More Aware and More Curious to Understand": Emotionally Challenging Experiences in Psychological Horror Games

Paper Title

'More Aware and More Curious to Understand': Emotionally Challenging Experiences in Psychological Horror Games

Publication Info

• Topic area: The role of psychological horror games in fostering mental health reflection and empathy.
• Keywords: Psychological horror, mental health, empathy, reflection, game design, narrative, discomfort, immersion, emotional challenges, agency.

Background and Problem

• Problem / challenge: Psychological horror games often perpetuate stigmatized portrayals of mental illness, and there is limited research on how these games can foster mental health reflection and empathy.
• Significance: Understanding how games can promote mental health awareness is crucial for reducing stigma and fostering empathy, especially as mental health becomes a global priority.
• Motivation and related work: Prior studies have shown that games can evoke emotional engagement and reflection, but few have explored the unique potential of psychological horror games to address mental health in a non-stigmatizing way. Existing research often highlights negative stereotypes, while recent efforts like Hellblade: Senua’s Sacrifice demonstrate the potential for thoughtful portrayals.

Solution

• Proposed approach: A qualitative study analyzing how emotionally challenging experiences in two psychological horror games (Alan Wake 2 and Senua’s Saga: Hellblade II) foster mental health reflection and empathy.
• Novelty:
  1. Identification of features that encourage mental health reflection through emotionally challenging gameplay.
  2. Analysis of how discomfort and fear enhance emotional empathy and immersion.
  3. Comparison of narrative and gameplay mechanics in fostering mental health awareness across two recent AAA titles.
  4. Recommendations for ethical and responsible game design to avoid stigmatizing mental health.
• Procedure and key techniques:
  • Conducted semi-structured interviews with 16 participants (8 per game).
  • Selected emotionally challenging cutscenes for analysis.
  • Measured empathy using the Toronto Empathy Questionnaire.
  • Performed reflexive thematic analysis to identify themes related to immersion, empathy, and reflection.

Results

• Concrete findings:
  • Discomfort, fear, and tension enhanced immersion and emotional connection with characters in both games.
  • Senua’s Saga: Hellblade II fostered deeper mental health reflection and perspective change due to its grounded portrayal of psychosis.
  • Alan Wake 2 did not lead to significant perspective change, as its portrayal of mental health was framed supernaturally and participants were already familiar with the issues depicted.
• Advantage over baselines:
  • Senua’s Saga: Hellblade II demonstrated the effectiveness of integrating mental health themes into gameplay mechanics, surpassing Alan Wake 2 in fostering cognitive empathy and reflection.
• Experiments / evaluation:
  • Participants were interviewed about their experiences with the games, focusing on immersion, emotional challenges, and mental health reflection.
  • Empathy levels were assessed pre- and post-interview.
  • Thematic analysis identified key factors influencing player engagement and reflection.
• Limitations and future work:
  • Small sample size (16 participants) and gender imbalance (9 male, 6 female, 1 non-binary).
  • Focused only on AAA titles; future research should explore indie games.
  • Longitudinal studies needed to assess lasting impacts of mental health reflection.
  • Potential to expand research to other game genres beyond psychological horror.

Summary

This study investigates how psychological horror games foster mental health reflection and empathy through emotionally challenging experiences. By analyzing Alan Wake 2 and Senua’s Saga: Hellblade II, the authors found that fear and discomfort enhance immersion and emotional empathy, but only Senua’s Saga: Hellblade II prompted significant mental health reflection due to its grounded portrayal of psychosis. The findings highlight the importance of integrating mental health themes into gameplay mechanics and narrative design. Recommendations for future psychological horror games include ethical considerations, collaboration with mental health professionals, and a focus on authenticity and empathy. This research provides valuable insights for game designers aiming to create thoughtful, awareness-raising narratives.