If you take nothing else from this review, Lost in Vivo is a meticulously crafted survival horror that emulates the old guard of the genre, like SILENT HILL and the original Resident Evil titles. You pick your way through decrepit and frequently disturbing locations, finding ammunition, weapons, and strangely penned notes or old cassette tapes. What astounds me about Lost in Vivo is that, even after playing who knows how many other horror titles of the classic genre, is that I can still be frightened by it. It's a genuinely affecting game, with the primary theme of claustrophobia crafted so well that it becomes hard to want to push forward into new tunnels.

The game's quest to save your dog drives you ever deeper into labyrinthian tunnels. Horror design is used and subverted constantly. There are so many clever tricks that I wish I could discuss more in this review, but if I did, it would spoil the game's frequent scares. One minor one I liked was the fact that the map you could pick up was old or incorrect - it helped maybe 75% of the time, but certain areas had to be charted manually, adding to a sense that you were stepping into an unknown or liminal space.

Lost in Vivo has impressive enemy designs that stay frightening even after multiple encounters with them. They are all kinds of grungy and disturbing - a freaky ghost girl with extra legs and a grotesque face that you can't even bear to look at is one. A creature of flesh that stalks you indiscriminately through a storage facility is another. The game also uses its opening sequence to build towards the most effective jumpscare I've ever experienced in my life. I genuinely reacted without conscious thought, smashed the left mouse button, and leapt into the air. I've never been quite so viscerally frightened by a game like that, and I loved it. It doesn't rely on scripted elements to achieve its horror so much as allows you to stumble into the horror yourself.

So the game is fun to play, clever, and fiendishly scary at points. The main let-down, sadly, is the game's story. While the individual elements are quite cool as you piece together the context behind the game's various stages, and there is a fantastically well-done bit in the middle of the game about body image, there is very little to ground us in the character otherwise. So we're almost playing as a self-insert, but I feel that some additional grounding would have helped (i.e. as with a character like James Sunderland from SH2, who you can gain contextual information about the world from). Things were a little too muddy to connect with, so while this was fun to piece together the dots outside of the game, I just wish the story were a little stronger, a bit more defined.

This is not to say that Lost in Vivo is all of a sudden "not worth playing". Because it very much is. It is a horror game that understands the importance of the "game" part. It's not just a walking simulator with scripted jumpscares, or trite setpieces. No, it's a game that forces the player to confront the nightmares, to emerge a stronger person for it. Lost in Vivo is a game about bravery, about finding the strength to go on in the darkest places. It is a marvelously effective horror game, and one that will stay with me for a very, very long time.