In the real world, she killed her boyfriend Chris. The other murders (the ones that she interrupted and heard over the phone) never happened. She created a split personality to deal with the fact that she had killed Chris- this was "Joe". Remember that the murders started with where Chris was headed, and ended in her apartment building. I believe this was because she was getting closer to figuring out just how close the murderer was to her (ie it was her). When she splits into this delusional state, Chris becomes Frank. The boyfriend that cheated on her and broke her heart becomes this really sweet, caring guy. Notice he kept telling her "I'll never leave you again." She was getting from Frank what she never got from Chris. Also in the real world, she was seeing a psychiatrist. In her delusion, this became the FBI agent. Just like her doctor would have done, she caused the character to question her boyfriend figure's motives. The only people who were REAL were the main girl, her boyfriend Chris, the neighbor he cheats on her with, her psychiatrist, the two cops at the very end, and possibly the maintenance guy at the beginning that mentioned Chris. However, each played a different role in her delusion than they did in real life (if they showed up at all). That's why the phone line is dead at the end of the movie when she is with the real cops who come to ask about Chris's death. There never was anyone else on the other end; there never were serial murders. Joe is 100% in her head. The very end scene where he said it was always about her, I think this is more for the audience. We aren't supposed to focus on the "murderer" that "killed" the other women, our focus should have been on her the whole time. Also remember Joe kept telling her that she needed help,that she was messed up. She was mentally sick all along.
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