Choke comes from a Chuck Palahniuk novel, but you won’t find its terse prose and spat-out scenarios in the film version. Clark Gregg’s screenplay discusses the issues of protagonist Victor Mancini as a therapist might at an initial session.

How did your mother abandoning you leave an impact? How does being a depressed nymphomaniac make you feel? How would you describe your relationship with your father … who just might be Jesus Christ himself?

Take that plot point and a lead character so powerless to keep his pants on he targets a teacher on a field trip, and Choke seems like the last film to adhere to romantic-comedy tropes. It does, albeit with a twisted strangeness.

Before that, Gregg at least skirts the dramatic and satirical subtexts of macho malaise that are a hallmark for Palahniuk (who also authored Fight Club). It helps that he’s cast Sam Rockwell as Victor.

Rockwell makes scurrilous language sing, looks like Dana Carvey kicking a bad habit and energizes himself in a role Nicolas Cage might have taken in that actor’s bolder, hungrier times.

Choke begins in the same sterile-lighting support-group environment featured in David Fincher’s Fight Club film. It’s not long before Victor is having sex in a bathroom stall with a fellow addict — both of whom are far from their final step.

With his masturbation-happy friend Denny (Brad William Henke, a gentle-giant version of Seth Rogen), Victor works as a historical interpreter at a colonial-village reenactment park. It’s hardly a salary that would fund the constant care received by his dementia-addled mother Ida (Anjelica Huston, whose work is burdened by exposition). But Victor has a strange source for supplemental income — choking.

Victor offers a “renewal of the savior experience” to the privileged in nice restaurants — endowing them with a sense of purpose by saving his life. In other words, they’ll feel obligated when Victor feigns hard times and asks for cash.

It’s a comfortable, if psychologically unbound, set-up that derails once Victor meets, and falls for, Paige Marshall (Kelly Macdonald), a kindly doctor tending to his mom. After No Country For Old Men, it’s another movie where Macdonald spends more time swallowing her Scottish accent than acting. Wince at her pronunciation of “traumatic.”

Even if Choke lacks the gut-punch immediacy of Fight Club, it’s filled with hearty laughter as you’d find on, say, F/X’s Rescue Me.

Adherence to colonial language clashes with modern sexuality and profanity where Victor works. Gastrointestinal humor rarely has felt more dangerous. And, in a later scene, a violent sexual fantasy of which Victor is a part turns into sneaky black-farce slapstick. In just two scenes, Heather Burns delivers a memorably snippy turn.

Choke does have moments of fascinating character study — how Victor’s natural sexual instincts morph into perverse psychological malady; how far he’ll go to replace intimacy in a bottomless void of sex; and questioning what’s truly aberrant in a world of pain.

Those are the same ideas that propelled Black Snake Moan, but Choke frequently is too smart-alecky about it to really the redemptive shift Gregg has written into the story. It’s very different, and far less hopeless, than Palahniuk’s take.

Thankfully, there are enough morbid jokes to forcefully apply the Heimlich Maneuver to most moments when Choke tries to have its cake and eat it, too.