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Perspectives Differ on How 'Hellblade' Handles Mental Illness

Our Critical Distance roundup for the month highlights the best criticism on 'Hellblade: Senua's Sacrifice'
All images courtesy Ninja Theory

There are certain games that seem to inspire a lot of critical discourse very quickly. This past month saw the release of one such title: Hellblade: Senua's Sacrifice. Hellblade explicitly portrays mental illness, even calling out Cambridge neuroscientist Paul Fletcher in its opening credits, and uses a number of cinematic and game design techniques to portray paranoia in a sympathetic manner.

This game has been particularly interesting to critics because of the ways that it plays with ambiguity about what is real and what is imaginary, something that is arguably well-suited to gaming, a medium that requires that we suspend disbelief and accept conceits that can seem absurd to people who are not familiar with the form.


There has been an increase in writing about games and psychology in the past few years, from not only psychologists who want to study the effects of gaming on the psyche but also activists who want to see gaming portray mental illness in a non-stigmatizing manner. As a curator of criticism it has been satisfying to see writers take on the topic with considerable skill and nuance. Here are some pieces that I found particularly enlightening.

Religion and Psychosis in Hellblade: Senua's Sacrifice

M. Joshua Cauller writes about how playing Hellblade requires a sympathetic suspension of certitude about the nature of reality, in order to help the protagonist deal with the world as she perceives it, whether or not her struggles are the result of paranoid delusions.

"I have no idea if this is all in her head, or if the game is expressing her spiritual reality. But she believes it to be true, so I have to walk with her through each of these disorienting puzzles."

Hellblade: Senua's Sacrifice - YouTube

Critique Quest describes the sound design choices that make Hellblade's malevolent forces feel physically invasive.

Mental Health in Video Games - HeavyEyed - YouTube

Heavy Eyed takes Hellblade as a starting point for an investigation into general media portrayals of characters' psychological wellbeing. This video shows examples of cinema that either demonize or glamorize mental illness, contrasting this against TV shows that give a closer insight into the experiences of people suffering from mental health problems, and then shows how, and why, video games have an even closer proximity to mental states and are better equipped to portray mental illness.


Game Review Hellblade's battle with mental illness is an agonizing story only games could tell - Game Review - The A.V. Club

Matt Gerardi argues that this effect can be attributed to particular qualities of gaming as a form, while recognizing that certain attempts to translate psychiatry into interactive narrative result in something that might seem contrived.

"This is a character study in a way only video games can pull off, throwing audiences into the mind of someone who is experiencing a psychotic break, making them see what they see, hear what they hear, and feel what they feel."

Two steps forward, three steps back: how Hellblade reinforces myths about mental illness - ZAM

Steven Scaife similarly finds much to applaud in Hellblade's portrayal of mental illness, but also identifies that its win-lose video game format limits its ability to do justice to the subject matter.

"Hellblade reinforces one of the most prevalent stigmas about mental illness: that its sufferers can just snap out of it if they really want to. It paves a road to recovery that can only be traversed by those who truly commit, the exact fantasy by which so many people misunderstand mental illness."

I haven't seen a game inspire quite this much applause, albeit tempered, for its ability to make you relate to a character's delusions in a sympathetic and pragmatic manner. There's much more to be said about how exactly this works, particularly as people explore a number of different reasons why they see gaming as the ideal medium for this story. I hope to read more on this, be it on big enthusiast websites, in academic journals, or on people's personal blogs.

This is a digest of criticism from around the web, curated and archived by Critical Distance. We produce weekly roundups of games criticism, as well as a monthly podcast interviewing critics, and a monthly "roundtable" feature that gives you the opportunity to respond to a writing prompt and have your work featured on the site. We've worked as a hub for games criticism for the past 7 years, and are supported by our community of readers.