Butcher Block is a weekly series celebrating horror’s most extreme films and the minds behind them. Dedicated to graphic gore and splatter, each week will explore the dark, the disturbed, and the depraved in horror, and the blood and guts involved. For the films that use special effects of gore as an art form, and the fans that revel in the carnage, this series is for you.

Writer/director Pascal Laugier was deep in the throes of clinical depression when penning the screenplay for this cornerstone of the New French Extremity movement in horror. Bordering on suicidal thoughts, it explains the bleak, nihilistic tone that permeates the film throughout. That he also wanted to keep horror audiences guessing also explains why Martyrs feels like multiple movies in one; each act so distinctly different from the other that it effectively keeps its audience off-kilter. What begins as a sort of haunted past filled with ghosts segues into shocking revenge until descending into a harrowing study of pain. It’s not an easy watch, and one that many French studios and actors gave wide berth to when Laugier was attempting to get this made.

If we’re measuring strictly by gallons of blood used, Martyrs isn’t nearly as bloody as most, though there is plenty. Yet its visceral examination of pain elicits such a strong physical response it’s still one of the more extreme entries in the genre. A large part of that can be attributed to the cold, clinical way Laugier homes in on his narrative. There’s pure shock in watching Lucie (Mylene Jampanoi) burst into a family home without warning and blow them all away with her shotgun. With her childhood friend Anna (Morjana Alaoui) as the audience proxy, it’s exacerbated with the realization that Lucie’s loose grip on reality may mean Lucie builds up an even higher death count of innocent bystanders in her quest to end her own suffering. Granted, we learn Lucie was more on the nose later, but Laugier toys with the psychological ramifications of Lucie’s PTSD for a while before really pulling the rug out from under the viewer for act 3.

With the end of the second act being marked by a brutal throat slashing, the final third of the film begins one long, drawn-out test to determine just how much pain the human body can endure. For the film’s characters, it’s quite a lot, and it’s uncomfortable to watch. From the other victims found in the basement dungeon, there’s an emaciated woman with metal stapled into her head. That a screwdriver is used to try to pry off the staples from the victim’s flesh means screaming and spraying blood. It’s only the beginning of the suffering that ensues, culminating in one gruesome flaying.

The special makeup and effects team delivered on gory effects that effectively sold Laugier’s traumatic ode to pain. Special effects supervisor Jacque Godbout (Scanners, Texas Chainsaw 3D), prosthetic and special makeup effects artist Manuel Beccaro (Gremlins 2: The New Batch, Army of Darkness, AVP: Aliens vs. Predator), visual effects supervisor Pierre-Simon Lebrun-Chaput (Arrival, Doomsday), and their teams crafted amazing effects that made the deaths and excruciating torture so horrific. There’s never been a flayed victim on screen quite like this before or since.

In horror, there’s often a level of detachment from the gore and viscera on screen due to the fantastical or supernatural. We root for werewolves, zombies, and various other monsters when they rip apart their victims; none of it is real. In Martyrs, there’s a sense of realism made even more grim by Laugier’s austere, anarchic tone. It’s ugly, it’s vicious, and it’s a wholly different kind of gore that’s not as easy watch, but it’s also clear why this ranks highly among French horror fans.