Aronofsky's most frequent criticism is that its simply exploiting the emotions of the audience. Images such as pulling skin from a finger is a clever one because its not overly grotesque (Requiem for a Dream) and everyone can relate and feel the pain. The question is whether or not if the image was isolated would it cause the same reaction? Or is it meticulous cinematic build up that makes it so disturbing?
Aronofsky's dark and dirty scenery is changed for the hyper polished and clean ballet studios and this is a breath of fresh air. Ballet studios are magnificently SHOWN in dark and dirty ways instead rather than the other way round. Just as he showed the sensitive side of a wrestler he shows the inner demon of a ballet dancer. Its good but not perfect.