How Hellblade: Senua’s Sacrifice Became the Game’s Benchmark for Mental Illness Stories

And why help from the professional community is so important

Disclaimer: This article contains spoilers

Hellblade: Senua’s Sacrifice is a game created by Ninja Theory. And the plot is quite simple, the main character Senua is trying to find a way to save the soul of her lover from the Scandinavian hell of Helheim. But when the credits start to appear, you will see the name of the first person at the very top, and it is not the developer, but a professor of psychology Paul Fletcher. The fact is that the studio decided to raise the difficult topic of unstable mental health. And touching on it in all aspects of the game: from the plot, sound, design to some aspects of the gameplay. What came of it? Let’s figure it out!

Start of development

First of all, it’s worth mentioning that Ninja Theory, after creating a new alternative version of Devil May Cry, which was not very successful, wanted to take a bold and unexpected step. The studio decided to dive into indie waters, but with AAA ambitions. According to co-founder and project manager Tameem Antoniades, publishers would not want to invest in such an obscure game that they wanted to create.

Hellblade: Senua’s Sacrifice was supposed to be an indie game that could compete with high-end titles in terms of graphics, production design, and gameplay. And then there’s the psychotic protagonist. Obviously, that’s an incredibly difficult concept to pull off.

This is our first independent game, so we were lucky to be able to create a project that we have the freedom to creatively control. Without any restrictions, we wanted to make something unique and special, and that’s how we came across this topic Dominic Matthews, Hellblade Lead Developer at Ninja Theory

Of course, it would have been possible to go the route of caricature characters with psychological problems, but the developers chose a completely different approach. Ninja Theory decided to show psychosis from the perspective of the main character. And most importantly, they wanted to make the depiction of the disease in Hellblade scientifically accurate, thanks, to which players will be able to better understand and even feel the state of psychosis.

Plato’s Cave: Seeing the Shadows of Reality

We are so far removed from objective reality that the whole concept, at least from a human perspective, is practically meaningless. It is essentially an allegory of Plato’s Cave and I wanted to explore that.

Tamim Antoniades, co-founder and CEO of Ninja Theory

And initially, the idea of ​​exploring such a heavy subject didn’t seem all that difficult. Antoniades says he was simply fascinated by the topic, just as he was fascinated by Scandinavian aesthetics.

Exploration and gaming in one bottle?

The goal is set, but where to get the money for this daring experiment?

The answer is very unclear — what if we make not just a game, but a research project?

And here Ninja Theory was lucky, because the Wellcome Trust — an independent international charitable foundation that finances medical and biological research, gave them a grant of about 500 thousand dollars to develop the game.

The foundation has a team that supports entertainment and artistic projects that attract a wide audience to scientific topics, and Wellcome supported the Hellblade project.

Entertainment doesn’t always do a good job of covering mental health issues. But with Ninja Theory, we felt they were interested in approaching [mental health] in the right way, to be able to more authentically and sensitively portray the experience of psychosis in a way that wasn’t demeaning but was also engaging.

Dr Ian Dodge, co-CEO of Wellcome

And to pull it off, they needed a real professional to help them. That person was Professor Paul Fletcher, a psychiatrist at Cambridge University who specializes in psychosis.

Fletcher says he was drawn to psychosis when he was a medical student and worked with a patient who believed he was receiving messages on TV. Paul was fascinated by what could make someone have a completely different view of the world.

In 2013, he received an email out of the blue from Dominic Matthews asking for his collaboration.

Professor Paul Fletcher

Fletcher admits he had some initial reservations about the way mental illness is portrayed in video games. Paul was familiar with video games before Ninja Theory approached him — he played Red Dead Redemption when it came out — but he tries not to get too involved in them due to his busy academic life.

Once they met and Ninja Theory explained what they wanted to do, he was reluctant to agree. At first, Paul’s work with Ninja Theory was purely advisory: here’s what psychosis is, here’s where to find examples, and so on. But it quickly evolved into a broader scientific study around questions like what it means to have psychosis, what kind of people might experience it, is it always an illness, can it be caused by trauma, and so on.

A real collaborative research project had begun! Paul introduced the development team to some incredibly important organisations: Recovery College East and Peterborough NHS Foundation Trust (CPFT), which houses a group of people affected by mental illness. And the Voice Collective, a community of “voice listeners” — people who experience auditory hallucinations but don’t recognize the condition as an illness. All of this was made possible thanks to Fletcher’s help, funding from the Wellcome Trust, and the courage of the developers.

During the development of Hellblade, Antoniades and several members of his team personally interviewed patients suffering from psychosis and learned about their real-life experiences. The developers visited patients every two months with the game’s developments. They discussed and made adjustments. It was an ongoing collaboration.

A group of people with psychosis

Tamim says he found it difficult to emotionally separate himself from the people he was meeting. In one particular interview, Antoniades was talking to a teenage girl about the voices she was hearing.

We asked her if she could see the voice, and she said, yes, sometimes I can. And we asked if it looked real, alive, and if you were in a room with a bunch of people, how would you know who was fake? The ones with no eyes. It was a much more “unique” experience than we had imagined. Tamim Antoniades, co-founder and director of Ninja Theory

It was a moment that Antoniades remembers well — the moment when he realized the seriousness of the topic he intended to cover

Psychosis in the game’s plot

First, we need to answer the main question: what is psychosis?

The word “psychosis” is often misunderstood because there is confusion between the terms psychosis and psychopathy. Psychosis is a disconnect from reality. Psychopathy is a lack of empathy. Another misconception that society has about psychosis is that people who experience it are dangerous. This makes sense, because people with psychosis may scream and act in a scary way, but they are much more likely to be violently assaulted than they are to other people.

In very simple terms, psychosis is a symptomatic disconnect from the “real world” — whether that’s sight, sound, or other things that other people don’t perceive. Fletcher says that much of normal human experience is the result of receiving and contextualizing the signals we receive through our various senses. We all think we’re looking at reality as if it’s right there in front of us, but in reality, all we have are binary messages coming into our nerve endings. They are very complex and ambiguous, and we somehow assemble them into our model of the world. In this context, what actually happens most of the time is that our perception itself is a controlled hallucination. A person suffering from psychosis interprets these stimuli differently than most of us.

Suddenly you start noticing all these coincidences everywhere. Every time you move your head, the trees sway, and the idea that these things are connected can be psychosis. Sometimes there can be a change in how you perceive the world. Paul Fletcher, a psychiatrist at Cambridge University who specializes in psychosis

Moving on to the game, I will say that the plot is quite simple: the home of the main character named Senua was destroyed by Vikings. The invaders brutally killed her lover, and so she goes to look for him in Helheim. During the game, Senua catches visions and hears many voices. These are symptoms of what is now called psychosis.

The creators of Hellblade: Senua’s Sacrifice mixed the thorny topic of mental illness with an unusual presentation of the mythology of the Celts of the Orkney Islands and Vikings.

I think that many mythical journeys of the past were not necessarily just made-up stories, but were someone’s literal experiences. I think that fantasy, psychosis and mental suffering are inextricably linked. This is what led me to this topic Tamim Antoniades, co-founder and director of Ninja Theory

The game skillfully intertwines Senua’s psychosis and historical context. It is a dual narrative about a journey through Norse mythology and simultaneously experiencing her own past and internal problems of the main character. We learn the details of the mythology from Drut, a ghostly narrator and old friend. Senua always turns to him when she seems scared or confused.

After all, Hellblade takes place in a time and historical context where Senua’s mental illness is seen as a curse.

Through visions, players learn that much of Senua’s life has been marked by social stigma, due to society’s reaction to her “curse.” Senua’s father appears as one of many voices in her mind as the game progresses, constantly belittling her and imposing the idea of ​​a curse on her. This is compounded by the fact that Senua’s mother also suffered from hallucinations in life, and was burned alive by her father.

Senua’s psychosis has made her an outcast, and her father has prevented her from leaving the house or interacting with others. These themes of isolation and stigma speak to the ever-present and timeless nature of social rejection of those who face mental illness today.

Another major theme in Hellblade is the loss of a loved one. One day, the girl was finally able to get out of isolation and met the warrior Dillion, who accepted her as she was and loved her with all his heart. But the happiness did not last long. The village was attacked by Vikings and he was killed.

Celtic mythology assigns the head the role of the receptacle of the spirit. Therefore, this part of the body is necessary for the liberation of Dillion from the world of the goddess Hel

At the beginning of the game, we may not fully understand what has driven Senua to go to Helheim, but we do understand that she wants to save her lover. Only later does it become clear that this entire journey is likely a psychic response to a traumatic event.

The love of her life was hanged by the Blood Eagle. Legend has it that this was the worst Viking death sentence. The ribs on the side of the victim were broken with an axe, then the skin and muscle opposite each rib were cut and the ribs were pulled out. Then, through wider cuts in the upper back, the lungs were taken out and placed under the ribs; thus, the dying man’s breath, rising and falling on the ribs, represented the wings of a bird that gave the execution its name, and any cry during the execution will result in your soul going to Hel, or hell. Dillion was the only person who truly believed and supported her, and so, seeing such a death, the psychosis entered an extremely acute form.

Blood Eagle

In other words, we begin to understand that the journey we are taking with Senua is a journey into her own psyche — a journey into what is currently Senua’s reality.

This is all spoiler territory, but the ending doesn’t change the fact that Dillion is dead, that she will hear voices that will always be there for her. But she can let go of the suffering that comes from the idea that it’s her fault. This idea of ​​a curse, a reality that her father put in her head. Dillion almost destroyed that idea. He had a competing idea: that she wasn’t cursed and she wasn’t guilty. When Dillion died, her father’s reality took over and dominated her.

The important thing that some people got wrong, and I don’t know why they interpreted it that way, is that in the end, she was somehow cured. She definitely wasn’t cured in the sense that her psychosis went away.

Tameem Antoniades, co-founder and CEO of Ninja Theory

This is illustrated perfectly in a moment in the game where Senua experiences a flashback to a plague in her village. Insects buzz across the screen and the world is covered in a foul fog. We then see Dillion kneeling over his father’s body, who accuses Senua of bringing the plague to their village because of her curse. She spends the entire game feeling guilty about her loved one.

As is often the case with traumatic experiences, one of the most difficult but vital elements in opening the door to recovery is accepting what has happened. Senua finally accepts that her beloved has passed on to another world, and also accepts that her illness is not a curse, but simply a part of her perception of the world around her.

Implementation of psychosis in gameplay

Throughout Hellblade, numerous game mechanics illustrate the various possible symptoms of people suffering from psychosis. Visuals are often represented through hallucinations and altered reality. Moreover, various environmental puzzles are based on visual hallucinations and pareidolia, the detection and formation of seemingly illogical patterns.

Where a “healthy” person sees just a shadow, a person with psychosis will see a certain sign. It is this deviation in the brain that the game’s puzzles are based on.

Puzzles

This is based on research conducted by Paul Fletcher: in tests where you look at a random drawing and ask people if they can see a hidden image or something in it, people who are predisposed to psychosis highlight these patterns much more often.

For example, Senua sees a locked gate with runes on it, after which she must find images of these runes for the gate to open. But runes can be hidden everywhere — in reflections or even in shadows. Sometimes Senua will have to go through magical arches that change reality. The entire world of the game is a reflection of the main character’s mind and is incredibly plastic and changeable. The game wants you to look at the world differently, for example, the face of Senua’s mother can be hidden in a waterfall or in rocks, a kind of collectible. Your brain automatically looks for people in non-human objects, which is a typical example of pareidolia.

Also, frequent deaths of Senua will lead to the loss of all progress. The fact is that with each loss, the mythical darkness will spread more and more from hand to head, bringing the heroine to a state in which she would finally lose her mind.

This mechanic of final death is a kind of harsh metaphor for the frequent suicides of people with psychosis. Also, unlike most games, Hellblade does not contain additional visual information for the player on the screen. There is no health bar, no mini-map. Due to the lack of a classic interface, in order to dodge or block in time, you need to listen to the voices that warn you of danger. This is done to fully immerse yourself in Senua’s story, to see the world as she sees it. The game often plays with you visually. This is very clearly seen in the fight with Fenrir, the guard dog of Helheim. You can easily be deprived of your sight or subjected to unpleasant psychotic-epileptic visions.

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The high level of graphic detail is worth mentioning separately. The actress’s face had to be made as lifelike as possible. Senua is the only character depicted with a full 3D model, dialogue, and facial expressions. This meant that the team had to focus all their efforts on making her as realistic and believable as possible. The motion capture technology did a 100% job. And this is despite the fact that the developers had a very small budget and they recorded the motion capture in their conference room.

Without publisher support and only the funds from the last project, we couldn’t hire a regular mo-cap studio and had to improvise. We often discussed whether we could make a studio in our conference room. Many insisted that it wouldn’t work, but we had no choice — we had to take a chance. One of our guys went to Ikea and bought some wardrobe bars, we got Vicon cameras… and in the end it all worked great! Dominic Matthews, Lead Developer of Hellblade from Ninja Theory

Senua is played by Melina Jurgens, who worked as a freelance video editor at Ninja Theory and is not a professional actress.

Melina Jurgens

But Jurgens was able to fully immerse herself in the role and was able to masterfully convey the full range of emotions during psychosis: fear, confusion and anger.

I had to cry real tears and scream my heart out, and it’s hard when people are watching you do it. Sometimes I’d just sit in the middle of the room for half an hour, thinking about really bad things and trying to cry Melina Jurgens

And with this new and powerful connection between gaming technology and mental illness, it goes beyond entertainment, simply allowing players to experience simulations of mental illness, to promoting mental health.

There have already been trials to help people with psychosis learn to control their voices through avatar therapy.

This involves a psychiatrist working with a patient by creating a computer simulation of his hallucinations and then training him to resist them.

Sound as the most important element of immersion in psychosis

The most incredible and truly groundbreaking aspect of Hellblade is how it presents sound. Throughout the game, the player hears a continuous chorus of voices in Senua’s mind. Using binaural 3D microphones, Ninja Theory was able to create a unique auditory hallucination experience. Binaural sound is sound recorded using two microphones to simulate a three-dimensional space. This method of recording uses a special system that replicates the anatomy of the human head, right down to the ears. This was personally studied by Dr. Charles Ferneyhough, a professor of psychology who studies auditory hallucinations.

Dr Charles Fernyhough

The use of these different sounds encourages the player to understand Senua’s internal struggle, but their use also acts as a mechanic within the game itself, providing information and warnings to players. These voices are present throughout the game, offering advice in many different ways, one second they’re sitting on your shoulder whispering ominous words in your ear, and the next they’re gently encouraging you

I’ve often heard that you can’t rely on sound as a primary interaction mechanism in games… but after the work we did on Hellblade, I don’t think I’ll ever agree with that. Sound is really important, it needs to be part of the experience Tamim Antoniades, co-founder and CEO of Ninja Theory

Заключение

Hellblade: Senua’s Sacrifice is a unique video game. It’s unlikely that the stars will align again and a similar experiment will be repeated. Only an expensive indie project with motion capture, realistic graphics and breakthrough sound could afford to go so far into the theme of psychosis and so far from entertainment.

A central design principle of Hellblade is that the story and characters must be underpinned by a deep understanding of the cognitive neuroscience of psychosis, to avoid simplistic or superficial representations.

In the ongoing development diaries kept by Ninja Theory staff and in the making-of documentary, Hellblade highlights the key role of mental health professionals, scientists, and people with mental health issues as advisors throughout the game’s development.

The official Hellblade and Ninja Theory websites provide resources where players can learn more about mental illness and potential places for people with mental illness to seek help. Since the game’s release, dozens of spin-off projects have emerged, from the Senua Scholarship in partnership with the charity Head to Toe, which allows one student to be trained each year to become a mental health tutor, to the Insight Project, which aims to help people with mental health issues through games.

The main success of Hellblade: Senua’s Sacrifice is not that the game has received over 67 awards, including 5 BAFTA awards, but that Ninja Theory was able to create a mass project in which players come to an intuitive understanding of the nature of different perceptions of the world by people, which gives rise to a powerful sense of empathy and, most importantly, an understanding of psychosis.

A few years ago I had a psychotic break. My brother never understood me. One day he said he was ashamed of me. After beating the game he turned to me and said he was sorry for what he said. You conveyed the message I couldn’t. Letter from a Ninja Theory player