Michael Fassbender plays Brandon Sullivan, a New Yorker whose carefully cultivated private life allows him to indulge in wanton sexual addiction. However, his sordidly pristine world is disrupted when his sister Cissy (Carey Mulligan) arrives unannounced for an indefinite stay. The most mesmerising look at addiction since Leaving Las Vegas.
James Badge Dale
For a film about sex addiction, Shame starts off surprisingly slowly. It is so calm and collected, in fact, that you may well spend the first half an hour wondering what all the fuss is about.
The genius of the film is that it is very aware that sex addiction is still regarded by many as something of a joke, and so it briefly allows its audience to maintain that position before subverting it.
Sure, Brandon, the fiercely private office worker (Michael Fassbender) uses prostitutes. And yes, he pleasures himself. A lot.
But for a while, even though you know what's coming, you still sort of wonder whether he really does have a problem. After all, he might just be a bit of a rake.
Ant then - bam! Just as Sissy, Brandon's sister, comes crashing unexpectedly back into his life, so too are any illusions that his behaviour might just be in bad taste completely shattered.
Now, his desire seems dangerous. Those compulsive stares on trains; his prolonged gawping at sex-mad neighbours; his internet porn. For Brandon, this is suffering at its most acute, as compulsive as it is repellent.
Sissy, (an ever-wise-beyond-her-years Carey Mulligan) is Brandon's only anchor to humanity, warm where he is cold, needy where he is private. We don't know what has happened to them exactly, only that they are alone and both as screwed up as each other.
For them, New York is a loveless, lonely place and McQueen's stunningly brave prolonged shot of Sissy as she sings New York, New York transforms the cheery musical number into the saddest song in the world.
The entire film, in fact, is a sort of symphony of loneliness, from the endless shots of Brandon running, to the close-ups of his excruciating expression as he has the most desperate threesome ever.
Shame has more sex in it that any film in recent memory and yet it is anything but erotic. The key is Fassbender, who is terrifyingly good. Forget his lack of clothes - it is his face that is naked, heavy with the weight of secrecy and self-loathing.
A normal relationship seems almost within his grasp when he attempts a "normal" date with a co-worker. But the prospect of a real connection is too much for him.
"Why are we here, if we don't matter to one another?" she asks him playfully over dinner. His baffled response is almost unbearable to watch.