Psychological horror is more focused on building a sense of player dread than pumping your adrenaline with sudden shocks and jump scares stuff. When psychological horror done right, it really sticks with you long after the game is over. Whether it’s delivered through techniques like breaking the fourth wall to mess with players directly, or crafting genuinely disturbing stories that pick at our primal fears, video games that employ horrific mental states are disturbingly effective. We’ve chosen a list of the 10 best psychological horror games, ones that cut deep into their players’ psyches. While their approach to style and subject matter might vary, these games will get under your skin, one way or another.

Amnesia: A Machine for Pigs

A Machine for Pigs Frictional Games, The Chinese Room

The sequel to Frictional Games’ hit horror game, Amnesia: Dark Descent, this spiritual sequel was actually helmed by a different studio, The Chinese Room. Famous for their dark remake of Dear Esther, The Chinese Room took the oppressive, gothic atmosphere of the first game, turned down the scares, and turned up the emotional devastation.

A Machine for Pigs is more narrative-heavy than the first game, opting to craft a pristine story that felt like a truly dramatic departure. While fans of the first game were disappointed that the game was less “streamable”, A Machine for Pigs was more interested in sharing an emotionally intense experience.

Spec Ops: The Line

Spec Ops Yager Development, 2K Games

Don’t let this military shooter fool you. Spec Ops: The Line is a genuine terror, through and through. A video game retelling of Joseph Conrad’s Heart of Darkness, Spec Ops follows a battalion venturing into a deserted Dubai in search of a rogue Colonel, John Konrad.

The game quickly begins to unravel the sanity of its lead soldiers, who may or may not be suffering from PTSD. The game’s story changes depending on your actions, which are some of the most psychologically taxing choices presented to a player I’ve ever encountered. War truly is hell, and Spec Ops delivers an exhaustive, rewarding experience for players who are willing to make it to the end.

Alan Wake

Alan Wake Remedy Entertainment, Microsoft Corporation

Remedy Entertainment set out to make a dark, pulpy, noir thriller and they came up with Alan Wake. One of the best mystery games of all time, Alan Wake fully embraces its source material by crafting a deliciously loving ode to Stephen King and David Lynch.

While not as psychologically complex as some of the other games on this list, it certainly talks the talk of some of the best in psychological fiction. The game might be heavy on action, but as far psychedelic storytelling goes, Alan Wake is one of the most cinematic takes on psychological horror we’ve seen. We’re still holding out for a sequel.

Eternal Darkness: Sanity’s Requiem

Eternal Darkness Silicon Knights, Nintendo

Eternal Darkness might be a little dated, first appearing on the Nintendo Gamecube, but it’s the only game on the list that messes with mind of the players directly. Depending on the severity of your character’s in-game insanity at any given time, the game will decide to switch off your game’s screen, delete your save file, or begin purposefully glitching out. Eternal Darkness might genuinely make the player question their own sanity after playing the game too long.

Deadly Premonition

Deadly Premonition Access games, Rising Star Games

Basically Twin Peaks the video game, Deadly Premontion is the mad brainchild of Japanese auteur SWERY65. The original prototype was perhaps too much like Twin Peaks to be legally comfortable, but the revised Deadly Premonition is no straight ripoff. Taking place in the fictional Northwestern town of Greenvale, the game stars FBI special agent York as he tries to pin down a supernatural serial killer. With a colorful cast of characters, one of the most unique open sandboxes to play in, and a story that quickly goes from quirky to dark, Deadly Premonition deserves every bit of praise lavished onto this cult favorite.

Dead Space 2

Dead Space 2 Visceral Games, Electronic Arts

Dead Space 2’s smartest move was to give its protagonist, Isaac Clarke, a voice. Delving into the head of the traumatized protagonist from the first Dead Space game, the sequel maintained its aggressive pacing by having Isaac deal with psychotic hallucinations of his death multiple times throughout the game. What makes them successful is how seamlessly they happen in-game, throwing into question what is real and what is being imagined by a clearly psychotic protagonist.

Siren: Blood Curse

Siren: Blood Curse Sony Interactive Entertainment

Siren: Blood Curse is an exercise in pure masochism. Utilizing a hide-and-seek mechanic that forces players to hide from the darkest nightmares of Japanese horror tropes including pale ghosts, and bloody spectors, Siren keeps players a throw’s difference from the most terrifying images ever generated on screen. Siren is downright nightmarish from a visual standpoint, but the trauma of having to hide so close to the terror, will last a lifetime.

Until Dawn

Until Dawn Supermassive Games

Until Dawn became a surprise hit, taking the classic slasher horror formula and turning it into a decidedly meta horror game. Relying on equal parts dread and camp, the best bits of the game involved sitting in a psychiatric session with your therapist (played by Peter Stromare!) answering questions for a psyche evaluation. You answers will determine which of the many multiple endings you’ll encounter at the end. Sometimes silly, often thrilling, Until Dawn is genuinely fun to play. That’s more than I can say for some of the other games on this list, which, while fun, are often emotionally taxing.

Yume Nikki

Yume Nikki Kikiyama

A free-to-play, independent game from Japan, Yume Nikki is a psychotic take on the Legend of Zelda adventure game. Top-down and pixelated, Yume Nikki stars a young Hikikimori (an introvert who chooses not to leave their room. Think Agoraphobia for a like approximation). Refusing to venture outside the confines of her apartment, she instead chooses to delve into her surreal, Lynchian dreams. Mostly dialogue-free, Yume Nikki relies on beautifully rendered imagery that is both surreal and disturbing. Don’t expect much help on how to finish, Yume Nikki plays more like a free-form adventure game with no clear context, but loads of atmosphere.

Silent Hill 4

Silent Hill 4 Konami, Team Silent

Really, any game in the Silent Hill series could make it on this list. Silent Hill 4 is the often under appreciated entry into the series despite being made by the original Team Silent developers in charge of the first three games. Tackling similar themes about social anxiety and societal withdrawal as Yume Nikki, Silent Hill 4 tackles some interesting subject matters like voyeurism as a sexual fetish. While not the most polished game in the series, Silent Hill 4 is arguably the most domestic, taking place entirely in a supernatural apartment room. The anxieties tackled by this game hit close to home, because most of the anxieties are born from being cooped up inside too long. You shouldn’t play all the games on this list without a couple breaks in between.