What begins as a barbed satire of our pill-popping, self-medicating society morphs into something intriguingly different in Side Effects. Steven Soderbergh's elegantly coiled puzzler spins a tale of clinical depression and psychiatric malpractice into an absorbing, cunningly unpredictable entertainment that, like much of his recent work, closely observes how a particular subset of American society operates in a needy, greedy, paranoid and duplicitous age. Discriminating arthouse audiences not turned off by the antidepressant-heavy subject matter should be held shrink-rapt by what Soderbergh, after years of flirting with retirement, has said will be his last picture "for a long time."
Establishing a mood of grim foreboding with a brief glimpse of a blood-spattered domestic scene, the film rewinds three months to the incident that sets things in motion. Emily Taylor (Rooney Mara), a New Yorker in her mid-20s, awaits the prison release of her husband, Martin (Channing Tatum), a former business exec who has just finished serving four years for his involvement in an insider-trading scheme. But the couple's happy reunion is complicated not only by Martin's period of readjustment and unemployment, but also by Emily's ongoing struggles with anxiety and depression.
The story is thus immediately rooted in an easily recognizable and, for some, relatable world of financial difficulty and pharmaceutical overreliance. After Emily's condition declines to the point of attempting self-harm, she sees a psychiatrist, Dr. Jonathan Banks (Jude Law), who puts her on a try-this-try-that regimen of drugs that include Prozac, Zoloft and Ablixa. The names of these antidepressants and their assorted side effects are rattled off with cheeky proficiency in the well-researched script by Scott Z. Burns ("Contagion," "The Informant!"), and soon Emily starts to manifest the byproducts of so much medication, including nausea, a heightened libido and a disturbing habit of sleepwalking.
Soderbergh's sinuous HD camerawork (done under his usual pseudonym, Peter Andrews) maintains an unnervingly intimate focus on Emily in these early passages, dominated by breakdowns and consulting sessions. Yet even in intense closeups that enable Mara to vividly register Emily's panic, fear and vaguely suicidal impulses, the direction has a certain cool-toned detachment that keeps the film from becoming a wholly subjective portrait of mental instability. That distanced quality persists even when Emily's behavior, under the influence of Ablixa, takes a shocking turn for the worst.
At this point, the dramatic perspective shifts to Banks, who suddenly finds himself professionally compromised as a provocative question comes to the fore: If a patient is not responsible for actions taken under the influence of a powerful drug, does the liability shift to the doctor who prescribed it? But as Banks launches himself into an increasingly obsessive quest to clear his name, leading him into private conversations with Emily's former therapist, Dr. Victoria Siebel (Catherine Zeta-Jones), the peculiar feeling persists that not everything about the case may be what it seems.
The very title of Side Effects — a suggestion of unintended, undesired consequences that distract from the matter at hand — provides a clue as to the level of narrative misdirection Soderbergh and Burns are up to. Suffice to say that what the film is actually about, and the specific social malaise being diagnosed, suddenly seem to shift beneath the characters' feet, as the story turns its attention from chemical dependencies and shaky medical ethics to the dark recesses of the human mind. The rapid-fire twists, reversals and flashbacks that crowd the third act may strain plausibility to the breaking point, but by the end, viewers are likely to feel as though they've been craftily but not unfairly manipulated.
The casting of Soderbergh alums Law, Zeta-Jones and Tatum lends the picture a somewhat valedictory feel, and if Side Effects is indeed the final chapter of at least one phase of the director's career, it gets the job done in modest but assured fashion. Thematically, this efficient genre piece feels entirely of a piece with Soderbergh's prior work; no less than Magic Mike and The Girlfriend Experience, it's keenly invested in the material question of how individuals operate in an economy that leaves them with fewer and fewer honest options.
The film's careful attention to the details of its psychiatric milieu compels fascination above and beyond the characters, and indeed, Soderbergh's typical disinterest in conventional audience identification has rarely been more pronounced. Mara's chilly yet vulnerable quality, exploited so effectively in her films with David Fincher, keeps the viewer at a sympathetic distance; Law makes Banks seem weaselly and pompous even when he assumes the role of protagonist; and Zeta-Jones, as usual, plays her part with a slyly seductive allure. Of all the actors, Ann Dowd (Compliance) rings the sole notes of earnest emotion in a small role as Emily's mother-in-law.
Editing is sharp and precise, and Thomas Newman's churning score amps up the story's intensity. Expertly chosen locations and Howard Cummings' production design create an offhandedly diverse snapshot of New York, ranging from a high-security mental institution to a table at Le Cirque where Dr. Banks and his colleagues talk shop.
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