In the movie which brought her into the spotlight, 2011’s We Need To Talk About Kevin, the filmmaker approached the topic of postnatal depression in the most disturbing way possible.

In the movie, a mother is confronted with the inherent evilness of her child.

I met up with Ramsay in a hotel in London’s Soho to discuss her new feature You Were Never Really Here, a dark and violent thriller starring Joaquin Phoenix.

The movie won two awards last year at Cannes, including best screenplay and best actor for Phoenix, and was nominated for the prestigious Palme d’Or.

It almost didn’t make it to the competition, but Ramsay and Phoenix managed to shoot the whole thing in little more than a month to make the deadline.

“I wrote it on spec,” she told me, explaining she adapted the script from a novel by US author Jonathan Ames.

“We didn’t have the rights to it. I just started writing it without knowing if Jonathan would go for it. And then things just started happening.”

The movie features a heavily bearded, mostly silent, ultra violent Phoenix playing Joe, an over the hill mercenary who befriends a little girl.

“There was something really fascinating about his character,” she said.

“He is this middle age guy going through this middle life crisis, he is suicidal.

“And one thing Joaquin brought, because he came in really early in the production process, was that we decided he was going to be tender and human but also terrifying.”

In many ways, You Were Never Really Here follows in the footsteps of other genre movies like Taxi Driver or Drive.

But unlike most of its ancestors, it dodges on screen violence and retribution cliches.

“He isn’t the knight in shining armour who goes and gets the girl,” Ramsay told me. “There’s this big retribution scene at the end.

“He comes back to life through the movie, he is like a ghost in his own life and it is the girl who brings him back to the present.

“There’s a humanity in it you don’t usually see in these kind of films. But it is still exciting and unexpected and defies what you think it’s going to be.”

The humanity of Joe’s character is in stark contrast to his ruthlessness, and the movie often oscillates between tenderness and rage in a way audiences are not accustomed to.

I asked Ramsay if she thought this was a more female approach to violence.

“I don’t know… I guess it depends on the person really. Some people give more masculine elements to the character, some more feminine elements,” she said.

“Certainly Joaquin is quite a feminine person… But I don’t think about it in terms of gender, I just think of myself as a filmmaker

“But I do think of violence in a much more psychological way than just spectacle only. It’s a balancing act, I think.

“There is a very sophisticated audience these days, which can join in the dots. You don’t need to see everything that happens to imagine it.

“That’s almost more potent. Violence has become banal. It’s so explicit.”

:: You Were Never Really Here opens in UK cinemas on 9 May