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"You can feel it every you go. The walls getting closer, the sky dropping further down every day. With labored breath your world is shrinking; like a snake constricting its prey, or several layers of cellophane wrapped on someone's mouth. You can't scream, and you can't breathe."
PSX Backcase narration.
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Lost in Vivo is a horror game revolving around claustrophobia and other psychological fears.

You are walking with your dog when a storm comes, with the sudden rain your service dog falls down a broken sewer drain. You find the nearest sewer entrance and run in after it.

Along the way you will meet other people that are also stricken by an abnormal or psychological fear. You may be able to help them, just as you may be able to free yourself, but just as likely, they or you may be beyond any help.

Lost in Vivo is a horror First-Person Shooter inspired by classic PlayStation horror games. Players control an unnamed claustrophobic as they descend into a nightmare world of tunnels and tight spaces. As they get deeper and deeper into this strange underground world, reality itself seems to break down. The already arduous journey soon becomes a spiraling nightmare in which the protagonist must fight for their life against warped otherworldly horrors.

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Developed by Akuma Kira, the game's available online through itch.io and Steam.


This game provides examples of:

  • Abandoned Laboratory: Nezumi Labs is deserted by the time you get there.
  • Abandoned Hospital: Explored during one of the Lost Tapes. Fittingly it’s a mental hospital, haunted by past patients.
  • Abnormal Ammo: The shotgun found in the Metro System fires rock-salt shells. This makes sense since it's a police shotgun, and despite sounding absurd, rock salt shells are real and are traditionally used for wildlife control.
  • Adult Fear: Finding yourself alone trying to find someone dear to you who got lost, while you are suffering a psychothic breakdown with hallucinations caused by an overwhelming fear.
  • Ambiguous Gender: Nothing is stated about the protagonists gender, but when they cough and vomit a male voice is used. That being said, there's several hints in-game that suggests the player is female.
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  • An Axe to Grind: Two of the three sledgehammer skins unlocked upon New Game+. One being a fire axe and the other being the axe from Spooky's Jump Scare Mansion.
  • Animalistic Abomination: Nezumi Testing Labs is rife with hideous, hunch-backed rat-human abominations. It's heavily implied that they're the result of Sotiris' influence over Dr. Piccinini.
  • Animal Testing: The tests in Nezumi Labs. Dr. Bowers, the author of the notes, argued to his colleagues that what they were doing had absolutely no practical applications in medicine or the military and seemed to be sadism for its own sake. He was ignored but he and the other objectors were unable to leave due to how classified it was. Eventually their testing resulted in scientific impossibilities, but these were also useless to any sane person. Dr. Piccini, one of the objectors, eventually went mad and created something that could save the rats (and himself) from the science team, the result being Sotiris.
  • Arc Villain: Each of the major sections uses a single overarching figure to menace the player.
    • The subway uses the Suicidal Ghost to haunt the player in the darkness, and helping her get over her body-image and abortion guilt issues is the key to escaping. The mines has the dog mimic pursue you viciously, trying to fake you out multiple times. The labs has Sotiris, with his Leaning on the Fourth Wall influence causing him to really mess with the player. The drains have the giant legless Siren.
    • Unsurprisingly, the titular wolf of the Lost Tape titled “The Wolf”
  • Bedlam House: One of the lost tapes is set in one. Considering the ambiguous link between the protagonist and the tapes, it’s either based on their memory of one, what they fear one to be like having never been in one, or something else entirely.
  • Beneath the Earth: The whole game is subterranean other than the brief intro. All areas are archetypal closed in tunnels of various kinds (Sewers, subways, secret bunkers, etc.).
  • Body Horror: Some of the enemies at least resemble skinless corpses twisted in seemingly impossible ways.
  • Boss-Only Level:
    • The mine is pretty much just a cat and mouse game with you as the mouse and the mimic as the cat.
    • The first train station is a one on one fight against the Ghost Girl, who appears in the dark and very quickly respawns every time she’s killed
  • Central Theme: Claustrophobia. The vast majority of the game takes place in crushingly small spaces and the protagonists journey takes them deep underground. In addition, most of the major areas deal with some kind of crushing social terror as well- the subway talks about body image issues that are causing the afflicted person a great amount of anxiety, while the laboratory is themed around Demonic Possession.
  • Cool Guns: The main pistol used by the protagonist is a type of Ruger Standard Pistol that is rather hard to identify.
  • Crazy Homeless People: The first enemy of the game is a homeless man who gouged out his own eyes to appease a “red thing” that came into his room when it thought he was asleep. Judging by some of his journal pages he was already pretty crazy (such as breaking open a television and filling it with rotting meat, then treating the bugs as live programming) even before the tunnels influenced his mind.
  • Creepy Cockroach: Some of the locations sport cockroaches that are as big as dogs.
  • Cursed Item: Lost Tape #3 is said to cause serious harm to viewers, and turns others slavishly loyal to the unseen Bayagototh, an Eldritch Abomination mentioned across Kira's games. It’s implied to only work on the Neurotypical, as the protagonist and the note writing professor the professor (who is heavily implied to have post traumatic stress disorder from performing tests on animals) were unaffected while Dr. Piccinini started to build Sotiris after watching it.
  • Did You Just Punch Out Cthulhu?: In the non canon Midnight Mode, the demon swordsperson (possibly a woman, if the portrait is a portrait of them) can kill the two invincible Eldritch Abomination antagonists from the main story, Shoggoth and Bayagototh. Though it's ultimately Subverted in the case of Bayagototh, in which it's made explicitly clear through it's boss title (Mirage of the Starving God), that the protagonist has only managed to defeat an illusion of the Elder God.
  • Down the Drain: How the game proper begins. But then the Mind Screw starts kicking in, and you find yourself in locations that feasibly shouldn't be in a sewer.
  • Driven to Suicide:
    • The woman whose notes you can find throughout the first subway area is revealed to have killed herself by walking down the tracks in front of an oncoming subway train due to her body dysmorphia.
    • A second woman, the author of the Grand Bulim notes, would later take her own life years later in the same stretch of subway over her guilt about terminating her pregnancy due to her self image issues.
  • Easter Egg: Quite a few.
    • By playing around with the settings, you can unlock a gallery of the game's models without the threat of them coming for you. Plus, your dog is there with you!
    • Also by playing with the settings, you can unlock a mode in which you simply drive home in the night, with some music playing along the way. Just don't get out of your car.
    • By playing the game at midnight, you unlock a mode aptly titled Lost in Vivo: Midnight, a more stylistic rogue-like dungeon crawler.
  • Eldritch Abomination:
    • Sotiris is quickly revealed to be far more than just another monster. His chapter has the most Leaning on the Fourth Wall and The Fourth Wall Will Not Protect You moments and most of them are his fault. It puts him well above most of the other abominations in terms of power.
    • Bayagototh, the Eldritch Forest God featured in many of Kiras works, appears here as well. Lost Tape #3 is an artifact of his, and Sotiris is implied to be another of his children like Specimen 8 from Spooky's Jump Scare Mansion. He’s associated with woodlands and the animals within, and many of his children seem to be a form of divine vengeance against humanity whom he despises.
    • Shoggoth the Eel King, a gigantic drooling abomination with Reality Warper powers. When he appears, you die. No matter what. you only manage to make it through your first meeting with him due to the bizarre nature of the tunnels causing your death to be subject to a Cosmic Retcon, possibly by Virgil.
  • Eldritch Location: The Grand Bulim Avenue Station, overlapping with Sinister Subway. The entire station is filled with an odd, red haze, one room's floor bulges upward like a massive tumor, and the layout is completely nonsensical for a subway station.
  • Eye Scream: Seems to be a theme.
    • The homeless man in the sewer area gouged out his own eyes to appease a “red thing” that was watching him sleep. His model is, obviously, missing them.
    • The game over screen, very prominently, features a red, bloodshot eye twitching violently with blood streaking around it.
    • Sotiris is shown to be lacking eyes, as well. Until He jams a single eye into one of his sockets.
    • Should you get killed by Sotiris, You will be treated to the lovely sight of rats crowding around you before gnawing at you with some very squicky sounds. You are then taken to a special variant of the game over screen in which the aforementioned twitching eyeball is replaced with a single, pitch black, empty socket. Nothing Is Scarier in full effect.
  • Eyes Do Not Belong There: In lost tape #3, look carefully at the sky through the chapel window, and you’ll see something is staring back.
  • Fission Mailed:
    • The first fight against Shoggoth the Eel King is both unavoidable and unwinnable. You get a fake game over and the game pretends your save was corrupted, before you’re dropped into a save room with your progress preserved.
    • Used again during the sequence where you accidentally kill yourself with bleach and get a game over. You even get to see your own melted corpse on your way through the level again.
  • Found Footage:
    • The premise of all of the Lost Tapes but especially The Cabin, The Pound, and The Wolf. The Clinic sits on the borderline since it’s so outlandish for a location not in the nightmare tunnels that it’s hard to tell if the footage is real.
    • The Hotel, and The Way Out, while still found footage (a lost recording/piece of media that is found to have survived in a physical medium) in the dictionary sense, appear to be allegorical stories. The first dealing with an Ironic Hell Eldritch Location where tortured souls wander for rest they can never, ever have and the second is a pure Mind Screw story about abuse, entrapment, and suicide.
  • The Fourth Wall Will Not Protect You: Sotiris talks directly to you in a fake out credits sequence. At first it’s regular credits, then it starts crediting people for blood and Sotiris gets a thank you for being the savior of rats... then it becomes messages to you, as in the person playing.
  • Ghost Train: As you explore Grand Bulim Avenue, you're attacked by huge apparitions that take the form of subway trains. They attack by biting you with their huge, lamprey-esque mouths, which also happen to serve as their weak point.
  • Greater-Scope Villain: Bayagototh is potentially responsible for what the underground contains, since in the ending where you empower him with a ritual the surface becomes indistinguishable from the nightmarish tunnels
  • Hellhound: Monstrous dogs are a recurring theme in the game; troubling, considering tracking down YOUR lost dog is the game's premise. One of the enemies also has the appearance of a dog. Specifically, yours.
  • Hell Is That Noise: The game is full of unpleasant noises, and they're often heard before you see what's making them.
  • Hopeless Boss Fight: Any encounter with Shoggoth the Eel King outside of Midnight Mode. The first fight, and the only unavoidable one, results in a Fission Mailed, the rest you get a game over
  • Hope Spot:
    • Near the end of the opening area, you'll find your dog in the tunnel ahead of you, teasing an early reunion, but as soon as you get close, something drags it off into the darkness. You didn't really think it would be over so quickly, did you?
    • Made lethal in the mine area. To whit, you are looking for your missing dog, and the mine mimic happens to look exactly like him...
  • Humanoid Abomination: Dr. Piccini was turned into one for his loyalty to Sotiris. He can see without eyes, his body can fit inside your inventory, though the game draws attention to it being impossible. Despite being dead for a long time he can get up and walk like it’s nothing and seems to be immortal.
  • Knife Nut: The main character can grab an antique rusty kitchen knife to defend themselves with. After beating the game, they can gain two New Game+ skins, one being the Combat Knife and the other being Spooky's Knife. The former is slower but does more damage compared to the base knife while the latter is quite fast but doesn't do as much damage.
  • Maybe Magic, Maybe Mundane: the whole game, in some endings.
  • Meaningful Name: Grand Bulim Avenue station is haunted by the ghost of someone with both an eating disorder and self image issues. "Bulim" is two letters short of bulimia.
  • Mercy Kill: What Sotiris is to provide for the rats. And everything else, had he been completed properly.
  • Mirror Monster: Grand Bulim Avenue is infested with monsters that take the form of floating, ornate mirrors which show off a frightening reflection. Once killed, they shatter into pieces.
  • Multiple Endings: They range from happy, to depressing, to absolutely nightmarish:
    • In the good ending you face your fears and are reunited with your dog. It is ambiguous whether your journey was a psychotic break or a real experience, but either way you’ve grown so much as a person that for the first time in your life your claustrophobia has retreated.
    • In one bad ending you simply turn around and leave in the first area. Your claustrophobia gets worse and you never see your dog again.
    • In another bad ending you shoot your dog. You become depressed and overcome by guilt. The entire journey to that point is all but stated to have been a hallucination
    • In yet another bad ending you make it to the end and escape without your dog. The things you saw in the tunnels and your own failure haunt you for the rest of your days. The journey is implied to have been real.
    • In the nightmare ending you summon the Eldritch Abomination Bayagototh in the tunnels. When you arrive at the surface the entire world now looks the way the tunnels did. You look up in time to see the sky become a solid living membrane and begin to smother the entire world. A claustrophobics literal nightmare come true.
  • Mundane Horror: The secret Dark Mode scenario. driving home isn’t normally scary, right? But what about driving home while vividly disassociating?
  • Mysterious Watcher: A character referred to only as Virgil in the game files observes you throughout the game. He also intervenes several times, never in your favor. that being said, Word of God says he is also the power behind the save rooms which is why the statues look like him. This only makes his motives even more obscure.
  • Non-Malicious Monster: The ghost girl is said to only be blindly lashing out, and holds no actual ill will towards you. Accordingly she’s also the only one of the major ghosts who actually gets a happy ending, as she’s able to pass on peacefully once she accepts your help.
  • Non-Standard Game Over:
    • You can shoot your dog a bit after getting the gun. Doing so goes as well as you would expect.
    • Shooting any of the stray cats will trap you in a pink void surrounded by disembodied eyes, before sending you to the Game Over screen.
  • Nothing Is Scarier: In spades.
    • There are many parts on the game that are eerily devoid of characters.
    • Many sections of the game have very, very long walks and/or crawls through cramped locations in which absolutely nothing happens.
    • Quite a few sections have simple rooms and locations where you'd expect something to happen, such as a delapidated bathroom. Yet again, nothing happens.
    • Lost Tapes #2 and #3 end just as shit hits the fan in both of them, leaving it up to the player to fill in the blanks. In the former, the character escapes the asylum only to end up trapped in a room with strange beings and in the latter the character burns an idol of Bayagototh while the forest lord is watching. Neither have their fates expanded upon.
  • Production Throwback:
    • An ad featuring Spooky from Spooky's Jump Scare Mansion is in the subway. Both games were made by Akuma Kira.
    • Alongside that, one of the New Game + skins for the axe and knife, is none other than the axe and Spooky's giant knife from the same game respectively. (Although the last one is rather scaled down.)
  • Railroad Tracks of Doom: Wandering too far down the tracks in the subway system results in a subway train hurtling down the tracks toward you, killing you instantly. A lot like what happened to the woman whose ghost now haunts the subway.
  • "The Reason You Suck" Speech: The talking brains towards the end give this to you. It can be a very emotionally powerful moment if the player struggles with the issues the game explores, such as anxiety, body image issues, and self hatred. This makes pounding the bastards to a pulp or blasting them to kingdom come all the sweeter.
  • Reliably Unreliable Guns: The damaged handgun you can acquire early on in the Sewers will occasionally jam when you fire it. Not really making it the most reliable weapon.
  • Rule of Symbolism: Tons.
    • In vivo exposure therapy, from which the game takes its name, is also called “flooding”. A flood is what starts the events of the game. The term “in vivo” also can refer to live animal testing in lab reports.
    • Almost all the ads in the subway deal with food, fitting for an area haunted by 1-2 (left ambiguous whether both ghosts are different manifestations of the same women) ghosts who suffered from severe body dysphoria.
    • Enemies in the area centered around self image are monstrous mirrors.
    • The enemy in the mine is based on paranoias about friends and loved ones.
    • Almost all of the Mersus Tape “the way out” is cryptically symbolic. From your fellow prisoners being based on the Seven Deadly Sins to the exaggerated suicide methods each of the Wraths encountered in their visions.
  • Screw This, I'm Out of Here!:
    • The station master had the right idea and quit when the subway station revealed its sinister nature to him. Oddly his last notes are from a little over 10 years before the time the game takes place, but it appears the station kept running until it was the site of a second suicide a couple years before the game starts which begs the unsettling question of who was running it in the meantime.
    • YOU can do this, by immediately turning around and using the same sewer entrance you came through at the beginning of the game. Fittingly, this gives you a bad ending.
  • Sinister Subway: The Royal Phantome Subway has been long abandoned, the system is prone to electrical failures, and the notes left behind by the former staff mention it as being in a bad side of town. Oh, and it's haunted, too.
  • Shout-Out:
    • Many subtle ones to Silent Hill, both in aesthetic and soundtrack. Just compare the opening them "Broken" to the main theme of the first Silent Hill or the sequel's "Theme of Laura".
    • The talking brains speak like the fetus from P.T. And even give you a similar Hannibal Lecture on your personal failings.
    • The brown bag in the backseat of your car in Dark Mode looks a lot like the talking bag, also like P.T.
    • In an early part of the sewers, you can spot a drawing of White Face from Imscared.
    • The opening features quotes from various old internet horror stories that have naturally lost much of their followings to the passage of time, such as Jeff the Killer. This is likely to intentionally “date” the game as being from years earlier than its actual late 2010s release date and make it feel like it came from an earlier time.
    • Lost Tape #4 is a long reference to Franz Kafka’s The Metamorphosis. Your character wakes up progressively more and more of a cockroach. Unlike the story it references, you are killed by a disgusted human rather than how Gregor killed himself
    • The shotgun's New Game+ skin is a double-barreled shotgun which in an update note states that it was based on the famous Boomstick from the Evil Dead Series.
    • One of the names in the graffiti in the opening sewer section is ‘Julianne Stingray,’ the full name of the protagonist of VA-11 HALL-A.
  • Stringy-Haired Ghost Girl: In contrast to the authors other works, this one isn’t cute or eerily elegant, but instead looks like an oversized mummified fetus with filthy matted hair. It seems to take a more traditional form normally, as the station master didn’t describe it as the horrific form players see, but just as a girl who was in the station at time she shouldn’t have been, in areas she shouldn’t have been in.
  • Stylistic Suck: The game uses a deliberately low-poly, low detailed art style that brings to mind PlayStation 1 and Nintendo 64 games. This is meant to make the world feel even more alien and foreign, and it succeeds in spades.
  • Surreal Horror: Full of it. Sometimes it becomes really hard to tell if what's happening is literal or not. The best example is that at the end of the first "Rusty" sequence just before the subway, the protagonist wakes up at the bottom of a hole that looks similar to the one they were forced to jump down during the nightmarish sequence they just came from. Was that entire sequence a dream, then?
  • Through the Eyes of Madness: It's hard to tell if what is happening most of the time is actually real or an hallucination of the protagonist.
  • Token Good Teammate: The ghost girl is the only one of the major ghosts who isn’t evil.
  • Video Game Cruelty Punishment: Once you have the gun, you can shoot both stray cats, and your own dog. ...but you REALLY don't want to.
  • Visual Pun: In the second to last area, the Drain, the map shows that fittingly for a psychologically symbolic area, it is all contained within a CT or MRI slice of someone’s brain. Probably yours. Regardless of whose brain it is, it’s a literal “brain drain.”
  • Where It All Began: The last level is the same tunnel you entered from, only even more warped than when you entered. You even escape through the same tunnel you came in through.
  • Whole Plot Reference: Is essentially a slightly more surreal one to Dante's Inferno. The game's supernatural events are proceeded by entering a ominous sewer grate with "Abandon all hope ye who enter here" in graffiti, is set Beneath the Earth, is a continuous downward (figuratively and literally) spiral through increasingly grotesque, nightmarish locales inhabited by tortured souls and nameless horrors, and the protagonist's "guide" is a mysterious character named Virgil.

 
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Lost In Vivo

Sometimes it becomes really hard to tell if what's happening is literal or not. The best example is that at the end of the first "Rusty" sequence just before the subway, the protagonist wakes up at the bottom of a hole that looks similar to the one they were forced to jump down during the nightmarish sequence they just came from. Was that entire sequence a dream, then?

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