
However, there is no doubt that the Otherworld is shaped by minds and the psyche of those present, usually to the effect of creating their own limbo. The Otherworld may be viewed as a cancerous disease slowly infecting reality until reality becomes Hell on Earth, or a dimension invading another dimension. The Otherworld is not reality, yet it is still real on another plane of existence that is impossible for ordinary humans to comprehend and is difficult to describe by human language. The doctor's journal implies it lies on the border where reality and unreality intersect, a place both close and distant.

However, both "world" and "dimension" have been used in reference to the Otherworld both in-game and in official guidebooks. It may be viewed as a parallel or nonparallel plane of existence, although the Otherworld is an abstract concept which has never been officially or completely defined, and attempting to categorize the Otherworld as one or the other would be arguing semantics. The Otherworld, also occasionally referred to as the Otherside, Alternate World, Another World, Dark World, Nightmare World or Reverse Side throughout the series, is the dark and nightmarish mysterious effect that materializes through the ancient powers of Silent Hill, Maine. Valtiel above Heather crying in the Otherworld. Heather in the Otherworld Hilltop Center.

Could it be that the real world awaits beyond the collapsed roads?

It may be that the town itself has moved somewhere that is like another dimension, or it may be that this is all happening inside someone's dream. In Silent Hill, the border between reality and unreality is indistinct.
