Raw as an open wound, Marina de Van's debut feature, In My Skin is a disturbing, self-obsessed psychological horror film. The director, who also stars in the film as the afflicted Esther, slowly and subtly builds a sense of unease to tension and dread. De Van literalizes a connection between material success and unhealthy self-image that leads to disaster. In My Skin seems to be as much about Esther's probing discontent with her values as it is about her uneasy relationship with her own body. This is brought to the fore in a supremely uncomfortable and darkly comic scene in which Esther tries to control her self-mutilating compulsion during a fancy dinner with important clients. She loses interest in the banal chatter of the clients when she imagines her left arm has detached itself from her body and is lying limp next to her plate. Pulling it under the table, she proceeds to surreptitiously violate the misbehaving limb with a fork, before awkwardly excusing herself. De Van uses some restraint in the early going. She achieves a ghastly effectiveness using sound effects and a good deal of grotesque, but not bloody, body imagery. As Esther slips deeper into madness, restraint is thrown out the window and the film becomes a bloody mess. De Van makes her points early on and later seems to be struggling for a way to shock us anew. As a result, the film's denouement is thematically muddled. Still, In My Skin is intensely personal filmmaking, and de Van deserves credit for her boldness in exposing her obsessions.