Furthermore, "American Psycho" explores themes of identity, performance, and the blurring of reality and fantasy. Bateman's violent fantasies and actions are often intercut with his mundane, everyday life, making it difficult to distinguish between what is real and what is just a product of his fevered imagination. This blurring of reality and fantasy serves to underscore the instability of Bateman's psyche and the artificial nature of his world.

Leo paused. He checked the original theatrical cut. The figure was gone, hidden behind the black bars of the widescreen crop. He moved to the "Hip to be Square" sequence. As Bateman donned his translucent raincoat and swung the axe, the bottom of the frame—the extra space provided by the Open Matte—showed the floorboards vibrating. Not from the music, but from something underneath them. A hand, pale and pixelated, was clawing at the gap between the carpet and the wall.