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Spread the Terror

Source Horror Adventures pg. 198
Once the incarnation of a fear is chosen, the GM can then support it with surroundings and allies that evoke the same theme. Horror often takes place at night since the dark holds the promise of lurking threats, but a horror tale might take place anytime or anywhere with a disturbing atmosphere that reinforces the chosen menace. For example, the tooth fairies that embody the fear of loosing teeth might have created an underground hive constructed from billions of molars, and a mechanical terror could unfold in a half-functioning clock tower. Whatever the choice, it should provide challenges for the characters to overcome, as this—or another later setting— will likely become a sort of dungeon to explore.

While the horrors of fiction and film often work alone, such is rarely the case in Pathfinder adventures. GMs should choose lesser threats that prop up the horror’s main avatar. These might be its allies, opportunistic hangers on, deranged victims, the remnants of the creature’s work, or the source of the creature’s monstrousness. These allies might be less powerful than a primary foe, or at the very least, less actively horrific. For example, the Leng spiders might surround themselves with a cult of ettercaps, while the tooth faeries might feed their stolen teeth to a half-slumbering, albino purple worm. Traps, hazards, haunts, and other challenges should provide lesser encounters that grant the PCs experience but also winnow away their resources, causing them to face the final threat with some vulnerabilities.