How does one begin to describe a film like Antichrist, aptly characterized in the press notes as director Lars von Trier’s latest provocation? It is repulsive and perplexing. It is also brutally effective.

This is not a film for the squeamish. It is, by design, a disquieting experience, filled with images of extreme violence, often perpetrated for no compelling or discernible reason. The question is not so much whether you’ll enjoy the film, but whether you have the stomach to tolerate it.

Von Trier’s story begins in the apartment of an unnamed couple, known only as He (Willem Dafoe) and She (Charlotte Gainsbourg), who copulate furiously as their infant son crawls to an open window and plummets to his death. It is an arresting sequence, beautifully shot in stark monochrome, and a cheerless portent of misery to come.

The healing process is rocky, to say the least. He is a psychologist, determined to drag his wife back from the brink of madness and restore order in the face of calamity. She is a destructive force of nature – as, von Trier seems to suggest, all women are – hysterical and increasingly deranged, spurred by some primordial instinct to sabotage his best efforts.

If anything about Antichrist seems obvious, it is von Trier’s desire to shock, and his belief that women, driven by forces beyond their control, are agents of chaos. Once turned loose in the couple's cabin-in-the-woods retreat, named with sledgehammer irony Eden, She comes undone, which can only spell trouble for He and his oft-exposed genitalia.

Such misogyny might come as little surprise to those familiar with von Trier's past works, among them Breaking the Waves (1996) and Dogville (2003), in which the Danish auteur subjected his female leads to indignities large and small. Yet in those films, von Trier seemed at least sympathetic to his doomed protagonists. Not so here.

Gainsbourg (2007's Dylan biography I'm Not There) won Best Actress at Cannes for her work here, and it's not hard to understand why. Her performance is as nakedly wounded – both figuratively and otherwise – as Isabella Rossellini's in Blue Velvet (1986), a film that now seems almost sedate by comparison with von Trier's vision of hell on earth. Gainsbourg throws herself into the role, and if her willingness to subject her body to unthinkable on-screen butchery seems a bit too raw for Oscar voters, no one can question her courage.

There is a lot of calculated ugliness in Antichrist, but also scenes of such stark despair that it would be impossible not to be moved by them. Whether that’s incentive enough to sit through this film depends largely on your threshold for pain.