The main criticism has always been that Betty and her mental illness are merely a device for the hero to fulfill his potential, a proto-manic pixie dream (eventually nightmare) girl if you will. The film is indifferent to Betty's viewpoint in the story and shows no interest in why she loses her mind. In the end she has to be dispatched for the hero to grow, she's reduced to a tragic episode in his life who will inspire his writing and make him a better artist. I always felt its the type of mainstream art house film which may feel profound to some people because it shocks them into feeling something but it never really earns that emotional response because thematically its rather shallow.