Tusmørke describes Autumn as "glimpses into a character’s journey during the months following a sexual assault: her struggles with herself and the world around her." The story is revealed in reverse chronology and divided into seasons; it begins with summer, months after the attack and follows the character's transformative recovery and path toward finding a sense of hope. Spring focuses on confronting others, and coping with the feelings of judgement and shame that can too often follow an experience of rape. Winter portrays the deepest moments of despair: fear of leaving the house, constant depression and panic attacks. "Autumn," Tusmørke says, "is when her life is shattered."

Marta first sensed the necessity for an interactive experience like Autumn after talking to a group of her male friends about her own persistent sense of fear in regards to sexual assault. As she tried to explain just how different her daily experiences as a woman could be to theirs—how her male friends didn't have to think twice before walking outside alone after dark—she began to see how words weren't enough.

So, she decided "to make a game to convey this sense of vulnerability, to take people through the looking glass," and provide an experience that communicates the fear and powerlessness inherent to sexual assault. "People have a lot of problems understanding what those who have been attacked go through afterwards," she explained. "The constant consequences: the pity, the shame, the lack of empathy. Understanding their trauma gets obscured by all that noise, and the victims become quiet and paralyzed." First and foremost, both members of Tusmørke saw a dire need "to change the way we talk about rape, remove the stigma, and stop making the aftermath so difficult for victims."

Having once been attacked herself (though she managed to escape the assault), Marta used a combination of her own personal experiences alongside those of friends, filling in the rest with diligent research about post-traumatic stress in rape survivors. "While going through the process, I had to fight my own anxieties and fears," she said. "But it felt important for me to engage in that process—it was cathartic, in a way."

While creating Autumn, Marta and Mikkel kept two different types of players in mind. On the one hand, they hope Autumn enables empathy in those who've never experienced an assault personally. On the other, the game could also potentially serve survivors of the trauma themselves, allowing them to confront and engage with their emotions in a safe environment and on their own terms. From their research, the team found that online communities of sexual assault survivors often suggest lists of books and movies that deal with the subject as part of "emotional trigger therapy." Many found that by deliberately triggering themselves, they not only felt less alone but also gained a sense of control over their trauma, using different media as a way to confront memories rather than try to bury them.