Silent Hill: Shattered Memories divides its gameplay between two different settings. The first section is set in a psychotherapist’s office and the second in a town called Silent Hill. In the first section, the player interacts with Dr. Michael Kaufmann, a therapist who is a non-player character, from a first-person perspective. The player responds to Kaufmann’s questions and completes a psychological test, fills in a questionnaire or colors pictures. The player’s responses to these tests alters aspects of gameplay in the second setting, including the available areas, the physical appearance and behavior of characters encountered, and the physical appearance of the monsters.
Shattered Memories returns to Kaufmann’s office periodically throughout the game.