I avoided this movie for years. Thought it would be too much horror-movie and less psychological suspense-thriller. It's actually a mixture of both. Further, the horror was actually tamer than I expected, although there are some seriously disturbing scenes that are not for the weak of stomach.
At it's heart though - beyond the visually inventive effects, the rich cinematography, the lush costumes and the suspense - lies a story about an innocent boy, who was so badly abused and damaged by his sadistic father and the abandonment of his mother, that he grew up twisted and gnarled inside of his mind and emotions. Unable to cope with both his demons and a rare illness, he becomes a serial killer of the worst magnitude.
The suspense part of the movie is how to catch him and save his latest (8th) victim) - who is going to die in less than 40 hours, as is the killer's pattern. Vince Vaughn is the FBI agent in charge of tracking him down. When the chase goes haywire, psychotherapist Jennifer Lopez is called in to do a kind of "mind-meld" with the killer, in an effort to uncover his secrets. Of course, once inside his mind , she gets way more than she bargained for.
For the first 2/3 of the movie, I thought Jennifer Lopez and Vince Vaughn were miscast, but they won me over by the final third of the movie. Actually the best acting was by Marianne Jean-Baptiste, in a medium-size but important part as one of the doctors involved in the "mind-melding" experiments. Vincent D'Onofrio is effective as the killer, while Jake Thomas plays his younger (boy) self with the right mixture of sensitivity and sympathy.
There are a few twists and turns, and the movie moves fairly quickly as it tries to cover alot of ground in a short period of time. There are elements here of Silence Of The Lambs, The Matrix, as well as any number of horror / suspense-thrillers and oddly enough, music videos. There is a fair amount of Catholic and religious imagery. Overall, I would not call this a classic, but it is a worthwhile watch if you are o.k. with the subject matter.