“Turn back!” cries a voice. “She never listens”, mocks another one. “She must go on!” a third demands. The cacophony of voices reaches a crescendo as you stretch your arm toward the door. Your vision starts to blur. Swirly, dark shadows slithers across the landscape. The sky darkens. You open the door.
The Darkness subsides. “She’s not… dead”, whispers a surprised voice. You may yet be consumed by it, but you escaped this time.

Welcome to Hel
Hellblade: Senua’s Sacrifice follows Senua, an 8th century Orkney warrior who ventures into the Norse underworld, Hel, to liberate her lover Dillion’s soul from Hela, the Goddess of Death.
While on the surface it could be classified as a linear action adventure, Hellblade is significantly unlike most other games of its ilk. What sets it apart is its unwavering focus on living with psychosis.
This is not just an action adventure with mental disorder thrown in as an interesting gimmick. Senua’s mental state is the game’s raison d’être, and every facet of the game is deliberate, exploring and educating the player about living with severe mental disorders and hammering the main point that the greatest battles are fought in the mind. And I do mean every facet: Combat, exploration, puzzle solving, interface, visuals, camera, acting, art direction, music, ambient sounds, narrative, symbolism, even the lack of instructions or consistency in the interaction with the world – all serve the same purpose and adds to the game’s unflinching atmosphere and message.

Me, myself, and the rest
It’s a difficult game to review, though, because the more I explain, the more I ruin your experience. Part of Hellblade’s appeal is its mystery, not only narratively but also mechanically. Most games quickly teach the player what can and can’t be done in the game world. In Hellblade, the rules are never really explained and new elements are introduced throughout, synergizing with the weird world Senua lives in and has to make sense of. I therefore won’t explain much about mechanics or story, but instead focus on how the different parts of the game come together.
Perhaps the most striking aspect of the experience are the voices in your head. They are with you every step of the way, questioning you, ridiculing you, agonizing over your choices, even helping you. They are recorded binaurally, meaning that if you play with headphones – which is more or less mandatory in this game – it’s like having voices talking right next to you in real life, moving around in and outside your head.
Not only is the effect remarkable in itself and put to excellent use; the general sound design is one of the best in a game ever, right up there with the sound design of Mass Effect 3. In particular, the clear separation of the voices in your head from all the other sounds, such as during combat, is masterfully tuned.
The voice acting, too, is wonderful – in particular that of Senua and her voices. I cannot find words to describe the nuanced emotions conveyed by Senua’s varied monologues and panicked screams – you simply have to play the game to experience it.

Stunning art direction
One should be careful in focusing on “good graphics”, but in Hellblade, the technical possibilities of modern hardware really shines. It is gorgeous, sure, but more importantly, the visuals bring Senua’s twisted, strange world to life in a way that would not have been possible otherwise. And the art direction is simply unparalleled. The use of colors, lights, effects and more is central to conveying the experience of psychosis, and the “cutscenes” are worthy of an award-winning movie, every frame a painting.
Even the lack of a HUD is carefully chosen to support the rest of the game. You’ll find no highlighted enemies, minimaps, or button prompts. Instead, the voices are put to use as helpers. They bark and chatter angrily if you haven’t figured out that you must hold the Focus button – “Focus!” / “She must focus!” – and the deliberately claustrophobic combat camera works because the voices cry “Behind you!” if an enemy has snuck up on you.
The sound effects and music adds to the atmosphere, whether it’s the gurgling of amorphous enemies, ambient sounds to evoke dread as the Darkness slowly envelops you, or heart-pumping, drum-heavy combat music with viking voices chanting Norwegian-like lyrics about destroying everything.
It’s not only the presentational aspects that come together to support the game’s central theme; the narrative, too, pulls in the same direction. It’s full of symbolism you can try to decipher, but which is never in the way or in-your-face, and the immersive storytelling shows how the medium of games is uniquely suited to evoking empathy, which is crucial for this experience.
The goal is to have you experience Senua’s world; a living nightmare, where you don’t know what is real or not (or whether it really matters) and where you still feel vulnerable despite your sword, because the sword can’t save you from everything. The end result is an enlightening, sensitive, and highly believable experience. Experts as well as people with lived experience with psychosis has been involved in the development every step of the way, and comment that they are very happy with the process and the result.1

Labor of love
For all my praise, I don’t mean to say that the game is perfect. While the combat system is surprisingly deep, the game doesn’t teach you anything. If you want to figure out the workings of light and heavy attacks, timed blocking, double evading, and combos, not only do you you have to experiment yourself – you have to figure out that these features exist in the first place.
Furthermore, the game is not particularly accessible. There is no way around the combat, and you have to learn core aspects of it without any tutorial. If you have played a minimum of mechanically similar games before, it’s not that hard to discover enough to get you through the game, and the voices also help you by giving you hints both in and out of combat. But if you haven’t played any similar games, Hellblade might be a tough place to start.
What strikes me, though, is that none of these drawbacks are due to poor craftmanship. Hellblade is developer Ninja Theory’s boldest game yet – an independently developed and published title with AAA production values.2 It is of course not a labor of love, but it gives that impression – the indie love and caring shines through everywhere, and it is clear that all the aforementioned drawbacks are necessary sacrifices in order to create the experience Ninja Theory was after. In its current form, the game is probably too narrow to have been accepted by big publishers, and catering to their demands would likely have watered down what makes Hellblade what it is.

Conclusions
Hellblade: Senua’s Sacrifice is an experience I highly recommend.
The quality is thorough and consistent in a way I can’t remember to have seen before. All aspects of the game – voice acting, audio design, art direction, mechanics, narrative – are thoughtfully tuned to fulfill the developer’s vision of what kind of experience Hellblade should be.
Many have argued that Hellblade is one of the most important games ever, and I’m not here to argue it’s not. It is certainly the most sincere, sophisticated and consistent presentation of psychosis in any game I have seen.
Simply put, Hellblade: Senua’s Sacrifice shows what games can do as a mature, creative medium.
Final verdict
Hellblade: Senua’s Sacrifice uses the game medium’s unique empathic strengths fo deliver a thoughtful and exceptionally crafted experience.
After playing, I highly recommend you check out this video – a critical view on Hellblade by one who struggles with psychosis, voices, and hallucinations.↩
Wikipedia tells me this is called III (triple‑I).↩
Fully agree with your thoughts on this one. Though Hellblade have some areas for improvement, I’d consider this one of the most important games of the current console generation. A true masterpiece, but definitely not for everyone.