Theres very little violence or gore. Its mostly walking and puzzles with an occasional mutilated animal (its often too dark to see them well). The hearts are surreal enough to not be gory (just weird). The blood looks really fake and bad (like mud or oil).
The devs couldnt be bothered to make actual combat but you sure spend a lot of time repairing ladders and chopping veggies manually (including selecting tools). What you get is a typical indie walkie horror that pads itself with busywork depriving itself of the brisk minimalist gameplay of Outlast . Its inconsistent tone and campy voice acting also ruins the atmosphere, further dampening the lackluster story. At least the production values are good for a 2-man team, and there is so bad its good dialog.