The game Hellblade picked up five awards at the 2018 Bafta Games Awards, including best British Game, and follows the story of Senua, a traumatised Celtic warrior who is on a quest to save her lover’s soul from the underworld. Senua experiences frequent hallucinations and delusions during her journey, all symptoms of psychosis – a condition that the game’s developers Ninja Theory were keen to portray as accurately as possible.


Hellblade has received funding from the Wellcome Trust, and its creators have been working closely with Prof Paul Fletcher (PF), a neuroscientist and psychosis expert at the University of Cambridge. We spoke to Fletcher and Hellblade’s creative director Tameem Antoniades (TA) about how they went about representing mental illness onscreen.

Who is Senua and what is her story?

TA: Senua is a Celtic warrior from the late 8th Century whose Orkney homeland has been invaded by the Vikings. They’ve sacrificed her lover to the Norse gods and so she sets off on a quest to Hel, the Viking underworld, to retrieve his soul and lay him to rest. During the game, Senua experiences visions, voices and delusional beliefs – symptoms of what we now call psychosis.

How does Senua’s psychosis fit in with her backstory?

PF: To some extent, Senua has always seen the world differently from others, but the idea is that the profound trauma she’s experienced has triggered these symptoms. Because of her experiences, Senua has lost touch with the reality of those around her. That’s really the formal definition of psychosis. We’re all more or less prone to psychosis, depending on how we view and experience the world, but trauma can often act as a trigger.
How did the latest research and thinking around psychosis feed into the game’s development?

PF: We wanted to represent symptoms such as voice-hearing and hallucinations, but also to go below the surface and explore what we know about normal perception. We all tend to think that we have a clear representation of reality, but most of the time our minds are actually making it up, deciding what should be there rather than what is there. It’s a kind of controlled hallucination. This idea, too, is deeply embedded in the game: the player becomes sensitive to the visual clues and illusions around them as they progress through the world.

Psychosis used to be thought of as this extreme phenomenon that was completely separate from the normal experience of the world. But we are coming to realise that there’s a continuum, and all of us are prone to becoming separate from reality. Hopefully this game will help to demonstrate that.

How did you represent such internal and subjective experiences onscreen?

TA: Throughout her journey, Senua hears her internal chatter as voices, and so the player hears these too. The voices take on different characters, which are sometimes harsh and berating, sometimes friendly and helpful. We worked closely with a group of voice-hearers to try and get these sounding as realistic as possible.

She also experiences flashbacks as visual hallucinations, and there are subtle changes in the game’s environment as she moves around, based on people’s descriptions of how delusions manifest in real life. So trees might shift position slightly, or you might see a hidden pattern in a shadow or a reflection. It’s these patterns that the player needs to find in order to progress in the game.

What else do you hope to achieve with the game?

TA: First and foremost, it was about creating a compelling, adult, fantasy game. But the deeper we’ve gone into development, the more we’ve seen that there’s also an opportunity to raise awareness of psychosis. For my part, I’ve learnt that people can experience hallucinations and delusional beliefs without it being a problem – the illness comes when those experiences cause suffering. Often the recovery is not about curing yourself of hallucinations, but finding ways to live with them. That was a revelation to me.

PF: It’s been refreshing to see a representation of psychosis in which the person isn’t just a sort of passive receptacle for madness. Senua is the hero of her own story, trying to make sense of her experiences and work her way through them – that’s incredibly de-stigmatising. In representations of mental illness onscreen, you usually have the illness first, and then a two-dimensional character attached to that. In this case, the character is fully-formed, and they are not defined by their condition. It’s been exciting to see Senua received so positively by those who have lived with experiences of psychosis. The portrayal of Senua’s psychosis is based on solid science

Hellblade: Senua’s Sacrifice is out now on PS4, Xbox and PC (£24.99, Ninja Theory)
Hellblade: Senua’s Sacrifice © Ninja Theory


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James Lloyd
James LloydStaff writer, BBC Science Focus

James is staff writer at BBC Science Focus magazine. He especially enjoys writing about wellbeing and psychology.