First things first, ahem:

SPOILER ALERT! SPOILER ALERT! SPOILER ALERT! SPOILER ALERT! SPOILER ALERT!

This guide is nothing but spoilers, so if you haven't beaten the game yet, then stop reading this guide and do so because I am not putting spoiler tags on anything.

Now onto the important stuff. This guide will be broken in 3 groups.

01: The pages you can read after each episode (There are 83, but only 82 are related to the story. 83 is just a note about how to access New Game+)

02: The Asylum Environment

03: Theories

Now the first two I'm only including what is actually factual and written. For three, it is all theory. Feel free to comment your theories and ideas! Now onto the story...

After completing each episode, a new page is added to the table that you can read.
*Because there is no actual date, I am going to say the events of this game begin on 17 Jul, 2019 (The Early Access release date) until I get an actual date.

PAGE_1
I HAD BEEN ANTICIPATING THE FIRST MEETING WITH THE PATIENT WITH A BLEND OF DOUBT AND EXCITEMENT. WHAT HAD I GOTTEN MYSELF INTO?

PAGE_2
THE PREVIOUS PHYSICIAN HAD FAILED TO IMPROVE THE PATIENT'S CONDITION AND HAD MANAGED TO GET RID OF HER FOR DUBIOUS REASONS.

PAGE_3
I SUSPECT THAT THE PATIENT WAS PUT INTO MY CARE AS SOME KIND OF LAST RESORT.

PAGE_4
I'VE BEEN CALLED "UNCONVENTIONAL" BY SOME AND HAVE A REPUTATION OF TAKING ON THESE IMPOSSIBLE CASES.

PAGE_5
I INTERALIZE THIS AS A POINT OF PRIDE. SO MANY MODERN PRACTITIONERS HAVE NO PASSION FOR THEIR WORK.

PAGE_6
THE FIRST TIME I SAW THE PATIENT, I MUST ADMIT THAT I WAS UNPREPARED, SEEING HER IN PERSON WAS A DIFFERENT EXPERIENCE THAN SEEING PICTURES IN HER FILE

PAGE_7
I WOULD LEARN LATER THAT IN THIS CASE, APPEARANCES WERE DEVILISHLY DECEITFUL.

PAGE_8
SHE HAD BEEN TRANSFERRED TO OUR ESTABLISHMENT EARLY ONE PEACEFUL SUMMER MORNING.

PAGE_9
SHE WAS SURROUNDED BY SEVERAL LAWMEN AND WE FIRST HAD TO HAVE A FULL STAFF MEETING ABOUT SAFETY WHEN DEALING WITH THE PATIENT.

PAGE_10
WE'VE HAD TO DEAL WITH VIOLENT INDIVIDUALS DAILY, BUT THEY SEEMED TO THINK SHE WAS UNNATURALLY UNPREDICTABLE.

PAGE_11
I MUST ADMIT THAT I FOUND ALL OF THIS STIMULATING AND I HAD CONFIDENCE IN OUR PROCESS, SO DIDN'T SEE CAUSE FOR CONCERN.

PAGE_12
I BELIEVE THAT SOME ON THE TEAM WERE MORE SHAKEN BY ALL THIS, BUT I SUSPECT THAT EVERYTHING WILL GO BACK TO NORMAL ONCE THE ROUTINE SETS IN.

PAGE_13
WE HOUSED THE PATIENT IN A SECURE ROOM ON THE SECOND FLOOR BEHIND SEVERAL LOCKED GATES.

PAGE_14
IT WOULD'VE REQUIRED MULTIPLE SYSTEM FAILURES AT THE SAME TIME FOR HER TO ESCAPE CONTAINMENT.

PAGE_15
THIS FIRST DAY WAS UNEVENTFUL OVERALL AND THE PATIENT HAD BEEN RATHER PASSIVE, WE WOULD SOON START CONSULTATIONS.

PAGE_16
AFTER A GLANCE THROUGH HER FILE, EVEN A LAYMAN WOULDN'T BEEN SURPRISED BY HOW THE PATIENT GOT INTO THIS SITUATION.

PAGE_17
IT HAD BEEN IN THE NEWS FOR ABOUT A WEEK BEFORE THE NEXT GRUESOME STORY TOOK ITS PLACE.

PAGE_18
THE PATIENT HAD BEEN LINKED TO A STRING OF MURDERS AND THE INSANITY PLEA HAD BEEN TOO CLEAR TO DENY.

PAGE_19
FOR A PERSON TO MORPHY INTO SUCH A... MONSTER, DEEP CHILDHOOD HAD TO BE THE REASON.

PAGE_20
AFTER LEARNING ABOUT THE FAMILY, IT SEEMED SURPRISING TO ME THAT THE PATIENT DIDN'T TURN OUT WORSE.

PAGE_21
HER PARENTS WERE MORE AKIN TO BEASTS THAN MEN, ESPECIALLY THE MOTHER.

PAGE_22
THE FATHER WAS YOUR TYPICAL PRISON FREQUENT FLYER, WHICH WAS A BLESSING, IN A WAY, SINCE HE WAS MOSTLY AWAY FROM HIS DAUGHTER.

PAGE_23
LIKE THE MOTHER, HE WAS A HEAVY DRUG ADDICT AND ESSENTIALLY LIVED ONLY TO REACH HIS NEXT HIT.

PAGE_24
HE WAS VIOLENT AND CRUEL, NOT QUITE CHARACTERIZED AS EVIL, BUT HIS OWN TRAUMA HAD LEFT HIM LESS THAN A MAN.

PAGE_25
HE FREQUENTLY BEAT AND ABUSED THE PATIENT, PROBABLY SINCE THE FIRST DAYS OF HER LIFE.

PAGE_26
HE HAD FINALLY PERISHED AT THE HANDS OF THE LAW DURING A DRUG FUELED FRENZY, CERTAINLY A BLESSING FOR THE PATIENT.

PAGE_27
THE MOTHER WAS A MORE PERMANENT FIXTURE IN THE PATIENT'S LIFE AND IS MOST TO BLAME FOR WHAT UNFURLED LATER.

PAGE_28
LIVING IN A CONSTANT DRUG FOCUSED MINDSET, SHE WASN'T THE CARING MOTHER MOST OF US HAD THE CHANCE TO HAVE.

PAGE_29
I EXPECT THAT THE BABY DIDN'T GET MUCH HUMAN CONTACT IN THE EARLY YEARS, PROBABLY LEFT ALONE WHILE THE PARENTS WERE OUT "HUNTING".

PAGE_30
IT WAS REVEALED THAT THE MOTHER KEPT THE PATIENT LOCKED IN A ROOM, OR EVEN CHAINED, FOR MOST OF HER LIFE.

PAGE_31
THE PATIENT NEVER RECIEVED SCHOOLING AND ONLY LEARNED ACTUAL SPEECH IN HER TEENS. SHE WAS TREATED SIMILARLY TO AN ANIMAL.

PAGE_32
HER ONLY CONTACT TO THE OUTSIDE WORLD CAME FROM OLD VIDEO GAMES AND MOVIES THAT HER PARENTS PROBABLY STOLE AND SOLD FOR DRUG MONEY.

PAGE_33
ONCE IN HER TEENAGE YEARS, AS FAR AS WE KNOW, HER MOTHER STARTED SELLING HER TO WHOEVER HAD THE MONEY.

PAGE_34
THE PATIENT LIKELY DEVELOPED FEELINGS OF HATRED FOR OTHER HUMANS AT THIS STAGE, AND A LOW REGARD FOR THE VALUE OF HUMAN LIFE.

PAGE_35
ONCE THE PATIENT REACHED MATURITY, SHE MANAGED TO ESCAPE HER MOTHER AND WAS THROWN, VERY UNPREPARED, INTO AN INHOSPITABLE WORLD.

PAGE_36
THE MIND OF A CHILD IS A MALLEABLE THING. IT CAN BE AS FRAGILE AS IT'S ADAPTABLE.

PAGE_37
TO SURVIVE SUCH A HORRIBLE CHILDHOOD, IT'S NOT UNCOMMON FOR A YOUNG MIND TO ADAPT WITH COMPLEX COPING MECHANISMS.

PAGE_38
WHEN TRAUMA IS TOO HEAVY TO BEAR, IT CAN HELP TO LET SOMEONE ELSEWEAR IT FOR YOU.

PAGE_39
BECAUSE OF A CHILD'S PLASTICITY, THAT SOMEONE CAN BE IMAGINED AND MADE AS REAL AS ONESELF.

PAGE_40
THIS CREATION IS MADE WITH THE FUNDAMENTAL ABILITY TO DEAL WITH THE SPECIFIC TRAUMA THAT IS AFFLICTING THE HOST.

PAGE_41
REPEATED TRAUMA, THE SEVERITY OF IT AND ALL KINDS OF DIFFERENT CIRCUMSTANCES CAN AFFECT THE NUMBER AND QUALITY OF FRAGMENTATIONS.

PAGE_42
IT'S NOT HARD TO BELIEVE THAT ONE COULD LOSE ITSELF IN A SEA OF OTHERS, ESPECIALLY IF THEIR STRENGTH WAS DESIGNED TO BE SUPERIOR.

PAGE_43
BUT THIS SAD EVENTUALITY ISN'T PART OF A PLAN, IT SIMPLY UNFOLDS NATURALLY AND ISN'T NECESSARILY FOR THE OVERALL BENEFIT OF THE HOST.

PAGE_44
UNDERSTANDABLE, FOR MOST PEOPLE, SHE'S A MONSTER, I INSTEAD FEEL PITY FOR HER.

PAGE_45
WHILE HER ACTIONS CAN'T BE FORGIVEN, THERE WAS NO OTHER PATH FOR HER, EVEN IF SHE FELT AGENCY IN THIS.

PAGE_46
I'VE MET SO MANY TORTURED SOULS IN THIS LIFETIME, THE WEIGHT OF IT HAS LEFT ITS MARK ON ME AND I FEEL BOUND TO HER CAUSE.

PAGE_47
I DON'T BELIEVE THAT ANYONE ELSE IN MY PROFESSION IS WILLING TO GO TO THE LENGTHS I HAVE GONE TO.

PAGE_48
WHILE THE ROAD IS BOUND TO BE FILLED WITH SACRIFICE AND PAIN, I BELIEVE THAT THE RESULTS WILL HELP SO MANY VICTIMS.

PAGE_49
SHE'S NOT A MONSTER YOU SEE, SHE'S HIDING FROM REAL MONSTERS THAT ARE INVISIBLE TO EVERYONE ELSE.

PAGE_50
THE INNOCENT LITTLE GIRL IS STILL ALIVE INSIDE, BUT THEY WON'T LET HER OUT WITH A FIGHT SHE'S UNEQUIPPED FOR.

PAGE_51
AS YOU'RE SETTLING INTO YOUR ROLE NEATLY, I BET YOU'RE STARTING TO QUESTION WHAT'S HAPPENING TO YOU.

PAGE_52
IT'S DIFFICULT FOR ME TO FULLY SEIZE AND IMAGINE WHAT BEING CONSCIOUS IS FOR YOU.

PAGE_53
I EXPECT THAT THE RULES OF YOUR WORLD MUST SEEM ALIEN EVEN TO YOU, WHAT DOES IT LOOK LIKE?

PAGE_54
YOU'RE PROBABLY FACING FEARFUL VISIONS AND IMPOSSIBLE TO COMPREHEND PHENOMENA.

PAGE_55
FROM THE WAY YOU SEEM TO BE COPING, I EXPECT THAT THESE DON'T BOTHER YOU ANYMORE.

PAGE_56
I ALSO IMAGINE THAT YOU'RE STARTING TO ENJOY THE FEELING OF POWER YOU MUST HAVE WHEN YOU GRAB CONTROL OF YOUR WORLD.

PAGE_57
DON'T TRY TO MAKE SENSE OF IT ALL, SIMPLY KEEEPING DOING WHAT COMES NATURALLY TO YOU.

PAGE_58
THERE EXISTS NO CHALLENGE THAT YOU'RE ILL-EQUIPPED FOR, YOU WERE BORN TO BE THAT WAY.

PAGE_59
YOU’LL UNDOUBTEDLY END UP FACING THE OTHERS. THESE FAILED CREATIONS WERE JUST A STEPPING STONE TO YOUR OWN.

PAGE_60
WHILE MY FAILURES WERE MANY, THEY WERE INEVITABLE STEPS TOWARDS THE IDEAL CREATION. INCREMENTATION IS KEY.

PAGE_61
I THINK YOU’RE READY FOR ME TO START ANSWERING THE QUESTIONS YOU MAY HAVE.

PAGE_62
FIRST, WHY AM I TELLING YOU ALL OF THIS? SOON, I’LL BE NEEDING SOMETHING FROM YOU.

PAGE_63
REVEALING EVERYTHING WOULD HAVE BEEN OVERWHELMING AND I ALSO NEEDED TO BE SURE YOU WERE READY.

PAGE_64
DO YOU HEAR HER? DO YOU HEAR HER CRIES IN THE AFTERMATH OF THE CARNAGE?

PAGE_65
SHE NEEDS YOUR HELP, YOU NEED TO FIND HER AND FREE HER.

PAGE_66
THE OTHERS HAVE KEPT HER HIDDEN FROM ME, BUT I WAS ABLE TO DETECT HER PRESENCE.

PAGE_67
SHE’S THE ONLY REASON THE PATIENT WAS ALLOWED TO STAY WITH ME.

PAGE_68
SHE MUST BE SAVED AT ALL COSTS, BECAUSE IF YOU FAIL HER, YOU ERASE YOURSELF.

PAGE_69
THE OTHERS UNDERSTAND THIS AND THAT’S WHY SHE WAS ALLOWED TO SURVIVE.

PAGE_70
THEY’RE NOT AS STABLE AS YOU ARE AND I FEAR THAT SOON THEY MAY HAVE CHANGED THEIR MIND OR ATTEMPT A DECEPTION.

PAGE_71
IF I HAD DOUBT THAT HER INNOCENCE WAS ABSENT, I’D HAVE TO TERMINATE THE WHOLE PROJECT.

PAGE_72
OVER THE YEARS THAT YOU’VE BEEN WORKING, I’VE SEEN MOST OF THE OTHERS DISAPPEAR.

PAGE_73
THIS MEANS THAT YOU’RE VERY CLOSE TO YOUR GOAL.

PAGE_74
YOUR FINAL CONFLICT WILL BE WITH YOUR PREDECESSOR.

PAGE_75
I HAD HIGH HOPES FOR HER, YOU BOTH ARE VERY SIMILAR.

PAGE_76
FINDING THE PERFECT RECIPE IS EXTREMELY DIFFICULT AND SOMETIMES A SMALL ITERATION IS ALL THAT’S NEEDED.

PAGE_77
SHE WAS FIERCE AND POWERFUL, BUT SHE HAD BEEN CORRUPTED BY HER EXPERIENCE.

PAGE_78
I’VE CREATED YOU TO BE BETTER, MORE FORMIDABLE AND MORE … REASONABLE.

PAGE_79
I NEED YOU TO DESTROY ALL THE OTHERS, TO STERLIZE YOUR WORLD AND TO BRING PEACE TO HER MIND.

PAGE_80
ONCE YOU FREE HER AND ONLY HER INNOCENCE IS LEFT, OUR WORK WILL BE DONE AND YOU’LL KNOW PEACE.

PAGE_81
THIS IS YOUR FUNDAMENTAL DIFFERENCE, YOU’LL HAVE TO MAKE IT RIGHT, YOU’LL GIVE YOURSELF AS FINAL SACRIFICE.

PAGE_82
……………………

IMPORTANT NOTE
Prior to Update #04, the Patient's room would remain the same. After the update, scribbles and writings will randomly appear in the room after each Nightmare (level).

THE ASYLUM - PATIENT'S ROOM
The Patient's room is a somewhat large room that has many items inside it.

• There is a bed with green sheets that when slept in will begin the next Nightmare
  
• A map on the wall that shows off the places the Patient visits in Chapter 1
  
• A sink and toilet (that can be flushed)
  
• A book case containing several random items

An interesting thing to note is that there are several items in the Patient's room that could very hazardous to herself and the staff despite the Doctor saying they had a meeting about how to safely care for the patient.

Upon completing the game, the Patient can find a teddy bear that'll appear on their nightstand




THE ASYLUM - FIRST ROOM
After a few Nightmares, the room to the Patient's door can be opened. Heading to the left will take you to a computer room with a single computer, some pencils and a mug.
Inside this room is also a breaker that when turned off will put the asylum into an emergency status


THE ASYLUM - STAIRCASE
Heading to the right will take you to a staircase. Upstairs is a destroyed part of the asylum and downstairs leads to the cafeteria and outside.

THE ASYLUM - CAFE
At the bottom of the stairs is the cafeteria. There are two rooms, the one to the right is inaccessible and the one to the right leads to the entrance


THE ASYLUM - BOILER ROOM
Inside the boiler room is another breaker to turn the power back on and stairs that lead to the underground section.

THE ASYLUM - TECH ROOM
The left is inaccesible, but the right leads to a tech room with a single computer and several filing cabinets.

THE ASYLUM - SEWERS
In the boiler room is a locked cage that leads to a small room that has a makeshift bed and several items strewn around. In the gate behind is a small outdoor area surrounded by trees.

THE ASYLUM - UPSTAIRS


THE ASYLUM - DESTROYED ROOM
Inside this room are 2 inaccessible rooms and a partially destroyed area that is exposed to the sky.


THE ASYLUM - DIRTY ROOM
In the room ahead is a standard hospital room that is in ruins. It is fillthy, dirty, the walls are peeling and have damaged all around, along with a chained off shelving area.

Remember, these are just theories based on what I've seen and played through. If you have a theory, please comment them down below.

THE PATIENT
The Patient is nameless and the only thing we know about her is through the notes. What we know so far:

• Abused her whole life (Most likely from birth)
  
• Has a deep resentment to all humans (Except for animals, especially dogs)
  
• Is considered dangerous, as evident by her being charged with homicide and murder
  
• Most of her knowledge comes from video games and movies
  
• When she dies and wakes up, at first she makes a scared, sudden gasping noise before turning into angry grunts, indicating that she is aware she is in a nightmare.

The Patient is in her late teens or early 20's at the start of the game. She doesn't speak (not sure if she can't or won't) and the only sounds from her are screams when she gets hurt or dies. She is considered to be very dangerous and might know how to use a range of weaponry. Whenever she goes to sleep, she enters a nightmare and must fight her way through. The monsters could be a representation of the abuse she faced from her family and the strangers her mother let into their home, or could be from the games and movies she watched. I believe the Patient killed her mother before escaping.
Beginning Chapter 3, it appears as the Patient's mind and psyche is slowly beginning to crumble and breakdown, as the locations she visits are more and more colder and less alive (the moon, a battlefield, the void, etc) and it finally combines into a mixture of all locations put into one.


THE PARENTS
The Mother and Father don't have a lot of information about them. We do know the Dad is a violent person who was most likely the victim of abuse and took to drugs to ease the pain, eventually turning him into a dangerous monster. He is a violent man and had been arrested many times, before eventually being shot by the police.

The Mother was also violent, but for reasons unknown. She would keep the Patient locked away and only give her the bare essentials to survive. The Mother was constantly in a drug-induced state and rarely interacted or show affection for her daughter. Her fate is unknown, but is most likely her daughter killed her.


THE DOCTOR (BEFORE CHAPTER 3)
Not much is known about the Doctor, aside from a few bits of info:

• Has no specified gender
  
• Takes pride in their work
  
• Doesn't believe any Patient is too far gone and can be brought back
  
• Is confident that the Patient can be cared for
  
• Believes that the Patient has a valid reason for the way she is

The Doctor is aware of the nature of the Patient and has acknowledged that they will need to be heavily monitored for the safety of their staff. The Doctor does care about the patient and sympathizes with her. I believe the Doctor is the Player themselves, which is why we aren't given any opinions, just facts. It is up to us to decide how we view the Patient. After Page 35, the Doctor seems to be leaning towards that the Patient is justified in their actions but isn't excusable.

THE DOCTOR (AFTER CHAPTER 3)

• The Doctor seems to have an emotional attachment to the Patient
  
• The Doctor has dealt with other patients before and they seemed to have either failed, given up or disappeared (transferred to a different facility or taken out of the system)

Based on the Doctor's notes, due to their previous failed attempts at helping Patients they have grown very attached to her and want her to succeed. The Doctor seems to be leaning towards the Patient burying their trauma and locking it away to maintain their innocence.


THE ASYLUM

• After each Nightmare, the time and weather conditions change. It can be day, night, raining, thundering, foggy or a green tinted haze
  
• Screams, laughter and footsteps can be heard in the asylum, meaning there are others in the asylum or they could be the memories of the previous Patients that were housed in the asylum

Salvation
Get the sacrifice ending

Upon defeating the final boss, the Patient is told by the Doctor to sacrifice herself and take away all of the horror and nightmares she had endured. By jumping into the fire pit, she'll burn (lock away) all the horrors she had face, allowing her to preserve her innocence and begin to heal.


Condemnation
Get the control ending

Upon defeating the final boss, the Patient can ignore the Doctor's instructions and confront the innocence that is left within her, forcing the horrors and nightmares she's faced and continuing to press on.

I know I most likely missed a lot of stuff in regards to the nightmares themselves, special items and events that occur within the facility.

If you have ideas / theories / things you have noted then please comment them below!