As the first true “next-gen console-exclusive” for Xbox, The Medium is a much-needed boost for Series S|X owners and, as a niche genre, a good fit for the Xbox Game Pass service (which will hopefully bring in players that might otherwise avoid the genre). To clear a few misconceptions first, despite the “psychological horror” label and gameplay trailers, The Medium is a linear, narrative-driven game with an unsettling atmosphere and several jump-scares - not dissimilar to Bloober Team’s prior games. Despite the shift in perspective and increased focus on puzzles – many revolving around the dual-world mechanic – this is not a survival-horror game, mechanically speaking, in the vein of Resident Evil or Silent Hill.

The Medium kicks off with protagonist Marianne returning to her foster father’s funeral home to lay him to rest. It’s a creepy and impactful prologue that frames the events you experience as being recounted to a mysterious figure, some point in the future. After coming to grips with the semi-fixed camera angles, the controls, and discovering a bit about Marianne’s past and personality, you’re tasked with solving a few basic puzzles. This sequence will give you an idea of the basic gameplay loop, your first taste of Marianne's ability to exist in both the physical and spirit world, and makes it clear from the start that she is a strong, selfless protagonist. Marianne has not only possessed her abilities since childhood but also used them countless times to help spirits pass on and convey messages to their loved ones.

This early scene provides a good overview of what to expect during the exploration and puzzling sequences: you’ll find objects that Marianne will comment on, giving insight into her past and personality; plenty of notes that flesh out both central and secondary characters; along with key items – literally in this case – that are needed to progress.

What kicks off the story in earnest is a desperate call from “Thomas”, a man who seems to know about Marianne’s dream and her powers. He asks her to find him at a former government-sponsored worker’s retreat, “Niwa”, abandoned in the 1960s after an apparent massacre. Marianne abandons her bike at the rundown entrance and sets off tracking the ghostly footprints of a child through the forest. At this point, The Medium demonstrates a disconnect between the player and protagonist that you’ll either love or hate. Despite the oppressive atmosphere and several horrifying encounters, Marianne takes it in her stride. She’ll be frightened or shocked at times but she’s well-accustomed to sordid histories, emotional trauma, and the manifestations they create in the spirit world.

…the bulk of the experience is an unexpectedly low-intensity affair, solving puzzles and hitting frequent story beats.

As a consequence of Marianne’s constant stoicism and only a handful of threatening horror sequences (in which you can die), the bulk of the experience is an unexpectedly low-intensity affair, solving puzzles and hitting frequent story beats. The Medium is content with creeping you out while you explore and, I’ll admit, it kept me on edge during my first playthrough. The change to a Silent Hill-inspired fixed-camera perspective, which dynamically shifts to highlight distant movement and sounds, or pulls behind Marianne during dramatic chase sequences, plays a big part of generating tension.


In more expansive areas, the visual design of both the grounded physical world and the surreal spirit world impress. Unfortunately, these are also the sequences where dynamic resolution kicks in hard on the consoles.

The fixed-camera position also ties into the dual-world gameplay, which requires Marianne manipulate objects in both the physical or spirit world, and traverse areas that are unnavigable in one realm. Unfortunately, this is not a player-activated feature and triggers at the developer's whim. It’s effective when it catches you by surprise and these sequences contain the most complex (and disturbing) puzzles. When exploring the physical world, The Medium takes a simple find-object/combine-object/use-object approach. Excursions into the spirit world, either during the dual-world sequences or when shifting freely between them, offer more elaborate puzzles.

Excursions into the spirit world, either during the dual-world sequences or when shifting freely between them, offer more elaborate puzzles.

Marianne’s spirit form can converse with lingering souls, engage in brief out-of-body excursions, absorb pools of spiritual energy to power devices or shield herself from ravenous spectral moths, and help trapped souls pass on. The traditional horror elements kick in when you encounter “The Maw” – a demon-like manifestation of grief, guilt, and rage that seeks to possess Marianne and escape the confines of the Niwa resort. These encounters alternate between chase sequences in the spirit world and stealth sequences in the physical world, in which The Maw manifests as a translucent presence that distorts light and shadow, but is unable to see the player directly.


Avoiding The Maw is always a tense experience, requiring you to observe patrol routes or create distractions to edge forward. If you’ve absorbed a pool of spirit energy, you’ll get one escape chance that makes these sequences more forgiving.

Unfortunately, encounters with The Maw are limited to a handful of short sequences, though it often stalks Marianne just out of sight, sprouting some choice language. As a consequence, The Medium relies on brisk pacing, an oppressive atmosphere, and frequent narrative beats to keep your attention (including two lengthy and more… aggressive diversions). To keep players moving forward, Marianne has an “insight” ability that highlights hidden objects and tracks (pro tip: remember to also use insight when the game swaps to the first-person perspective) and, despite the option for brief forays off the critical path for collectables, your progression through the resort and surrounding grounds is linear.

The Medium relies on brisk pacing, an oppressive atmosphere, and frequent narrative beats to keep your attention…

Instrumental to the atmosphere and storytelling is the presentation, and The Medium is often a stunning looking game. The physical world is wonderfully detailed, grounded in reality, and conveys a real sense of place (the grim, utilitarian style of Soviet-era Polish infrastructure); while the spirit world is inspired by the work of Polish artist Zdzisław Beksiński, who specialised in "dystopian surrealism". This realm is constructed of organic-looking materials and often draped in a sickly orange or green hue. However, the concept of rendering two distinct worlds simultaneously is clearly The Medium’s main selling point, giving the updated console hardware and custom SSDs a workout (the PC requirements are equally vicious). The voice work is excellent and the soundtrack can be more unsettling than the visuals, with Akira Yamaoka – of Silent Hill fame – composing several tracks for Marianne’s forays into the spirit world.


Two lengthy diversions flesh out the backstory of another important character and the fates of secondary characters you only encounter briefly as Marianne.

Every location oozes atmosphere, sporting high-resolution textures, atmospheric lighting, and reflections (ray-traced if you’ve got a Series X or appropriate GPU), but you will notice inconsistencies: Marianne’s stiff walking animation and a tendency to get stuck on scenery; basic lip-syncing in cutscenes; quick transitions during cutscenes or when switching to the first-person perspective demonstrate split-second textures loads; and there are performance drops on console in some late-game areas (which might just be optimisation issues that can be patched, as these locations appear no more complex than earlier scenes).

After reaching the somewhat ambiguous but genre-appropriate ending around the 9-hour mark (the potential for prequels/sequels is there), I was satisfied with the time I invested and immediately started a second run, aiming to hunt down missing collectables and spot environmental clues to past events. It’ll be a divisive choice, but I found Marianne’s perseverance, despite the horrifying situation she finds herself in, made her a great protagonist. As a linear, narrative-driven horror game, The Medium is easy to recommend – and a no-brainer if you have an Xbox Game Pass subscription – thanks to the balance of unsettling exploration, involved puzzles, a handful of terrifying encounters, and frequent narrative beats. The novel dual-world concept is both technically impressive and allows for some elaborate puzzles.

On the other hand, if the “psychological horror” label, fixed-camera angles, and otherworldly elements have you thinking of Silent Hill, you should be aware this is not a conventional survival-horror experience, with resource management and constant danger.

*Xbox Series review code provided by Bloober Team