The Lying Figure is the first creature James Sunderland encounters, after following trails of blood through Silent Hill. He confronts it in a closed tunnel after retrieving the radio, where it is seen feeding on a corpse.
They also appear in the Born from a Wish scenario and torment Maria.
Their entire bodies appear to be trapped in a straightjacket of flesh, complete with stereotypically feminine legs and visible buttocks. On their feet, they wear a pair of what seem to be platform heels encased in flesh. When they scurry across the ground, they make a high-pitched wailing noise that sounds like the scraping of metal against cement. They seem to have zippers on their faces.
They attack by spewing a spray of poisonous mist from an opening in their chest, which will knock James/Maria back and force him/her to recover for a few seconds before being able to resume his/her attack. Because of this, it's best to deal with them from range, preferably by using the handgun, as a few good shots can down the creature. However, if melee is the only option, it's advised to use the steel pipe while strafing left/right to avoid the poison.
They are slow-moving while standing upright; however, when knocked down, they can easily hit James/Maria by skittering very quickly along the ground, easily outrunning the player. It's best to flee if the situation arises.
The Lying Figure represents the image of a hospital patient squirming in agony. This is a manifestation of James's internal suffering. The novelization also mentions they were created from feelings of confinement.
In Silent Hill 2, Masahiro Ito designed the Lying Figure as reminiscence of Mary Shepherd-Sunderland in her state of terminal illness, which has been speculated to have something to do with physical distortion, as Mary said, "I look like a monster!". This furthers the evidence that the Lying Figure was meant to be similar to how Mary saw herself: suffering in agony and trapped in its own inescapable body.
As well, its main means of attack is spitting an acid-like mist at James/Maria; this is suggestive of vomiting, alluding further to the theme of illness. However, this may also be suggestive of how Mary spat hateful words at James during her illness.
As the creature appears to have its arms restricted, it can be assumed that it represents James's frustration from being unable to touch or hold Mary during her sickness. The way that it skitters along the ground and screeches like grating metal also likens it to a pest. This could point to Mary being burdensome and disgusting to James.
In the Born from a Wish scenario, Maria is observed to be able to see James' Otherworld and monsters, being a manifestation of his subconscious herself.
- The Silent Hill 2 "official" BradyGames strategy guide by Dan Birlew refers to them as "Patient Demon". However, this should not necessarily be accepted as an official name because it never appears anywhere else, and the "official" strategy guides occasionally have errors.
- In the making of Silent Hill 2 video, monster designer Masahiro Ito revealed that his inspiration for the Lying Figure came from watching a programmer friend walk into the office. Ito states that his friend was wearing a hooded sweater with his hands in his pockets and was walking "in a cool way" as he was listening to his walkman.
- In the early sketch, they wear red boots and have "mouths" that allow them to nourish themselves by feeding on corpses.
- Another early sketch features their upper bodies wrapped in cloth, heightening the idea of being restrained.
- The corpse in the alleyway where James first encounters one resembles a Lying Figure wearing clothing, possibly implying that Lying Figures were once human, or are human.
- In the Silent Hill Historical Society, there is a photo/painting called Death by Skewering. It depicts Lying Figures being pierced by tree branches.
- If James returns to Vachss Road at night which is the location where he killed the first Lying Figure, there is police tape on the fence which was not there before, which has the unfortunate implications that James may have killed a human being in reality while being trapped in the Fog World.
- In the Art of Silent Hill, there is an image of "beta" Lying Figures in which they seem to have mouths.