“Well, I’m pretty sure you just lost your mind,” Gerald (Bruce Greenwood) says to his wife, Jessie (Carla Gugino), with a smile. The chilling delivery of this line and Greenwood’s cold, blue eyes staring right into the camera is one of the first times “Gerald’s Game” strays into the bizarre. He looks like a grandfather condescendingly comforting a scared child, which clashes with the urgency of the scene. Based on the novel by Stephen King, “Gerald’s Game” is a twisted, violent psychological thriller about a woman’s fight to survive.

Director Mike Flanagan demonstrates that abnormality early and often. Jessie and Gerald go on a retreat to repair their damaged love life, but their vacation goes awry when Gerald’s sexual games go too far. Jessie is handcuffed to a bed, but before Gerald can act out his fantasies, he has a heart attack and dies. In response, Jessie props Gerald’s body up with her feet. The camera zooms in on Gerald’s slack, unresponsive face. The image is shot from Jessie’s point of view, so it makes the viewer feel like they are helplessly pinned down by Gerald’s corpse. Flanagan efficiently represents the downward spiral into madness through Jessie’s increasingly chaotic delusions. This progression adds a layer of uncertainty to Jessie’s struggle, as the viewer is unsure whether or not Jessie will be able to fight off her insanity, which she must do to save herself. The clash between Jessie’s imagined threats and real–world dangers strengthens the suspense of her fight to escape this life-threatening situation.

One of the film’s distinct characteristics is its depiction of a psychologically strained consciousness. Flanagan takes an approach viewers have seen before, but expands on it in a way that revitalizes the method. Jessie realizes she is chained to a bed with no one to free her, and she starts to go insane. She begins speaking to two figments of her imagination in the forms of her husband, Gerald, and an idealized version of herself. Flanagan captures a shot of Jessie’s imagined version of Gerald stepping over the latter’s actual body, which encapsulates the abnormal tone of the film.

Jessie’s desperation to survive is also a defining trait of the movie. She goes to incredible lengths in her fight to live, which makes some viewers wonder what they would be willing to do to survive. Her attempts to escape become increasingly frantic. As her panic rises, her inhibitions decrease, which makes Jessie reach the point where she will do anything to escape. She contemplates breaking her own wrists to escape the cuffs before deciding her wrists would not fit through them. The extremes Jessie is willing to take to free herself are both relatable and unpleasant. As a result, Jessie’s fight to escape becomes more suspenseful.

Flanagan sufficiently develops both main characters as the film progresses. However, he does not give the viewer a reason to become emotionally invested in either of them early in the story. This undermines the impact of Gerald’s death and, at least initially, the viewer’s interest in Jessie’s dire situation. The first few minutes of the film show Gerald and Jessie driving to a vacation home, and the viewer learns little about either character. By the time the two arrive in the fateful bedroom, Gerald has only been characterized as a man who dislikes dogs and scolds his wife for wasting expensive food. As a result, when Gerald dies, the viewer has no reason to care about him. His death falls flat when it could have been more effective. This lack of characterization contributes to an overall slow start to the film, but Flanagan compensates for this lack of character development later in the film.

“Gerald’s Game” analyzes the human condition, specifically, the fight to live. Flanagan explores the ways the human mind copes with inordinately strenuous situations. Gugino is an effective protagonist, as the viewer can sympathize with her desperation. This makes the viewer care about her struggle to survive. The lack of character development harms the impact of the beginning of the film, but Jessie becomes a dynamic character by the end.

If anything, “Gerald’s Game” is a warning: It’s all fun and games in the bedroom until someone gets hurt.