Despite my vocal objections to the overall gaming experience that is Martha is Dead, I haven’t been able to stop thinking about it for the past day. For all its poor execution, gore and body horror, this fever-dream of a game does have its share of intriguing ideas. Here’s my interpretation of what went down in Martha is Dead, I hope this story analysis helps make more sense of the game. Due to the ambiguity of the ending, it’s hard to settle on one definite answer, so let us know what you think of it in the comments!
Predictably, spoilers for Martha is Dead follow.
TW: Discussion of child abuse, trauma, and complex mental health issues
Is Martha dead?

Well, yes and no: Giulia and Martha were the same person.
Giulia records her conversation with her mother before she shoots her. Irene says that she found Giulia sitting near the lake in her underwear that ill-fated morning, repeating ‘nothing has happened.’ Following this, she ‘didn’t speak for days.’ This hints that Giulia believing she found Martha’s dead body and assumed her twin’s identity at the start of the game was actually an imaginary event.
However, the most important moment that suggests that Martha and Giulia are the same person is the puppet theatre sequence where Giulia relives her repressed childhood memories. She re-enacts her birth, and surprisingly only one baby is born, not twins. A girl named Martha.

Image: LKA
As Martha grows up, she faces increasingly abusive behaviour at the hands of Irene who is most likely addicted to Pervitin (an addiction hinted at by adult Giulia on multiple occasions). As explained in a brilliant video essay by Reginald Writes, Pervitin was an early version of crystal meth used in the German army to keep the soldiers alert and euphoric with minimal rest. A phone call to the family doctor during the game also suggests that the drug is available to Irene thanks to her husband Erich’s high rank in the German army, as it has been otherwise banned in the country.
Coming back to the puppet theatre, we witness Giulia’s memory of an incident from her childhood where she was assaulted by her mother with a cane and suffered blunt force trauma to her head. Most likely, the Pervitin contributed to existing abusive tendencies and led to Irene violently lashing out with physical and verbal abuse. Note that the puppet is called ‘Martha’ in this scene, even though we’re witnessing Giulia’s memories. As for Martha’s puppet, we see a close up of her lying on the ground after being hit, and the face shatters. Underneath is a new face, with its lips and ears sewn up.

Image: LKA
I believe this is the moment when ‘Giulia’ was born – a second identity Martha assumed to shield herself from her mother’s abuse. After being hit by her mother on the head, Martha stopped speaking and pretended to be deaf to protect herself. It won her acceptance and some measure of sympathy from her mother. Her fury was directed towards ‘Giulia’ now, Martha’s second identity who still talked for the both of them. Indeed, in the very next puppet-play scene, we see two girls, with no further mention of a sister being born. We also learn early on in the game that Irene suffers from infertility following childbirth, so it is unlikely that she gave birth to Giulia at that point in time.
Giulia ends up being on the receiving end of Irene’s abuse and has effectively blocked out this period of her life as an adult. ‘Martha’ however remembers all of it, as she mentions in the recording she leaves behind for Giulia.
Problems with depicting DID patients committing violent acts aside, this explains multiple plot beats in the game. Repressed trauma is often the reason behind Dissociative Identity Disorder, and it would also explain Martha/Giulia experiencing blackouts. The head trauma and child abuse could be behind Martha/Giulia’s hallucinations, paranoia, and delusions. For instance, when Giulia intercepts the letter from the asylum thanking her mother for her donation and discussing the arrangements for Giulia to be shifted there, we as players are inclined to give in to her paranoia and conclude that this was probably a bribe paid by Irene to get rid of Giulia. However, it could just as well have been a donation made to ensure that she would be treated better than the other patients at the asylum. Remember that their doctor had already warned Irene about the inhumane conditions at the asylum, so it wouldn’t be surprising if she took this step to secure Giulia’s safety.
Did anything in the game actually happen?
It is important to start off by mentioning that the entire tale is narrated by Giulia (and not Martha) in the ‘present’ (sometime after the war ended) from an undisclosed location, probably the asylum. Our trust in the accuracy of her recollections is increasingly brought into question the further one ventures into her story.

Image: LKA
Everything that Giulia has shared so far has been her memory of her past as experienced by her during her time in the asylum.
In a crucial moment towards the end, Giulia mentions that once she walked into the church, she completely ‘lost touch with reality.’ At first, we assume that Don Attilio, the priest, arranged for doctors to take Giulia into their custody as soon as she arrived. But she continues, telling us that the church was bombed on the very night she went there to seek help – and she survived because she was ‘already in the asylum.’ This strongly suggests that walking into the church was the moment when Giulia realized she was hallucinating and already at the asylum, and not when she was taken to the asylum for the first time.
Everything that Giulia has shared so far has been her memory of her past as experienced by her during her time in the asylum. For lack of a better phrase, everything she narrated to the player was in her head – while she was in the asylum. Trippy, I know. And of course, this wasn’t a simple trip down memory lane, but a rather convoluted jumble of reality and delusions.
So, what really happened? For starters, the majority of the events like finding her twin’s dead body weren’t real. It was symbolic of her journey trying to rid herself of ‘Martha’ and establishing her identity as Giulia, the resilient girl who had survived despite suffering terrible trauma in her childhood.
Why did she end up in the asylum then? This is where we talk about what really happened. It is highly likely that Giulia murdered her mother and dismembered her corpse to dispose of any evidence. This happens during her blackouts, and she only comes around after the deeds have been done. The death of her father at the hands of the soldiers, and her being tortured by them before that, are also events that occurred. We need only look at Giulia’s face at the beginning of the game to see that she has scars on her face and lips that correspond to her account of a torn lip and other facial injuries. It is most likely that she was rescued from the house once the partisans left and eventually taken to the asylum, where she held on to fractured memories of what happened in her past.
So, what was the game all about?
At its core, Martha is Dead is about Giulia wading into the murky waters of her troubled past. Through the lens of a complicated tale that follows Giulia assuming her dead twin’s identity and her subsequent attempts to uncover the mystery behind the death, we witness the fractured memories of a mentally unstable girl with undiagnosed DID who suffers from hallucinations and paranoia.
In the end, especially after listening to Giulia’s final monologue where she talks about how she wanted to get help but had no one to turn to, I felt like the game wanted to talk about the resilience of the human spirit in the face of unspeakable horrors of war, trauma, and child abuse. At the end, Giulia has survived despite all she has faced, and says that she is ‘ready to leave’, indicating that she is stable now and waiting to begin a new life; to ‘turn the page’ as ‘life opens its doors once again.’
If nothing else, Martha is Dead shall remain a learning experience on how not to talk about mental health in video games.
A commendable message, except that the game fails at all turns to get this through to the player. There is too much ambiguity around what happened to successfully deliver a message of hope. The violent tropes surrounding DID and Giulia’s recollections of her time at the asylum also don’t help. It is a shame that this flicker of a positive intention has been lost amongst the gorier aspects of body horror and mutilation in the game that have come to dominate the conversation surrounding it. If nothing else, Martha is Dead shall remain a learning experience on how not to talk about mental health in video games.
Thank you for joining us at Gamer’s Waypoint. While you’re here, make sure to check out our latest video on YouTube and follow us on Twitter to stay updated with our newest reviews, analysis and much more.
Looking for something different? Take a look at this piece on why Witcher 3 is a standout game amongst all open world fantasies.
35,113 total views, 94 views today