What do you think of when you think of a woman in pain? There are no tidy universalisms here, but for many of us, even most of us, pain is private and domestic. You could think of a mother shouldering burdens alone while her husband is at work. The father in the waiting room while the mother screams with strangers. A woman going to the doctor about an ache, only for him to tell her to lose weight and deny the problem is even happening.All these things are simple clichés--tropes stolen from life and television. When Silent Hill f conjures a woman's private pain, it is with cutting specificity. In one of the most grisly moments of body horror in video games this year (or ever, really), protagonist Hinako turns into an emblem of her own sorrow, her own compliance, her own screaming rage.Spoilers follow.Like its predecessors, Silent Hill f takes place both in a "real world," covered in fog and invaded by twisted human forms, and in an "other world," which distorts the real. Unlike its predecessors, the gap between the real world and the other world is clearly delineated. Whenever Hinako falls unconscious, she wakes up in the other world. At first, it would seem that her experiences in her hometown are "real" and her time in the other world, marked with Shinto monuments and dream mansions suspended over water, is fake. However, the game's first ending calls this binary into question. The sequence’s final moments reveal Hinako to be much older now than her appearance would suggest. The girl we've been playing the whole time is almost a psychic scream, a representation of the younger Hinako whose dreams were betrayed by the older.What was that betrayal? Nothing but the rite promised to all women: marriage. Her parents have promised Hinako to a suitor to settle a family debt. The real world represents how the arrangement slowly strips away her connections to her friends, her family, and herself . The other world stands in for the process of her courtship. The process of playing Silent Hill f, at least in an initial playthrough, is the process of tearing Hinako apart along those axes. She is both victim and thief. One version of her weds the thing that drains the other's world of life.In the other world, a mysterious man only called Fox Mask courts Hinako. After a few preliminary trials, including ritualistic killings of her close friends, Hinako descends a staircase to yet another set of ritual grounds. At each site, a new torture awaits. First, Hinako saws off her own arm, then cultists brand her back, and finally, they slice a portion of her face off and replace it with a fox mask of her own. It is easy enough, though gruesome, to write it out. But the visual presentation is grueling.Before each ritual, the fox cult display the tools of their torture. Then, they go about their work. The camera work is unsparring, but off center. We see a medium close-up of Hinako's face as she pulls the saw across her shoulder, or blood spilling between her feet as one cultist carves a knife into her face. There is a sense of witnessing, wanting to avert your eyes, but not being able to look away. Like all of Silent Hill f's cutscenes, there are no interactive elements. Here, that fact underlines how Hinako is treated as an object, which Fox Mask and the cultists chisel to their own liking.Outside of words of comfort and strength from Fox Mask, the cultists are totally silent as they conduct the rituals. They communicate their intent only through gesture and presentation. The effect is almost like a pantomime. These rituals are familiar to everyone present except Hinako. The camera frames her alone, in ordinary schoolgirl clothes, totally surrounded. She is ignorant; the cultists are her teachers. They cut their lessons on her body.Hinako's violent transformation rings out across the rest of the game. For one, it acts as the most profound distinction between the two Hinakos. While the student Hinako wields baseball bats, pipes, and if she is lucky, a kitchen knife in the real world, the other Hinako gains a magnificent, monstrous fox arm, a spiritual weapon that will never decay or break. The brand lets her open new doors, while the mask sees hidden paths. The more Hinako becomes a bride, the more power she gains.However, that power makes her more vulnerable. With each power, Hinako's "sanity" meter drains. Whether it is an accurate localization or not, I feel "sanity" does not accurately communicate how the mechanic works. One could also describe it as "will" or "resistance." Hinako's fox powers drain sanity and the regular food objects of the town restore it. It represents Hinako's willingness to give in to becoming a bride. The more Hinako embraces the fox, the more sanity she'll expend. The difference in how those mechanics impact the two different Hinakos makes an argument. Every time you use the arm, or regret its absence, you cannot help but think of Hinako's pain in acquiring it, of the tears of blood rolling down her cheeks.The ritual's horrifying power is something of a double-edged sword. In subsequent endings, the game turns redemptive. Fox Mask, actually a boy named Tsuneki Kotoyuki, is kind-hearted and well-meaning. Hinako reconciles her two selves. There aren't exactly any thematic problems with this. Fox Mask's good intentions are even a profound provocation. The system dehumanizes, however kind-hearted or well-meaning its agents are. Yet, Silent Hill f's ultimate run of boss fights and reconciliations can't help but feel hollow in the face of the game's prior violences.Still, it's hard to hold its deflating final ending, unlocked after a minimum of three complete runs, too much against Silent Hill f. Few games can claim to have any moments of such startling, unsettling power. Fewer still elaborate on those moments with intelligence and complexity. Silent Hill f does both and much more besides. It matters how much a game makes you feel. Each time Hinako bowed her head to harm, I felt such terror, revulsion, and aching, aching sadness. The feeling will stay with me long after the details of Silent Hill f are gone from my memory.This is part of our Best Of 2025 series looking back on highlights from the year. For more, check out our Best Of 2025 hub, personal favorite games of the year, and hidden gems of 2025.