Little Nightmares III Guide | How to Escape the Psychiatrist (Chapter 4)

Here's a guide on how to escape the Psychiatrist in chapter 4 of Little Nightmares III.

Game Guide by TauxicPandA on Oct 20, 2025

In this section, you must navigate through a vent system and eventually confront The Psychiatrist. Follow the steps carefully to navigate the chase sequence safely.

Reaching The Outdoor Area

Start by moving to the right at the bottom of the vent. Continue crawling until you reach an outdoor section where a tree is visible in the background. Here, you’ll find a stretch of water that you need to cross in Little Nightmares III.

Little Nightmares III, Guide, How to Escape the Psychiatrist, Chapter 4

Crossing The River

Wait patiently for the large Hand in the background to create a small wave. This action will cause a floating cushion to rise to the surface of the river. Once it appears, use the cushion as a platform to jump across to the other side. After crossing, keep moving forward to progress further into the area.

Little Nightmares III, Guide, How to Escape the Psychiatrist, Chapter 4

Entering The Hallway

Continue onward until you reach a hallway where the Hand shows up again. As soon as it appears, start running to avoid being caught. The Hand will chase you through the corridor, leading you into another area where both the Face and a second Hand appear in Little Nightmares III.

Little Nightmares III, Guide, How to Escape the Psychiatrist, Chapter 4

Performing The Quick Time Event

During this encounter, the right Hand will attempt to grab you. When prompted, take control of Low and execute the quick time event by shooting the Hand in the eye. Successfully doing this will cause the giant Psychiatrist creature to retreat, ending the chase and allowing you to continue forward safely in Little Nightmares III.

Also, check our Little Nightmares III Review and other guides below: