CIA brainwashing experiments helped make Outlast an iconic horror series

The Sleep Room in The Outlast Trials is named after a real-life space at McGill University’s Allan Memorial Institute in Montreal, where from 1957 to 1964, doctors conducted mind-control experiments on patients as part of the CIA’s MK-Ultra initiative. Led by Dr. Donald Ewen Cameron, these tests included electroshock therapy, sensory deprivation and heavy doses of psychedelic drugs. One patient, Linda MacDonald, went to McGill seeking help for symptoms of postpartum depression after giving birth to her fifth child. She was placed in a drug-induced coma for 86 days in the Sleep Room, and records show she was treated with 109 rounds of shock therapy. MacDonald lost her identity, memories and motor skills; she had to be toilet trained all over again.

Another patient, Robert Logie, was 18 years old when he went to McGill with leg pain. He ended up in the Sleep Room, where he was injected with LSD every other day for weeks, his syringe sometimes spiked with sodium amytal — “truth serum” — and other drugs. A speaker positioned under his pillow played the phrase, “You killed your mother,” on a constant loop for 23 days. Meanwhile, his mom was alive and well. Logie left McGill with amnesia, insomnia and a painful leg.

The old McGill hospital is just two miles away from the Red Barrels offices, where the Outlast games are made.

“The name of the Sleep Room in Outlast Trials, we took that from McGill hospital,” Outlast series writer JT Petty said. “In the 1960s, they had the Sleep Room where they would treat trauma with LSD and induced comas. It was insane. And the people who came out of that came out severely damaged, in worse shape than they were before.”

“There are still active lawsuits going on because of these events,” Red Barrels co-founder Philippe Morin added. (And he’s correct.)

Like all of Red Barrels’ games, The Outlast Trials draws from dark and true stories of government-backed inhumanity, religious manipulation and capitalistic greed, particularly during the 20th century. Trials is a cooperative four-player horror experience where participants, called Reagents, are trapped in the secret Sinyala Facility run by the Murkoff Corporation. The goal is to graduate therapy by completing objectives and surviving monstrous villains in various maps, including an orphanage, courthouse, police station and toy factory. As in the other Outlast titles, gameplay mainly involves running and hiding from prowling, deranged sadists, though this time you’re not alone.

“The first Outlast, it goes back to the oldest games, you're playing hide and seek,” Morin said. “In Outlast Trials, it's like you're stuck in a haunted house with friends. And it’s, how do we get out of here? That was the initial premise.”

Trials exists in a world familiar to Outlast fans. It’s a prequel to the original Outlast, which came out in 2013, and Outlast 2, which landed in 2017. Trials replaces the series’ camcorder with a pair of night-vision goggles, and the Sleep Room is the game’s lobby. Here, players can purchase prescriptions for upgrades, arm wrestle other Reagents, customize their cell and prepare for the missions ahead.

Trials entered early access in May 2023, went fully live in March 2024 and received its first major DLC drop in July, introducing the docks and a new baddie named Franco “Il Bambino” Barbi. Franco is a New Orleans mafia nepo baby with a degradation kink and a gun obsession, plus he has a habit of murdering his sexual partners. He’s eager to do the same to the Reagents trapped in Sinyala.

Franco joins two other Prime Assets, or bosses, in The Outlast Trials. There’s Mother Gooseberry, a deranged former children’s-show host who carries a duck puppet with a giant dental drill inside its beak, and Leland Coyle, a white supremacist and corrupt police officer with an insatiable desire to torture and kill people with his stun rod. Every enemy in the Outlast series employs a unique brand of violent cruelty, their favored forms of torture shaped by generational traumas and dangerous societal norms.

“We do a lot of work trying to make the characters kind of iconic and human despite being monsters, and that kind of love for horror characters — I feel like you know when you’re doing it right,” Petty said. “I'm a 1980s kid, I grew up on Freddy and Jason and all those guys and it's, I think comfort is the right word.”

It’s easy to see the demented priests, sadistic doctors, demonic cult leaders and free-swinging penises in the Outlast games and write it all off as edgelord shit, nothing more. But especially with McGill hospital looming just beyond Red Barrels’ front door, the commentary is clear, and this brand of gruesome social analysis was the plan from the start.

“All the games are about extremists,” Morin said. “People who take something and just go too far with it, whether it's religion, science, money, weapons, whatever it is.”

Outlast 2 tells a story about cult members who believe the antichrist is about to be born, resulting in a wave of ritual sacrifice, abuse and mass murder in the Arizona desert. The original Outlast takes place inside Mount Massive Asylum, an even-more-twisted stand-in for the McGill hospital.

“In the first Outlast, there's a lot about the archetypes of 20th century history,” Petty said. “There’s a character who’s a soldier, there’s a character who’s a businessman, there’s a character who's a priest, representing these big, cultural moments of the 20th century. I don’t want to get too grand with it, but there is the notion that everybody's so apocalyptic right now. Like, how did we end up here? I feel like that's the subtext of what Outlast is always about. Who made money getting us here?”

As the main writer for all Outlast games, Petty’s job is to take the team’s wildest, most potentially offensive ideas and make them palatable for a horror audience. He works with motifs of murder, torture, neglect, mental illness, sexual violence, bigotry and religion, and through comedy and hyperbole, transforms them into caricatures of greed, ego and oppression. There’s an undercurrent of humor in the Outlast games, strategically deployed to further highlight the terror.

“We have to come up with the worst, most horrible, most perverse thing that could possibly happen to you,” Petty said. “And then like two months later, it feels like, come up with something slightly worse and more horrible.”

“You know, for kids!” Morin joked. Later in the conversation he said, “The reality is, we know we're not surgeons operating on brains…. We’re creating entertainment. You need to have fun with it.”

There are no hard boundaries when the Red Barrels team is brainstorming new characters or themes, but Petty and Morin adhere to the same general wisdom when approaching sensitive topics: Don’t punch down.

“We don't want to victimize people who are already victims,” Petty said. “We're dealing with a lot of sensitive issues — mental illness, sexuality and violence, all of this stuff. And I just want to make sure we're always sympathetic.”

This approach to extremism has resonated with millions of players, allowing Red Barrels to turn Outlast into an enduring horror franchise encompassing single-player narrative games, a multiplayer live-service experience and a graphic novel series over the past 11 years. The first two Outlast games sold a combined 15 million units and pulled in $45 million for Red Barrels, while The Outlast Trials has been purchased by more than 2 million players already. There’s a healthy community of content creators playing and dissecting the games on Twitch and YouTube, too.

Supporting The Outlast Trials is a lot of work, especially for such a small team. The prototype alone took two years of conceptualizing and coding, and the project spent six years in development before going live in early access in 2023. As a living game, Red Barrels not only has to maintain the experience they shipped with The Outlast Trials, but players now expect new content, monsters, missions and mechanics on a regular basis.

Most online multiplayer experiences that look like The Outlast Trials — meaning AAA-level games — have teams of hundreds of developers, and many are backed by companies worth billions. Red Barrels has just 65 employees, and 20 of them joined just in the past year.

“We're now in a war of content creation,” Morin said. “We have to ship content as quickly and efficiently as possible. And to be honest, we’re still learning how to do that because a lot of us are used to, once you ship a game, you get a big downtime, conception phase and all that. But there's none of that right now.”

Red Barrels is only now expanding because they need people with expertise in multiplayer and live-service design. Morin and Red Barrels co-founders David Chateauneuf and Hugo Dallaire worked at EA and Ubisoft for years before going indie, managing large teams as senior developers. They founded Red Barrels because they wanted to get hands-on with game development again, ideally with a small crew of passionate horror fiends. (Also, Ubisoft turned down all their horror pitches. Thankfully — can you imagine if Ubisoft had greenlit the original Outlast? It probably would’ve been called something like Dr. Murkoff’s Manifesto and the gore would’ve been dialed way, way down. It might’ve given Miles a gun. Maybe, instead of sadistic psychiatric staff, its enemies would’ve been animatronic Rabbids. It could’ve gotten a Just Dance tie-in. Truly, the horror.)

Nowadays, Morin is doing less and less design as his studio becomes more complex, but he’s still involved in the creative process. Red Barrels just recently hired another writer, Jonathan Morrel, meaning Petty is no longer the entirety of the narrative department. The studio has a flat internal structure, where there aren’t harsh distinctions between roles like level designer and game designer. “We’re just all designers,” Morin said.

It’s hard to overstate just how small Red Barrels is, particularly considering the AAA quality of the Outlast series.

“I do remember the moment where, for IT support, I stopped going to one of the company's founders,” Petty said. “Hugo used to basically be IT for the company, as well as art director, co-founder. And it was pretty recent, right? It was like eight years into Red Barrels where he stopped being the IT guy.”

Morin added, “He just didn’t want anybody else to do it.”

Morin said that larger studios are always sniffing around Red Barrels, looking to acquire its talent and IP, but none of their pitches have looked better than independence so far. Red Barrels ended up creating the original Outlast with personal savings, loans and a $1 million investment from the Canada Media Fund. Even back then, there was an offer on the table from a major company that would have resulted in a few extra months of production time.

“But at that point, we had been working so hard to try to make this game on our own and didn't want to give up our independence,” Morin said. “We were not ready to do that, we were so close to shipping the game. So we just doubled down and worked our asses off to be able to ship the game without needing extra money. But there were options. So I think it's, ‘Never say never,’ but up until now, no. We never felt the need to go get more financing to be able to make the games we wanted to make on our own. We'll see if we can keep on doing that.”

For Red Barrels, the focus right now is The Outlast Trials. There isn’t time for anything else — but maybe there will be in the future.

“Ultimately, our goal would be to have two IPs, two projects in parallel, and have them be different enough so that people who need a change of scenery can go from one to another,” Morin said. “I mean, I love the world of Outlast and the reality is that you could narratively make [the second project] fit inside the same world and just do a different kind of gameplay experience. That could always be done as well. But I think creating an IP is a very hard thing, and so when you have success, you don't want to waste it.”

The Outlast Trials is available now on PC, PlayStation 4, PS5, Xbox One and Xbox Series X/S.