Karoline (Kara) Spencer still feels the emotional pain of the loss of her parents in a fishing accident. She is now engaged to Tyler and seems to be steady in her life as a counselor at a local church and as a waitress. But Kara's life is disrupted with the arrival of Tyler's ex-girlfriend, Isabelle (Elle) Lloyd, who is determined to win back her man.
"Psycho Ex-Girlfriend" (a.k.a., "Twisted") was well performed by the principal actors, especially the actress playing the unfortunate Kara, who must cope with the deranged Elle, the daughter of the local police chief. Through the harassment that she endures, Kara gets no help from the police, and even Tyler proves to be ineffective in preventing his ex from disrupting their marriage plans and getting inside the head of his fiancée.
A weakness of the film was in its unpleasantness, especially in the intentional drowning of Kara's beloved cat. Was that act really necessary to demonstrate how devious Elle could be? Another shortcoming was in Tyler's inability to stand up to his boss Frank and insist that Elle stop working as a waitress alongside Kara. At some point, Tyler needed to be decisive.
There was a narrative twist in the subplot of Kara and her client Laura, whom she has been counseling at Father Macey's church. Kara allows Laura to move into the trailer owned by her parents, in order to escape an abusive spouse. But there turns out to be a quid pro quo when Laura places an ad that invites strange men to visit her at her home. It was this ad that finally pressured the police, led by the diligent female detective Clemens, to challenge the authoritarian police chief and expose the machinations of Elle.
It turned out that the little orphan had some backbone, and she was also very adept at handling herself with a loaded revolver.
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