One thing that may not have occurred to you about the Heimlich Maneuver is that, during a crisis of survival, it is at the very least a reliable way of being held. That’s how Victor Mancini (Sam Rockwell) sees it, anyway. And just because Victor is a fatherless, sex-addicted med-school dropout who solicits bankable pity from diners at upscale restaurants by pretending to let them rescue him from choking doesn’t mean he’s wrong.

He uses that pity money to keep his demented mother (Anjelica Huston) cared for in a Catholic nursing home, whose staff Victor beds, or wants to (yes, he even imagines nuns nude), and whose patients’ own confused traumatic memories he indulges. It’s sweet, the way he gives them closure, says the young lady (Kelly Macdonald) who appears to be his mother’s most attentive attending physician. You can bet Victor wants to get with her too.

Anyway, Victor’s best pal by default is his fellow addict and roommate Denny (Brad William Henke), the kind of guy who woos a stripper by sketching her portrait and who can’t resist pleasuring himself to an old photo of Victor’s mom. When Victor does manage to get himself to support-group meetings, it’s mostly just to screw his sponsee on the bathroom floor. You think that’s bad? It gets worse: He has a day job as a professional reenactor of Colonial American history. What kind of sick bastard is this guy?

The kind who springs forth from the affectedly depraved comedic stylings of novelist Chuck Palahniuk, who sees right through the polite veneer of our fucked up world and believes in the redemptive power of adolescent spitefulness posing as sociopathy. Naturally. When director David Fincher made a film and a sensation of his novel Fight Club in 1999, Palahniuk just about became a household name, albeit not an easy one to pronounce, and the movie version of Choke, adapted by actor Clark Gregg for his directorial debut, has been highly anticipated ever since.

The self-described cultists can talk amongst themselves about this movie’s omissions and distortions of its source, but there’s no question of its basic fidelity to Palahniuk’s pet themes–particularly that memory and imagination, especially where trauma is concerned, are subjective and selective.

Thus, as in Fight Club, just when a significant plot turn starts to seem bogus, along comes an unexpected twist to explain and justify it–unexpected, that is, because the twist itself is so bogus, so obvious, that you never thought the story actually would go through with it. Well, sure enough. Obviously all of this is hard to discuss without giving anything away; suffice to say the plot turn in question actually is not the one involving Jesus’ foreskin.

Otherwise, with Huston doing the familiarly dodgy yet deep-feeling matriarch routine and Rockwell reading Victor’s mix of self-loathing and self-congratulation with a leisurely bemusement that makes him sound like a lost Wilson brother, some viewers may be left wondering what kind of unequivocal breakthrough or failure Choke would’ve been had Wes Anderson directed it.

Gregg, for his part (and he plays a part, too, as Victor’s priggish, Colonialese-spouting boss and unlikely romantic rival), does OK. Maybe he’ll lose points for lacking Fincher’s slickly overwrought style, but that works to the movie’s advantage. It’s a credit to Gregg’s discretion that Victor’s (mercifully few) choking scenes play out with more discomfiting intimacy than his drolly cynical sex scenes.

But to call yourself a true fan of rebelliously anti-mainstream transgressive solipsism, track down Caveh Zahedi’s I Am a Sex Addict for a proper Choke chaser.