When you first switch on Silent Hill 4: The Room, a title card appears. It reads: "Some parts of this game may be considered violent or cruel."

Uh, yeah. Some parts. Those between the beginning and the end, for example. If you have any of the spirit of the season in you, this will bring a nervous smile to your face. Halloween is just a few days away; naturally you are looking for a good scare. You have found one. Several, really, for Silent Hill 4 is an unrelenting parade of the horrific and the unsettling. It is angry, violent, and, yes, cruel. It is for grownups, and only for those grownups with strong stomachs and robust mental health and sunny dispositions. It is also one of the best games of the year.

Silent Hill 4 treads familiar ground, which you would expect given the large digit in its title. What is surprising is that anything this familiar can have such power to terrify.

Like all the games that came before it, The Room begins with the plight of a lone protagonist. This one is named Henry Townshend. He lives in apartment #302 of South Ashfield Heights. That is all we ever really learn about him, except that he is into photography and that he does not like to tuck in his shirt. (Then again, it is 2004 and nobody likes to tuck in shirts anymore.)

As the action begins, we take control of Henry in first-person perspective. We stagger around apartment #302, blinking at the pictures on the wall but not quite recognizing them. We drift into the kitchen, where the tiles and the countertops are smeared with blood. We pause in the living room, stopping to wonder whose furniture this is. We glance at the front door. We see that it is covered with chains and locks. Then something -- a horrible, nameless something -- melts out of the wall. It has a face and arms, but its body is a convulsive, writhing horror. Its head shudders violently. It claws and crawls its way toward us, and we are powerless to move.

Then we wake up. Yes, it was just a dream. Apartment #302 is not all smeared with blood after all. We do recognize the photos. The couch and the chair belong to us. But the chains are still on the door. We still cannot leave. Our neighbours still don't hear us when we yell for their help. A crashing sound comes from the bathroom. We go to look. The chattering voices of small children echo against the tile. There is a hole in the wall, just large enough for us to crawl into. And because there is no other way out, we swallow our fear and hoist ourselves in.

At the end of a long tunnel, we find a disused subway station, filled with the floating ghosts of dozens of dead passengers. We find filthy, wet-skinned dogs with metre-long lizard tounges that drag on the ground. They are aggressive, leaping at us and trying to tear out our throats. The same tunnel brings us back to apartment #302, where we catch our breath. We climb back into the hole.

It takes us into a swampy forest, where tree roots look like arms trying climb out of shallow graves. It takes us to a rusted, ancient prison, where two-headed beasts run at us on feet that look like hands, their faces the unblinking masks of human newborns. We swat clumsily at them with a broken chunk of pipe, hoping to hold them off at least long enough for us to find an unlocked door. We find a basement torture chamber. We feel certain that many, many people have lost their lives in this place. The scraping wet sound of sharp metal on flesh follows us everywhere.

Back in apartment #302, we look out over the city skyline. We see a pink bunny floating in the distance. We see pink bunnies walking down the steps to the subway. We realize we are so rattled we can barely breathe.

Because this is Silent Hill, there is a nightmarish hospital. There are wheelchairs with minds of their own. There are many, many decrepit public washrooms. They are fetid places, full of blood and ooze and gut-wrenching stink. Even though they are just pixels on a screen, you can smell them.

No one will blame you if you decide you would rather be a princess for Halloween instead.