Chapter 6, ''Psychosis'' / ''Vengeance'' takes place roughly five hours until dawn. In this segment of the game, the player takes control of Matt, as he and Emily try to get past the deer herd, Emily, as she and possibly Matt arrive at fire tower to call for help, possibly Matt once again as he tries to help Emily when she's hanging off the fire tower, Ashley, as she and Chris search for Sam around the lodge, and finally Chris as he makes a painful decision in The Psycho's trap.
- The scene where Ashley and Chris are tied up and Chris has the decision to shoot himself or her before the saw mutilates them is a direct reference to the Saw Franchise.
- This is the first time a protagonist (in this case, Matt) can die in multiple ways.
- The chapter's title depends on if Sam was caught by The Psycho in Chapter 5.
- You get Psychosis if Sam successfully hid from the Psycho.
- You get Vengeance if Sam was caught by the Psycho.
- This chapter has a total of 10 collectibles, tied with Chapter 3.
- They both have the 5th most number of collectibles in their chapter.