Pictured to the right: one of the sights you may see in your room upon waking up.
Absolutely nothing compares to the sheer terror you feel when you see a child's shadow whispering to you from the closet in your bedroom, and you realize that your one safe haven is no longer safe.
This effect is underscored by the fact that your health no longer recharges while in the apartment.
The player's "trust" that they're supposed to pick up every item they can is "betrayed" by a "Shabby Doll" that causes a haunting that H.R. Giger would dream up: grotesque-looking infants that moan and groan above your item chest, stuck inside the wall.
There's a particular haunting that possesses the chained door in the apartment. "Hm, everything's fine...wait IS THE PEEPHOLE OF THE DOOR BLEEDING???" And if you take the Schmuck Bait and look through the bleeding peephole? "HOLY CRAP BLEEDING VICTIM HENRY!" The most disturbing part is that "victim Henry" sways back and forth, moving his mouth as if he's saying something, but you can't make it out.
Not just bleeding Henry. Bleeding, eyeless Henry with 21/21 carved into his throat! If you turn your volume way up, you can very faintly hear him saying "Please help me."
There is also a chance that during your session of game, a shady-looking man may come to your door and stare back at you through the peephole while you look through it. You eventually find out that he is none other than Walter Sullivan.
One of the hauntings that possesses your phone. "I'm always watching you. I'm always watching you. I'm always watching you. I'm always watching you. I'm always watching you..."
Despite all the horrible, painful ways people can (and do) die in this series, few compare to Jasper laughing hysterically as he burns alive, glad to have met "the Devil", followed by carving 17/21 into his own chest with a candlestick right before he dies.
While we're at it, Richard's death by electrocution is much more terrifying, and he dies just as slowly as Jasper.
The bloody mannequin in the restroom. "Reminds me of Cynthia."
The giant Eileen head in the hospital with the realistic concussion eyes.
You can't mention Eileen's giant head without mentioning the heavy breathing it gives off, and the fact that those eyes FOLLOW YOU. Even with another character in the room, they only follow Henry.
Some of the murders Walter committed took place outside of the country. (That's right. You could be on a whole 'nother continent and Ghost!Walter could pop up at any time and kill you. Paranoid yet?)
Discovering Cynthia's body in the subway station, when 'Room of Angel' swells up... truly hair-raising. The static does not help.
The hospital in general, not just the Eileen head, but almost every other patient room is pointless except to scare you. There's the room with the (harmless) descending ceiling, the room connected to a sanitarium with a body in it, a room with a big tarp of skin held up ("On closer examination, there is a chunk of meat stuck in the middle of it"), the room with the wheelchair that disappears, and the room with the broken glass cases. The fact that the layout of all 24 rooms is randomized in every playthrough doesn't help.
The invincible, intangible Victims, which can pass through walls and attack you pretty much anywhere. Not to mention the loud vacuum cleaner-like sound heard when they are near.
Walter's horrific "new body" that looms over you during the boss fight with him.
The Nurses. Particularly the one that just appears in the hallway of one of the apartments in the second run through of the apartment world. At first, the apartment appears empty and your first thought is to search it for items, and while you're doing that a 7-foot high monster casually marches towards you from the hallway in an Unflinching Walk as if it was waiting for you this whole time. If you arrive early enough and go straight into the hallway, you can actually see the nurse materialize at the end of the hall and walk straight towards you. Very unsettling.
Twin Victims. Particularly the way they're pointing right at you as soon as you get a glimpse at them.
It gets worse when you find out what these things represent: Recall that Walter was first mentioned in an article in Silent Hill 2, which revealed that two of his earlier victims were children, a twin brother and sister. Do the math.
Forest World 2. You return to the forest and Eileen can read the previously indecipherable gravestones. So you let her read them, then suddenly you hear a deep chuckle, and then feel a gunshot. It's Walter. You run out of the gate in terror as soon as it happens, only to hear the gate creak well after Henry closes it. He's following you!
"Kid? That's no kid!" Made even worse by the fact that he's being electrocuted to death whilst saying it.
Real Life Phobias
After playing this game, one may be afraid to fall asleep, for fear of becoming imprisoned in a Dream Within a Dream, where waking up is All Just a Dream and their body is left to atrophy unconsciously like being in a coma.
Try dialing the phone number on the billboard outside of the bedroom. You hear some disturbing noises straight out of the Otherworld.
Robbie the Rabbit's cameo appearance in Eileen's room, where you can peek into her apartment from the hole in your wall. The most jarring bit of this is that, after your failure to save Eileen, Robbie will be accusingly pointing at you.
Robbie pointing at you could have an alternate meaning that isn't the slightest bit more reassuring. Remember, Eileen was the 20th of the 21 victims needed. In other words, Walter needs one more. Robbie pointing at you could be the game's way of telling you "You're next."
If you look out of your window before Eileen is attacked, you'll see Walter in an apartment across the way pointing at her room.
You know that bustling apartment building across the street you can see through your window? Look at it near the end of the game. It's empty.
The realisation that Walter's Otherworld, unlike previouslyencounteredones, wasn't born from a troubled person's negative feelings, but intentionally created. This world of violence and insanity, where Everything Is Trying to Kill You? It's the world as Walter wants it to be, the one where he feels like he can most be himself and where everything makes sense to him. It's his idea of Heaven.