Roughly, the dualities at the core of Vertigo, between the real world and the apparent world, correspond with the worlds of repressed and conscious desire; and life is aestheticised, in order to try to cope with tragedy - though in the process, Scottie loses both Madeleine and Judy. This liebtod theme is deeply Germanic, and reminds us that the early Nietzsche believed the world is one of terrible lack. To possess, but not possess fully, or truly, is terrible, to paraphrase Yeats. Scottie's double and utter loss, at the end of the film, is so deeply abject because his fetishistic attempts to totally dominate the image of his desire is also the utter destruction of the actual object of his desire. In a horrifying irony, his will to power ruins his attempt to make existence bearable - he over-stylizes his fantasy, and renders his world null and void of any meaningful possible future.
What then, to paraphrase Arthur C. Danto, whose book on art features an image of Madeleine, is "after the end of Vertigo"? What can be thought from that point on, that point of utter loss of hope and love? What is after negation? What sort of existence, creative, sexual, even spiritual, can Scottie - can the viewer - hope for?
As Danto, I think, observes, the end of a thing is not its death - it may even come back, later, proliferating in new varieties, post-historically (not least in pastiche, in other art works, and other genres, as in U2's banal pop song, or in other titles, such as American Vertigo, which borrows the force of the original by simply alluding to it). But has any film, since Vertigo, so profoundly enmeshed high, even Wagnerian art and emotionality, with the low arts that cinema allows (scopophilic satisfaction chief among them)? I can think of only one film that attempts to supersede Vertigo, in terms of its blend of eros, thanatos, and music, and it is non-Western - In The Mood For Love.