Asphyxia​

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Asphyxia is the manifestation of young Nora Holloway, the daughter of Judge Margaret Holloway of Shepherd's Glen; She is the third of the manifested creature-bosses encountered in Silent Hill: Homecoming.

Alex Shepherd comes across Judge Holloway in the Otherworld Overlook Penitentiary, strapped to a chair inside of an old gas chamber. After freeing her, Alex accidentally drops Nora's locket from his jacket pocket, revealing it to Judge Holloway, who's memories of her daughter's death manifest and summon the terrifying creature.

Asphyxia is symbolic of Nora's death, as she was suffocated sacrificially to appease the Order's god and hold her at bay, protecting the town of Shepherd's Glen. True to her symbolism, it is apparent that breathing oxygen is deadly to Asphyxia, as Alex finishes her off by parting the hands that cover her mouth, forcing her to breathe, and ultimately defeating her.

Asphyxia's design is also symbolic of the caterpillar in Alice In Wonderland, as it was Nora's favorite character from her most beloved book.