighted fascination with the body that makes her such a wonderful doctor. It is not, actually, much different than a horror film: by pushing the “bottom line” of what you can accept as a part of yourself, be it madness, fear, blood, and even malice, the fewer repressed “killers” there are within to stalk you.