Anyone who saw Yorgos Lanthimos' startling 2009 Oscar-nominated film, Dogtooth, will find Alps, the Greek writer-director's new film, familiar, in the sense that it's completely strange. Dogtooth followed three adult children who have spent their entire lives confined and fed misinformation about the outside world by their their parents. Alps takes place in an apparently real contemporary world, in which a quartet of guerilla grief therapists secretly meet at a high-school gym.

For a fee, the members of Alps will impersonate a recently deceased person, for several hours a week, to help the bereaved make the adjustment. Their leader is a militaristic paramedic (Arus Servetalis) who announces that the group will be called "Alps" because, like the mountains, they have no substitutes. The other members of the group include a nurse in her twenties (Aggeliki Papoulia), a young rhythmic gymnast (Ariane Labed), and her domineering coach (Johnny Vekris),

Because two of the Alps members are hospital workers, they have access to the families of many dying people. None of those approached seem offended or disturbed by the offer of a substitution. The script focuses on the nurse (Papoulia, who played the rebellious eldest daughter in Dogtooth), who becomes obsessed with being the substitute for a 16-year-old girl critically injured in a traffic accident.

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While her parents wait for their daughter to die, the members of Alps begin gathering all the information they can about the girl – her tennis-playing, her favourite actor (Jude Law), and so on. When the girl dies, the nurse decides to lie to her Alps fellow members, telling them that the accident victim has miraculously recovered. Privately, she arranges with the family to stand in for their daughter.

As the film progresses, we're witness to several of the nurse's pretend families and how they use the substitutes to re-enact bitter family confrontations. The nurse plays a scene in which the parents come home unexpectedly and discover her with a teenaged boy in her room. In another episode, she plays the diabetic wife of a widowed lighting-store owner (co-writer Efthimis Filippou), who criticizes her unhealthy diet, then requires her to express her scripted enthusiasm as he performs oral sex on her.

When the nurse visits an old man late in the evening, it takes a while to realize the man is her real father and she's in her home. Gradually, in her pursuit of love, or belonging, the nurse, too, gradually becomes more agitated, confusing her characters like a damaged robot.

These scenes might be wrenching in a more conventional drama, but Alps, in spite of its title, is a very flat film, from the shallow focus photography, to the actors' monotone delivery. Most of the themes and techniques can be traced back to absurdist theatre – the automatism, non-sequiturs and threats of violence – but Lanthimos' film, with its emphasis on death deferred, holds the chilly fascination of a gaping skull. Our habitual pettiness and social programming deaden us until one day, we're actually dead, no substitutes allowed.