This movie start quite gruesomely with a female being bound and psychologically tortured. There's male full frontal nudity, dead animal parts, dogs licking nipples, the female loosing control of her bladder. All shot in a gray cold color. Effective, but a little too much. We then move on to seeing the BTK killer's youth as well as the present and his history of crimes. The tension is entirely psychological and the scenes of the killer entering the homes of his victims and talking to them lasts for quite a long time and it's creepy. Here we don't see fancy or good imagery, it looks as if shot with your home camera. It doesn't look horrifying, but in a way seeing a criminal engage his victims for quite some time before killing them is quite unusual and chilling. What this movie doesn't have is any drama, really. There are some cop scenes every once in a while, but there's no excitement in terms of them finding the killer. There isn't much of an arc to this story. This could have been an effective psychological thriller, a study of madness. Unfortunately, the movie is filled with real slaughterhouse footage. It's dispersed throughout the movie and comes on suddenly again and again. Sometimes you don't know it's coming and don't have enough time to look away. And that I have to reject. I'm all for low budget horror movies but I don't tolerate animal suffering. It was unnecessary, excessive, and comes without warning. I'm glad that Lionsgate releases stuff that no one else does, but they should have passed on this movie or edited out the animal gore. Stay away from this garbage.