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Horror films seek to evoke fear in a variety of ways; some opt for creeping dread, some for unbearable mounting tension, and others employ jump scares. And some decide to elicit a primal sense of revulsion, leaving viewers recoiling in their seats from disturbing imagery on screen. While horror tends to be subjective, not even the most hardened of horror fans are usually immune to this tactic. 2018 had no shortage of disturbing moments in horror, rendering audiences uncomfortable by getting up close and personal with taboo-breaking moments that left you feeling shook. From unrelenting torture and extreme horror to humanity at their most depraved, we look back at the year’s 10 most disturbing moments in horror. In case it’s not obvious, there will be spoilers.

Annihilation – Screaming Bear

Everything caught inside the weird alien bubble known as the Shimmer saw its DNA scrambled and rearranged, offering otherworldly combos of floral and fauna in Alex Garland’s Annihilation. Often it was beautiful, as is the case of the human topiaries, but sometimes it was downright terrifying. Such was the case for the scene-stealing bear, nightmarish in its appearance but even more so in sound. The bear first claimed group Cassie (Tuva Novotny), and later came back for a second helping during a tense standoff between the remaining members. Emulating Cassie’s dying screams as bait was off-putting enough, but the slow reveal of its mutated face was pure nightmare fuel. The human skull within skull made even creepier by the humanlike noises the bear made as it stalked its kill. Disturbing.

Suspiria – Olga’s Twisted Dance

For the witches at the dance academy in Luca Guadagnino’s remake, dancing is their primary form of spell casting. It’s something that becomes abundantly clear early on, during an intense sequence that leaves dance student Olga literally bent out of shape. When star pupil Patricia Hingle (Chloe Grace Moretz) goes missing, no one suspects anything is amiss except for her best friend Olga (Elena Fokina). Olga’s defiance against lead choreographer Madame Blanc (Tilda Swinton) finds her trapped in a mirrored room alone. Enter Susie Bannion (Dakota Johnson), who’s dancing progressively gets more aggressive. The problem for poor Olga, though, is that Susie’s dancing causes Olga’s body to contort in ways it never should. Her mangled body is horrific, but not as horrific as the gleeful witches that drag it away with hooks.

Incident in a Ghostland – Home Invasion Nightmare

Ten years after shocking audiences with Martyrs, writer/director Pascal Laugier puts his morbid spin on home invasion horror. Though most of the runtime is a display of Laugnier’s brand of unrelenting, brutal terror, the most disturbing moment comes early on, when mom and teen daughters Beth and Vera are getting acquainted with the very creepy house they’ve just inherited. It’s interrupted by the arrival of Candy Truck Woman and Fat Man, two vicious criminals that have been on a streak of invading homes to slaughter the parents and torture the kids. Watching Candy Truck Woman and Fat Man in action is downright harrowing, as mom tries in earnest to spare her teen daughters from a grisly fate while succumbing to injuries. Leave it to Laugnier to up the violence in an already violent sub-genre, interweaving ruthless twists along the way. There’s no shortage of pain here.

Hereditary – Floating Decapitation

Ari Aster’s debut has not one, but two shocking decapitations. Both are surprising and visceral, but at least the first one is brief; it’s more focused on the emotional fallout and devastation. It’s the second one in the film’s climax that wins for being more disturbing. Though Annie Graham (Toni Collette) spends most of the movie inadvertently trying to escape her fate, she eventually falls in line with the cult’s plans and her body becomes possessed. Soon after, her son Peter (Alex Wolff) comes home to a dark house, and eventually finds his mother levitating in the attic. Both he and the audience watch in horror as Annie slowly saws her own head off with a piano wire. The sounds it makes is cringe-worthy.

Revenge – Glass Shard in Foot

Writer/director Coralie Fargeat’s debut painted the dessert red with copious amounts of blood. Fargeat put a stylized emphasis on the revenge part of the rape/revenge format by having Jen (Matilda Lutz) survive insurmountable injuries to hunt down her trio of oppressors with intense ferocity. The most squirm-inducing moment of all, though, comes late in the film, during a cat and mouse chase between Jen and Stan on an isolated road. After injuries sustained on both sides, Jen successfully tricks Stan into stepping on a shard of glass, which promptly embeds itself deep in the arch of his foot. He spends what feels like an eternity trying to fish it out of the gaping wound, eliciting viewer sympathy pain in the process. The profuse bleeding doesn’t stop when he does retrieve it; he tries to use this foot to drive his SUV out of the danger zone with painful results.

Apostle – The Heathen’s Stand

Writer/director Gareth Evans spent a lot of time researching medieval torture devices during the creation of Apostle, and it paid off with the traumatic scene in which undeserving Jeremy (Bill Milner) is subjected to a terrible death by way of the Heathen’s Stand. The film’s true villain emerged at this major turning point, framing Jeremy for a crime he didn’t commit and having him strapped down to the wooden stand. His feet, hands, and head are bound by vices, and a hand crank slowly tightens the head vices while a drill winds down into the top of his skull. It’s a measured, excruciating death that Evans’ not only makes us bear witness to, but he puts us in Jeremy’s shoes with a POV shot the moment the blood spools within his skull and clouds the lens.

Puppet Master: The Littlest Reich – The Ruthless Money Lender

Craig Zahler wasn’t interested in subtle when penning the script of this reboot; he seeks to offend with his brand of horror and humor. The entire film is filled with off-color jokes and revelry in excessive gore. None of it holds a candle to the introduction of puppet Money Lender, a controversial puppet in appearance alone. Money Lender takes his offensive nature to new lows with the film’s most vicious kill – he attacks a pregnant woman in her hotel bed through her birth canal and emerges from her shredded open stomach with her baby in tow, dragging its corpse away by umbilical cord. There are breaking taboos, and then there’s S. Craig Zahler giving the middle finger to taboo while blowing it to smithereens.

The House that Jack Built – Incident 3

Lars von Trier’s psychological horror film follows serial killer Jack over the course of 12 years, depicting the murders that shaped him. Divided up into Jack’s 5 most formative kills, the entire film is full of heinous murders and ruthless imagery. But the third segment, incident 3, proves the most scandalous. Jack has lured a single mother and her two young boys to a hunting ground, in the guise of demonstrating how doting of a father figure he can be. Except, he quickly drops the façade and makes it clear it’s this family that he’s hunting. Von Trier holds nothing back, either, as Jack uses his hunting rifle to decimate the family in bloody fashion, starting with the youngest first. Jack likes to play with his prey, and the unexpected deaths are then made even more uncomfortable by what he does next.

Climax – Sibling Jealousy

Truthfully, there’s a vast number of moments in Gaspar Noe’s latest competing for a spot on this list. Revolving around a night of partying for a dance troupe that devolves into hellish madness thanks to LSD spiked punch, Noe follows the ensemble through a series of long tracking shots as the night gets more and more depraved. Noe successfully pushes the envelope again and again as the dancers turn on each other, and your jaw will remain on the floor for most of the run-time. But arguably the most disturbing moment of the entire film is that of Taylor (Taylor Kastle) raping Gazelle (Giselle Palmer). Rape is disturbing by any measure, but in Climax it’s incestuous. That’s right; Taylor is the far too protective for comfort brother of Gazelle. It turns out his jealousy over her love life stems from forbidden attraction, much to her (and our) disgust.

Trauma – All of it

Meet this year’s A Serbian Film. Written and directed by Lucio A. Rojas, Trauma is an indictment on the political horrors of Chile’s recent past, specifically the military dictatorship of Pinochet. In other words, it’s a malicious onslaught of extreme horror not for the weak hearted. It’s graphic, it’s sickening, and effectively repugnant. It opens with a boy being forced to have sex with his mother for being a communist. That’s just the opening. Rape, incest, necrophilia, torture, pain, and lots of gore, Rojas unleashes a deep well of pent-up rage on screen. It’s savage and gut-churning.