The challenge of how to visualize the internal world of the human psyche through artistic efforts has been one of the key endeavors in the art scene for centuries now. The question is both artistically and philosophically intriguing since it deals with the ultimate subjective experience instead of one based on our senses we all share. Sure, we can and should empathize with the feelings of others, but we can’t really feel what they feel in the same sense we can see or hear what they see or hear. That’s just not possible.
So the feelings we go through every day are extremely personal and usually beyond description. However, most of the feelings, such as fear, joy, anger, or sadness, to say a few, we can provoke somewhat collectively through simulated experiences by watching a movie, reading a book, or, say, playing a video game. There’s one psychological state, though, that cannot be simulated only by watching, listening, or reading a piece of art, which is physical pain.
There’s hardly any question about whether pain is something produced solely by one’s mind, even if it’s mainly an effect of a physical contact imposed by an external force. Consequently, physical pain is simply unfeasible to simulate with “fake physical contact” like, for example, joy, sadness, fear, or even antagonism that are quite straightforward to arouse using fictional narrative. Fiction indeed can touch a person, but not, thank God, hurt one.
The problem, then, in the video game realm is that many of the titles are nothing less than based on the premise of inflicting violence on others in order to progress, and at the same time avoiding getting hurt oneself. Violence is such a fundamental mechanic in a myriad of games that dealing with pain the player is supposedly experiencing seems inescapable.
Now, this all comes back to the initial question of how to illustrate a psychological phenomenon so abstract, subjective, and irreproducible through simulation as pain is in a video game of which narrative is based on avoiding it? Okay, one could argue that the health bar, which is now partly obsolete due to the regenerating health, was there to visualize pain to some degree by altering the length as the player got hit, but that was more like a pure statistic than a visual representation which is under discussion here.
I believe Doom (1993) was one of the first notable games to use flashing red tint indicating the hurt caused by bites and bullets coming from the enemy. And it seems that red has ever since been the color of choice depicting pain, for the reason, I guess, that it’s an abstraction of blood, which itself is something of an epitome of hurt and violence, if there is one.
On that note, Call of Duty: Modern Warfare 2 (2009) received a notable amount of flack and ridicule for using somewhat photorealistic blood for that purpose, in addition to the blurred vision. Mostly people complained about the blood “pouring from one’s eyes” being unrealistic as if there was a realistic alternative available in the first place. Granted, the blood effect was a bit excessive at times, but, as said, I’m positive it was never meant to be realistic but rather symbolic in nature.
Personally I liked what Mass Effect 2 (2010) did with this issue from the aesthetical standpoint, which was to use imagery resembling retina blood vessels whenever the death was nearing. The solution in question grasps quite elegantly the fact that pain comes down, more than anything, to the workings of the human nervous systems, and that pain can be conveyed without splattering blood all over the screen. Interestingly, this approach received a surprising amount of whining in the forums, too.
However, the way Kane & Lynch 2: Dog Days (2010) dealt with pain was one of the most peculiar ones to date. As K&L 2’s visuals were based on simulating a low fidelity digital camcorder, the bullet hits manifested as various glitches and artifacts distorting the image accordingly, giving it a very gritty and dirty look.
In the end, there’s no “realistic” way depicting pain, or any other phenomenon of the human psyche for that matter. Developers just have to use their artistic intuition to find a way to visualize something that abstract, but at the same time very real and graspable.