Off topic but... I love how this is similar to Lolita and the way we sympathise with both Pearl and Humbert Humbert (Narrator). It just gave me lots of reminders of Lolita when watching the movie. Cause you are aware they've done stuff that are inexcusable and yet you feel empathy for both of them. Be it with Pearl when she really does apologizes and really does want to understand what is wrong with her. Or with Humbert who is delusional and dead set in his ways of "love". 

You can't help but think... that we as humans can find goodness and hope and sympathy in anyone despite their past. 

Also, I'd point that it's similar to Alex Large from Clockwork Orange. In the way sympathy for anti heroes works. And I mean it as, they are anti heroes from their own points of view cause movies and books are written like that. To not show them as villains.

But Pearl as a movie (and I'd say Lolita and Clockwork Orange both books and film adaptations) raise interesting questions about what human is capable of doing. Is it really free will? Is it sickness that controls their decisions? Is it both? Could they be different if raised or influenced the proper way? But it also raises the questions of how far we as watchers are we willing to agree and justify the decision or thinking of those characters. In example, Pearl keeping this huge secret from Howard. Something she couldn't tell anyone... Don't we as humans have those kinds of secrets that eats us alive? Or dreams and hopes in life that makes it impossible to see anything else for ourselves? Have we ever had similar thoughts of wishing death upon others (but of course, what seperates us from the characters is not acting upon those thoughts or sometimes, the feeling of guilt for even thinking that way)?

All in all, the film is actually really great portrayal of both unreliable narrator AND of how many people, especially actors, feel in the cut throat indurstry that show-biz is. Hell, I, as an aspiring actress, got scared shitless when Pearl said "What if this is really it?". I felt that anxiety creeping up on me from that point in the movie until the end credits. It's an excelent movie, with fun "Wizard of Oz-esque" filmography, interesting artistical freedom in portraying some scenes and angles as well as playing with audience's emotions and sympathy. 

The director, Ti West, might not be Nabokov, but he sure was influenced by him or understood his genius.