Mailer directed the 1987 film adaptation of the novel, which starred Ryan O'Neal and Isabella Rosselini. In the novel, Patty Lareine never actually appears; instead, she comes alive in Madden's sorrow over her departure and death. Since Mailer could not rely on a narrative voice in his screen adaptation, he introduced Lareine as a character. Initially, Mailer's plan was to rely only on dramatized action in the film, but in the end he was forced to use some voice-over narration to clarify Madden's point of view and certain plot elements. Most reviews of the film were negative, citing an uneven tone and unduly complicated plot. Reviewers wondered whether Mailer was intentionally parodying himself or taking himself too seriously.

They also panned his direction of the film, pointing to a lack of cinematic rhythm, and faulted his writing, finding some of his more foreboding lines ludicrous.