In cinematic terms, psychological horror prioritises mental anguish over physical peril. The narrative often centers on a protagonist whose perception is distorted, creating a sense of isolation. Visual cues—such as dim lighting, claustrophobic framing, and muted colors—support the atmosphere, while sound design leverages whispers, static, and silence to amplify anxiety. The genre blurs reality and imagination, leaving audiences to question what is truly happening.

The subgenre emerged in the late 1960s, with early examples such as Roman Polanski’s Repulsion and Nicolas Roeg’s Don’t Look Now, which emphasized psychological dread over visible monsters. Modern entries like The Babadook and Hereditary continue this tradition, employing ambiguous storytelling to explore trauma, guilt, and identity. By confronting internal fears, psychological horror offers a reflective lens on human vulnerability, making it a staple of arthouse and mainstream cinema alike.