Compared to film and other media, the video game industry is still relatively young, and many of its thematic genres haven't matured in quite the same way. When it comes to horror games, for instance, many titles in the genre embrace horror by going over-the-top with gore or focusing on jump scares. There aren't many examples of mature psychological horror experiences in PS4 and Xbox One video games, but one very notable exception is Ninja Theory's Hellblade: Senua's Sacrifice.
Hellblade: Senua's Sacrifice explores psychological horror in a couple of distinct ways. The first and most obvious way is through its gameplay. The titular Senua struggles with a "curse," which the player can deduce is actually psychosis. Senua's struggle with psychosis manifests itself in the form of threats to the player, represented by the enemies and obstacles that Senua has to overcome throughout the experience, as well as the voices that she hears in her head.
The second way that Hellblade utilizes psychological horror is how it messes with the mind of the player. Early on, the game makes players think that there is a permadeath mechanic that will cause them to lose their save and progress after Senua dies a certain number of times. Hellblade's permadeath isn't real, but those playing through it for the first time may not realize it, and this gives the game a suffocating sense of dread.
Whenever games can directly mess with the player themselves, they create a truly profound horror experience. Hellblade creates a real fear that the player is going to lose their save file progress, which lends significantly more weight to each of Senua's deaths in the game. And while knowing Hellblade's permadeath is fake makes it lose some bite, it's an incredibly effective tool the first time around.
Other horror games have used similar tricks to great effect. In some ways, Hellblade's permadeath trick is reminiscent of the horror gaming classic Eternal Darkness: Sanity's Requiem. That game would also mess with players by hitting them where it hurt most: their save. Eternal Darkness, for the uninitiated, would make players think that their save file was corrupted, which is a cleverly meta way of scaring the player beyond just what they encounter in the actual game itself.
With Senua's Saga: Hellblade 2 in development for PC and Xbox Series X, it will be interesting to see what new methods Ninja Theory comes up with to terrorize players in the sequel.
Hellblade: Senua's Sacrifice is available for PC, PS4, Switch, and Xbox One.