In order to appreciate Human Centipede II (Full Sequence), one ought to watch Human Centipede (First Sequence). It is not necessary, as much of the first film is in the second film, but the horror intensity is increased with detailed knowledge of the events in the first one.
Briefly, the first film is about a mad scientist/doctor who kidnaps three people and then sews them mouth to anus to create a human centipede, with the goal of ultimately sewing 12 people, mouth to anus, together. Human Centipede II is about a semi-mentally challenged man who is so obssessed with the movie Human Centipede, that he kidnaps twelve people and attempts to connect them mouth to anus, following the mad scientist's/doctor's "medically accurate" method.
Now I will stick to only the second film.
What makes Human Centipede so powerful, isn't just the brutal gore and disturbing images, but the psychological horror that the characters experience. Despite Martin's mental handicap, he is still able to put twelve people in positions of physical impotence. Even before he begins attaching these people together, the people know and live in the horror that they will "grafted" mouth to anus.
As an audience member our psychological horror is increased by the knowledge that Martin is not humanely conscious. Whether it is his mental handicap or whether it is his need for a human centipede, is unclear. However his actions make it clear that he only cares about his goal. In one scene he kills a man, kidnaps his pregnant wife (for the centipede), and then leaves their 3 year-old son in their car in a parking garage. No one is above and beyond his obssession.
Part of the strength of this film is the empathy that is creates for Martin. His goal, his desire, his obssession, his need is grotesque, monstrous, in-human, and yet we learn enough of his life to realize it is not an inherent aspect of him, but a consequence of the monstrous, in-human experiences he has been subject to. When his mother pisses over everything, figuratively, that is dear to him, mocking him as if he was an idiot, tears welled up in my eyes. Often the villains of horror films are condemned as evil, given little is any humanity. We, audience members, yearn for their punishment, applaud their demise. Such films make "life" black and white, construct obvious lines of good and evil. Reality is less clear. People, who have committed acts that can be described as evil, still have loved ones, still have desires, still have passions, just like us. And just like us they can be emotionally traumatized by ridicule, abuse, and disgust.
Because the film is directly linked with first film, the writer/director Tom Six was able to add a whole new level of disturbing (although this is more terrifying for actors, than anyone else). Martin is so obssessed with the film Human Centipede, that he attempts to trick the cast into coming for an "audition" for a film by a famous director...um I didn't recognize his name (ha ha). He gets one of them to come and adds her to the centipede. One might think acting in a horror film is innocent enough, but this film demonstrates a potential danger. The danger being that an avid fan of the horror film attempts to make you, the actor, live it out for real. An actor must have plenty of time to think about how it might feel to be in any of these dangerous situations, particularly grotesque ones, like having your mouth sewn to an anus (so that there is one digestive tract). To then be placed in said situation must flood the actor with unspeakable terror.
Ha ha ha. I didn't mean for that to be funny, but it is. "unspeakable terror"
While many criticize this film as being about shock value, I would argue that there is factual evidence to demonstrate that this is wildly inaccurate. This film (much like the first) shows what true horror is.
Because it's not being chased by a supernatural entity that can't be killed and who apparently likes to creatively kill his prey (Jason, Freddy, Michael, you get the point...).
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