Symptoms disrupts the patriarchal framework of horror cinema, where women are typically cast as passive victims or objects of male desire. Helen, the protagonist, is neither a damsel in distress nor a mere vessel for male spectatorship, as theorized by Laura Mulvey in her seminal essay "Visual Pleasure and Narrative Cinema" (1975). Mulvey argues that classical cinema positions women as objects of the male gaze, their agency stripped to serve male fantasy. In contrast, Helen’s subjectivity dominates Symptoms. Her descent into madness is not a spectacle for voyeuristic pleasure but a deeply internal process, conveyed through Pleasence’s haunting, restrained performance and Larraz’s lingering, atmospheric cinematography. The film’s refusal to sexualize Helen or Anne—despite their close, ambiguous relationship—shifts the gaze inward, aligning the audience with Helen’s perspective rather than objectifying her.

Helen’s agency, however, is complex and troubling. Her unraveling psyche leads her to murder Anne, an act that can be read as both a rejection of patriarchal control and a tragic internalization of it. Feminist film theorist Barbara Creed’s concept of the "monstrous-feminine" (1993) is apt here: Helen embodies a disruptive female power that defies normative femininity, her violence a rebellion against the confines of domesticity symbolized by the isolated manor. Yet, this rebellion is self-destructive, suggesting a feminist critique of how patriarchal structures limit women’s expressions of autonomy to madness or violence. The manor, a gothic staple, becomes a prison of repressed emotion, reflecting the societal constraints second-wave feminists sought to dismantle in the 1970s. Unlike Psycho’s Marion Crane, who is punished for her agency with death, Helen survives as both perpetrator and victim, complicating the binary of predator and prey.

Anne, too, challenges feminist readings. Her warmth and innocence contrast with Helen’s cold detachment, yet she is not reduced to a stereotype of feminine purity. Her death at Helen’s hands underscores the film’s refusal to offer a simplistic moral resolution, instead highlighting the destructive potential of internalized oppression. Symptoms thus aligns with feminist film theory’s shift in the 1970s toward analyzing the psychological and social forces shaping women’s identities, rather than merely their representation as objects. Queer theory, emerging later but applicable retroactively, reveals Symptoms as a text ripe with subversive potential. The relationship between Helen and Anne crackles with unspoken tension, suggesting a sapphic undercurrent that defies heteronormative expectations. Larraz never explicitly confirms a romantic or sexual bond, yet the intimacy of their interactions—Anne’s solicitous care, Helen’s possessive fixation—invites a queer reading. Teresa de Lauretis, who coined "queer theory" in 1991, argued for analyzing texts beyond heterosexual frameworks, and Symptoms fits this approach. The film’s ambiguity mirrors the fluidity of queer desire, resisting the closure of definitive labels.

Helen’s obsession with a lost lover, Cora, further queers the narrative. Mentioned in cryptic fragments, Cora haunts the film as a spectral figure, her absence amplifying Helen’s isolation and desire. This triangulation—Helen, Anne, and the ghost of Cora—echoes queer theorist Eve Kosofsky Sedgwick’s concept of the "erotic triangle" (1985), where desire circulates between figures in non-normative ways. Helen’s violence toward Anne can be interpreted as a displaced expression of this repressed queer longing, a tragic outcome of societal denial. Unlike mainstream cinema’s tendency to punish queer characters (e.g., the "Bury Your Gays" trope), Symptoms frames Helen’s actions as a psychological implosion rather than moral retribution, offering a nuanced portrayal of queer subjectivity.

The film’s setting enhances this reading. The manor’s isolation mirrors the closet, a space of concealment and revelation central to queer experience. Larraz’s use of mirrors and reflections—recalling Psycho—visualizes Helen’s fragmented identity, a motif queer theorists like Jack Halberstam might link to the destabilization of fixed gender and sexual norms. By refusing to resolve its queer subtext, Symptoms prefigures later queer cinema’s embrace of ambiguity over assimilation, aligning with the radical ethos of 1970s counterculture. Symptoms engages directly with Psycho, transforming its clichés into a feminist and queer critique. Hitchcock’s film hinges on Norman Bates, a male psychopath whose violence stems from a split personality tied to maternal domination. Symptoms inverts this: Helen’s madness is not explained by external figures but emerges from within, rejecting Psycho’s psychoanalytic reliance on Oedipal conflict. Where Norman’s cross-dressing and voyeurism cater to a male gaze, Helen’s actions lack a male counterpart to anchor them, subverting the trope of the male killer preying on female victims.

The isolated setting, a cliché of gothic horror, shifts from Psycho’s Bates Motel—a site of transient danger—to the manor, a domestic space turned sinister. This transformation critiques the sanctity of home, a feminist concern, while amplifying the queer theme of entrapment. The shower scene, Psycho’s iconic moment of female vulnerability, finds no direct parallel in Symptoms; instead, violence unfolds off-screen or in understated cuts, denying the audience the spectacle Hitchcock provides. Larraz thus reorients horror from external threat to internal collapse, a move that aligns with feminist and queer rejections of objectification. Alexandre Aja’s Haute Tension (2003), a French New Extremity slasher, bears striking parallels to Symptoms, suggesting a lineage of influence. Both films center on a female protagonist—Marie in Haute Tension—whose psychological instability drives the narrative. Like Helen, Marie’s violence emerges from a split psyche, revealed in a twist where she is both victim and killer, mirroring Symptoms’ fusion of subjectivity and horror. This twist, contentious among viewers, echoes Helen’s dual role, though Haute Tension amplifies the gore and pacing.

Queer desire is more explicit in Haute Tension, with Marie’s unrequited love for Alex fueling her rampage. This parallels Helen’s fixation on Anne and Cora, though Larraz’s subtlety contrasts with Aja’s visceral approach. Both films challenge the male gaze: Haute Tension’s opening dream sequence sexualizes Alex, only to pivot to Marie’s perspective, much as Symptoms privileges Helen’s viewpoint. The isolated settings—rural France versus the English manor—reinforce themes of entrapment and forbidden desire, a nod to Symptoms’ gothic roots.

Aja’s film transforms Symptoms’ slow dread into kinetic brutality, reflecting New Extremity’s focus on bodily excess. Yet, the core idea of a woman’s psyche fracturing under repressed emotion links them, suggesting Symptoms as a precursor to Haute Tension’s radical reimagining of horror tropes. Where Symptoms critiques Psycho’s clichés through restraint, Haute Tension explodes them, amplifying the feminist and queer stakes for a modern audience.