Haven't really played a game that's able to so effectively pile on the stress in the way this one does. Design choices on top of design choices that seem perfectly hand crafted to interact with one another in such a way that you're almost never able to feel fully comfortable with anything you do, all of it working near-flawlessly in this approach, even when your first playthrough is on one of the easier difficulties. Basically what I'm saying is that this is a borderline magical game with how well it accomplishes almost everything it sets out to do with basically every decision made being one that further contributes to the experience as a whole in a positive way. With this said, the way that the game's player hostility feels is rather interesting, since despite how unforgiving it often is, there's an underlying element of the game still wanting to push you towards success, even if it's one that can often be hard to see, at least on the first few difficulties. It's a cool dynamic because it never really feels like you hit a point where your progress is severely hindered unless you play really terribly, it just always feels like everything is going wrong and you're able to only barely scrape by, making for a really effective experience with how you always feel on the backfoot.
The level design stands out to me as a really high point, with the mansion being borderline magical with how it plays out, being as small as it is while still expanding outwards in such a way that the amount you have left to do feels almost intimidating. The mix of tight corridors and more expansive rooms makes for a nice balance in how it feels like you're expected to deal with enemies, giving you enough opportunities to easily kite around while still providing those moments where you either feel forced to precariously bait out grabs to run around or sacrifice some of your hp to take a hit while trying to escape. This works well with the tank controls providing just enough imprecision to your movement to make the former option feel like a real risk to take, often leading to the 2nd outcome anyway, further making you carefully consider your options when the only way to get past the situation without using any resources not only will be quite difficult, but will also most likely lead to you having to do this in the same location repeatedly due to backtracking, which could ultimately lead to a worse outcome than just spending some resources to destroy what's in your path and prevent the issue from constantly resurfacing.
This type of decision making reaches its peak with the entire crimson head mechanic however, straight up being one of the greatest bits of game design I've seen with how much it's able to transform the feeling of navigation. Because of these, the idea of not killing a certain enemy becomes just as interesting as killing them, due to having to take into account how much kerosene is left lying around making it that you're having to expend a lot if you want to stop the crimson heads from appearing, not just with raw items, but also with inventory space, since if you want to make full use of this mechanic, it'll cost you either one or two inventory slots, depending on the character, or force you to backtrack constantly, either way feeling like quite an unfavourable, yet necessary outcome at points. I also feel like this works in forcing the player to heavily consider their surroundings and the layout of the mansion, since there are so many factors at play that are vital to keep in mind to avoid wasting a lot of what you have later down the line, since as it is, most interactions with an enemy can already feel extremely costly without a bit of luck on your side.
While this gameplay experience definitely settles down a bit once the player leaves the mansion, the atmosphere does more than enough to make up for it, while also still keeping a decent amount of this feeling of dwindling resources to go along with it. The art direction and camera angles particularly do a great job at this, especially with how breathtaking a lot of the backgrounds are, with the amount of movement that takes place in them despite being entirely pre-rendered being downright mindblowing. Basically every room is rich with detail, with this constant theme of decaying grandiosity pervading everything, whether you're exploring a mansion, a garden, or a lab, and I feel like it adds a lot to the weight of the situation while also leaning into a fantastic sense of mystery that slowly unravels as you discover more of the dark secrets of your setting. The camera angles are definitely a strong point for contributing to a sense of horror with the way it often feels like the cameraman put good money on the zombies killing you and wants to rig things in any way possible.
If you're not careful you will be hit by zombies around a corner that you couldn't see because of how everything is positioned, but due to how you already have a ton of stress put on you from all the other interactions that have eaten away at your resources, it's not like you can afford to try preemptively make the first move in case you're wrong and have just wasted even more than you already feel like you've had to. Basically, while the game didn't actively scare me more than a couple of times, there were very few moments throughout that didn't feel extremely stressful in one way or another, with even a 2nd playthrough being able to evoke similar feelings given how much inventory management is centred around balancing survival and having key items to progress, an impressive feat considering I expected knowledge about where most things were to have made it an extremely smooth experience, even with a higher difficulty setting. Simply one of the greatest games of all time, the amount of game locations I like more than Spencer mansion is probably countable on one hand.