The entire relative linearity of Silent Hill is very subtly terrifying if you think about it. The games are well-known for their locked/jammed doors, but whereas in other games these would just be an annoying and illogical inconvenience, in Silent Hill, it gives very much the feeling that the town is leading you, pulling you about on a string, making sure you go where it wants you to go. For example: There are occasions in all games where something happens and the text that comes up as you leave is not "You unlocked the door.", it's "The door is unlocked now.", implying that whatever was keeping you there is letting you go. Think about this on a much grander scale. Everything you do, is it not in the town's plan? The monsters, the puzzles, the obstacles both physical and psychological that you must overcome — are they a test? Are they some rite of passage? Or are you the town's plaything to throw around until you finally give in and succumb or die? Or all three? ...Sleep well.
from the third game: "That was supposed to be the exit, but it seems that no-one wants you to leave" - courtesy of a disembodied voice.
The hospitals are bad enough, but the notes lying around suggest that they're staffed entirely by sociopaths. Take the budget note from Origins, where it states that Alchemilla's cutting "spending on inpatient care and consultancy fees", directly above a note mentioning how they're not cutting any funding for the staff party ("our recreation budget is locked away where no one can tamper"). Or the iron lung warning from the same game ("Patient deaths during therapy are not to be treated lightly. I find it hard to believe that someone could 'accidentally' overload every valve on the equipment..."), made worse by the fact that someone's scribbled "Have fun!" on the instructions for the iron lung. Or the notice from 3 stating how nurses that abuse the patients get locked in solitary confinement instead of being fired. Or the electroshock note from Homecoming:
"...setting the electroshock machine beyond the seizure threshold has yielded impressive results in the patients. The most violent and depressed patients are rendered completely docile... The only side effects have been minor: memory loss, some dislocated bones, one fractured leg, and a patient bit off his tongue. This accident was quite a nice side effect as this particular patient was also one of our noisiest. I've instructed the doctors to continue with this intensity level for all treatments."
Going back to that notice in 3. Read the handwritten notes on top of it. "The chief is a pervert! Christie would have been better off if she had been fired..."
The part where the group of religious fanatics roasted that little girl alive, while she's screaming for her mommy the whole time, was just too much to bear.
So much fuel for this fire: Officer Bennett and her gruesome, on-screen roasting in front of a screaming Sharon although she's done nothing wrong; Pyramid Head, who is the epitome of nightmare fuel. He rips off Anna's dress, exposing her breasts, genitals and pubic hair, after which he seizes her breast and rips off her skin, killing her, and attacking Rose and Cybil in that boiler room looking place; Colin the janitor, brutally reverse hog-tied with barbed wire, first her having to take the note out of his mouth then him crawling and groaning out of the stall. And of course the final scene, Alessa ascending to organ music in a bloody rampage Christabella, after the barbed wire plunges into her vagina, impaling her brutally and killing her and she wasn't the only one reduced to bloody shrapnel.
Say what you will about Jodelle Ferland's acting, but what takes the cake in her performance are her shockingly real screams of pain while being burned alive and even afterward in the hospital. Just hearing her scream is horrible enough, since it sounds so real, but the film had to show the audience Alessa's burned body afterward.
The ending is just haunting...being trapped in the fog world forever? Not cool.
Turns out, according to the sequel, there IS a way to get out using a particular talisman. Don't have it? Oh just go ahead and cut and/or burn a copy of the runic circle into your flesh. The person who goes through this is Vincent, who because of his age was either taken when he was a baby, or actually born in the nightmarish Otherworld.
The Dark Nurses and their awkward, jerky movements. It was very, deliberately unnatural.
There is something subtly horrifying about the hopscotch game that you see at the school in the courtyard. The beginning is labeled 'Hell' and the end of it 'Heaven'. Many people have only ever seen it with just the numbers, so a heaven-and-hell drawn in would be pretty creepy if you'd never seen it before.
Those bugs with the human-esque faces that hung out with Pyramid Head.
When Cybil is burned alive, you see her epidermal layer of skin blacken and flake off, and the layer below that bubbling.
The comic books flat-out state the entire city feeds on guilt and fear and can lure anyone it desires to the town. Seriously, read them and look at the artwork... as if the games weren't bad enough on their own.
Past Life has more than its fair share of disturbing moments. Pretty much every appearance of the skull-faced creature (including the revelation of its true identity) counts, as well as the backstories revealed in issue three and the entire fourth issue.
The three videos from the Art of Silent Hill DVD (and later, The Silent Hill ExperiencePlaystation Portable UMD): "Fukuro", "Kinoko", and "Usagi". "Fukuro", starring Pyramid Head and the Lying Figures from Silent Hill 2, and the "Fukuro Lady" (actually Lisa Garland), is probably the most disturbing due to its sexual and gory imagery (despite a lack of violence).
Word of God indicates that the creature named "Fukuro Lady" from the video is neither Lisa Garland or the Brookhaven nurse. This misconception may be attributed to an entry◊ in the Book of Lost Memories that mentions Lisa'safterimage in an area of the hospital in Silent Hill 3. This afterimage is not Fukuro, but bears an extremely similar appearance to her.