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David Cronenberg, like John Waters, is a once-pioneering director whose taste, style and ideas have been co-opted so much by the mainstream you can see his influence everywhere - and yet, like Waters, he can rarely get the budgets he needs to make the films he should be making. I recall being on the set of Spider (2002), which was being filmed on an allotment just outside London, on the day that a significant chunk of the modest $8 million budget was suddenly withdrawn. Now, clearly that money was replaced because filming continued, but there was a very real possibility that the plug would be pulled. That was an eye-opener for me. Cronenberg was calm considering the circumstances, but I couldn't believe that the director of Videodrome, The Fly and Dead Ringers was in this situation.

Since then, Cronenberg has proven himself as a mainstream contender again with two successful, accessible thrillers - A History Of Violence and Eastern Promises - but both, to a degree, have been slight compromises. Of the two, I much prefer A History Of Violence, since although, outwardly, it is a pulpy, violent B-movie, under the skin it is about one of Cronenberg's key obsessions: change in the human mind and body. In that movie, violence itself is a virulent infection, like the parasites in Shivers, or the TV signal in Videodrome, and once exposed to it, no one is safe. Coming in the wake of A History Of Violence and Eastern Promises, A Dangerous Method will definitely be seen as a throwback and one of David Cronenberg's more divisive films. For a start, it's period. Secondly, it's a kind of chamber piece. And third, it's based on a stage play, which makes it an instant companion piece with 1993's underrated M Butterfly.

It begins in the early 20th century, with hysterical patient Sabina S (Keira Knightley) being driven to a sanatorium in Venice [sic]. There she is put under the care of Dr Carl Jung (Michael Fassbender), a leading proponent, after Dr Sigmund Freud (Viggo Mortensen), of psychoanalysis, aka "the talking cure". Jung breaks through Sabina's screaming fits and outbursts to get to the root of her neuroses: she is a sexual masochist, the victim of bizarre abuse by her domineering father. At this point, Jung is happily following the party line, seeing Freud as a father figure. But when Otto Gross (Vincent Cassel), a psychotherapist who has somewhat fallen off the wagon so to speak, is placed in his care, Jung begins to wonder. Is sex really the root of everything, as Freud maintains without debate? And what is normality? Should the human mind do what it wants, what others want, or what it is capable of? Gross thinks the latter, and his chilling but logical amorality turns Jung's head. Before long, Jung and Sabina - who has worked her way up to be his assistant - are having a reckless affair, one that will drive a permanent wedge between himself and his mentor.

Now, the people that don't like this movie will be two camps: people who will be, er, overwhelmed by Keira Knightley's alarmingly physical performance and people who have not been following Cronenberg's entire career. To address the former, it's not that Knightley is so powerful, rather that she is extreme from the very offset. Gurning, screaming and doubled up in all sorts of bony contortions, Sabina is like a wild animal, and though she mellows, this really throws us in at the deep end. I'm not sure having such a recognisable actress in this role was the very best idea (such is the reality of modern film financing), but Knightley gives it her best shot, and if you can see past the surface trimmings, she does a pretty good job once the hysteria subsides. And as for the latter point, this really is a very pure Cronenberg movie. Imagine Videodrome with no special effects and you're halfway there. Carl Jung is like a man who's just dropped acid - in this case, the acid is Otto Gross's reasoned provocations - and the bulk of the film is him letting the drug take hold, coursing through his body and brain.

Fassbender is very good as Jung, cementing his reputation as a major new talent; Cassel steals all his scenes as the psychotic Gross; and the only disappointment is Viggo Mortensen - not because he's bad but because the part is so small, coming in like the Young Mr Grace of psychoanalysis to tell everyone they've all been doing very well. The film's stage roots and budgetary constraints show, especially in a trip to New York, and the ensuing professional gulf between Jung and Freud is not really explored. But Cronenberg completists will enjoy the film's perversity, its richness of ideas and defiantly uncommercial outlook. And it will certainly tide them over until Cosmopolis.