So, about the doctor.

[Mr. Bear]

How much of him was real and how much was fantasy?

At first he sounds all logical while analyzing you, but then he shifts into being a little bit too emotionally invested which makes me think that the doctor was real at first, but at some point he became a character from the mind of the protagonist.

[Hook Master]

I think he was real the entire time, he just knew who he was talking to. He starts the game addressing a third party, merely recording the interactions he had with the protagonist. As he slips into more detailed analysis of her mind, he switches to addressing the character directly, which shows his methods when talking to a patient. He wouldn't be addressing anyone but his patient in the manner he does, and knows he's talking to someone who's protecting their true self with a psychopathic killing machine that has committed massacres in the past. The doctor uses fantastical and verbose language to appeal to the monstrous side of our main character (which is what we play as)

Language like "my child" in the final monologue can be a double meaning, painting the doctor as an almost holy figure of light AND appealing to the main character's lack of true, loving parents.

The doctor isn't a figment of her imagination, he's just good at what he does.


At least, this is what I took from it after reading all 82 pages, I could be dead wrong should the dev overule anything I've said here.

[Mr. Bear]

Originally posted by StaticSpark:

I think he was real the entire time, he just knew who he was talking to. He starts the game addressing a third party, merely recording the interactions he had with the protagonist. As he slips into more detailed analysis of her mind, he switches to addressing the character directly, which shows his methods when talking to a patient. He wouldn't be addressing anyone but his patient in the manner he does, and knows he's talking to someone who's protecting their true self with a psychopathic killing machine that has committed massacres in the past. The doctor uses fantastical and verbose language to appeal to the monstrous side of our main character (which is what we play as)

Language like "my child" in the final monologue can be a double meaning, painting the doctor as an almost holy figure of light AND appealing to the main character's lack of true, loving parents.

The doctor isn't a figment of her imagination, he's just good at what he does.


At least, this is what I took from it after reading all 82 pages, I could be dead wrong should the dev overule anything I've said here.

I won't deny the fact that the doctor is implied to be good at what he does, or at least he's unconventional. I think one of the pages mentions how he was called for his particular way of approaching things.

He might be so good in fact that he tricked me as a player into thinking he was part of the protagonist's imagination. lmao.

[Hook Master]

Originally posted by Mr. Bear:

He might be so good in fact that he tricked me as a player into thinking he was part of the protagonist's imagination. lmao.

Well, you may be onto something there. Throughout the game we see the mist face man who can help or hurt your run. I believe this is the doctor represented in the protagonist's mind. This and the final monologue being audible in her brain make me think that you may be right to an extent. I believe that over time the therapy sessions are helping her and her brain is holding on to these memories. The documents on the table are most likely transcripts, meaning she's heard them while talking directly to him. The final lines may just be something he said at their last session, or it may also not be real at all. The doctor is part of her mind as it's his words she's holding onto when she falls asleep.

[Mr. Bear]

Originally posted by StaticSpark:

Originally posted by Mr. Bear:

He might be so good in fact that he tricked me as a player into thinking he was part of the protagonist's imagination. lmao.

Well, you may be onto something there. Throughout the game we see the mist face man who can help or hurt your run. I believe this is the doctor represented in the protagonist's mind. This and the final monologue being audible in her brain make me think that you may be right to an extent. I believe that over time the therapy sessions are helping her and her brain is holding on to these memories. The documents on the table are most likely transcripts, meaning she's heard them while talking directly to him. The final lines may just be something he said at their last session, or it may also not be real at all. The doctor is part of her mind as it's his words she's holding onto when she falls asleep.

I think the documents themselves on the table are more for gameplay purpose than for the plots because this game doesn't have cutscenes, therefore, it is a way to directly communicate a plot to us.

If they are transcripts in the context of the game, it would be a bit weird to have one of the transcripts being a line of dots, as it is the case with the final note. But maybe they are, who knows...

[Julius Seizure]

I got the impression that the voice-acted documents were deliberately being sent by the Doctor to slowly reveal the true nature of his therapy to the personality he 'forged' in the Patient's mind, who I assume is meant to be the "Nightmare Reaper" the game is named after. Creating that personality is the 'unconventional method' he describes in the early documents, and he needed a way to guide it along the intended path he wanted his therapy to take without directly interacting with it due to the danger involved. So, he explains who the patient is and tries to develop a sense of sympathy in the Nightmare Reaper personality in the hopes that she will complete her mission of restoring the girl's sanity by giving up her power after slaughtering the Patient's inner demons.

He does this because he has no way to guarantee that the Nightmare Reaper will be as cooperative as he hopes, given that her predecessor became one of the same nightmares keeping the Patient's innocence and sanity locked away. My takeaway was that the previous iteration of the Reaper didn't have the context of those documents and enjoyed her power too much to give it up when she had to, or perhaps didn't even understand what her objective was in the first place. Of course, it's possible the Doctor's placing a little too much faith in his methods given how easy it is for the Reaper to betray her purpose at the last second, but that's up to player discretion anyway.

[[N] Night Gal]

I have another assumption, that might be true in some points
The notes "we" can read are not real and the hospital "we" walk true isn't either.
By this I mean, that it is a sort of gateway between real world and her Nightmare world.
The hospital might or might not have the layout of the real one, but the rooms represent her path to remembering the real world. We gradually open new areas that tell stories/memories of her past alongside Doctor's treatment. The papers we see might be memories materialised from subconsciously hearing Doctor talking about her case.

Then, at the end, she is prepared to set herself free from the monstrosities she has faced and we get the choice at the end - either save herself or keep the control.

Where I have second theory - if the hospital we can walk through is constructed in her head and notes are organised memories, choosing to remain in control might mean rejecting the treatment and falling back on stage one, getting herself to fight the horrors again until she is again strong enough to lift her past.
Then, by playing again, we go through the "bad" ending again and again and choosing "good" ending and not playing game anymore we finished her Nightmare Reaper persona.