You’re walking in the woods, all alone at night. Out of the corner of your eye, you spot something moving about thirty feet back. He gets down on all fours and breaks into a sprint, He’s gaining on you! Shia LaBeouf!
As funny as this amazing work of art is, if it would happen to you, you would be absolutely wetting yourself with fear. I will show you what the underlying structure of fear is. With which you will be able to build fear in your players.
Step 0: Understanding Fear
The oldest and strongest emotion of mankind is fear, and the oldest and strongest kind of fear is fear of the unknown.
— H. P. Lovecraft
Fear is, as the inventor of cosmic Horror, put it, the “strongest emotion of mankind”. As a game master, you want your players engaged in your world emotionally. So in a sense, scaring them is just plain efficient. But what is fear? Ultimately, is our brains’ assessment of danger. But our brains are preconditioned with some inherent fear triggers, such as darkness, grotesque things, and large animals.
Now, fear is usually the last thing you want to feel, but if you know that you are in no actual danger, it can be trilling to experience it. Though using it in D&D is a little tricky. You most likely play as more than capable heroes, that can overcome almost anything. I would suggest you don’t start your horror adventure at level 10+ but rather between level 1-3. This reduces the amount of direct answers the party could have for the horrors you invent. Which in turn makes them fear for their characters’ life more.
Start off mundanely to add contrast to the horrors to come. Show a lovely town, playing kids in the streets, taverns full of laughter. Because when the unnatural things start happening, it causes an even harsher contrasted between those two. But if the town is miserable as is and not even worth saving, maybe evil themselves, it soon causes habituation. Habituation causes players to react to each new “danger” with decreasing interest because they have nothing to compare it to. If you want your evil-town™, then maybe start your players off in good-village™.
Then try to keep the following 4 Steps of fear in mind when running.
Step 1: Creating Unease
Unease is the fertile soil on which fear is grown. To create unease, sprinkle in weirdness. Things out of the ordinary. Wells without water, NPCs with little to big eyes and fish smell, a good guy doll that seems to move on its own. Things that are weird but could have a logical explanation. Maybe the Well just dried up, the big eyes are just genetics and the smell is because they fish here often, and the doll was probably moved by a child.
If they suspect something being wrong, don’t correct them. The unknown causes fear.
Step 2: Building Dread
Build dread by planting seeds into the fertile soil of unease. Dread is the perceived presence of danger. The party finds out: the Well dried up after a gruesome murder there, the people here hadn’t always have big eyes and they most certainly don’t fish, the doll disappeared from the high shelve where no child can reach. With this, you soft-confirm that something is most certainly wrong and the characters are possibly in danger. They go from rationalizing to scrutinizing everything.
Step 3: Causing Terror
The seed is now a full-grown tree. The danger is real, and now it is coming to get you! From the Well, slowly, emerges a long haired ghostlike woman, the NPCs gather in the town square, whisper-chanting “Dagon. Dagon. Dagon.”, tiny footsteps can be heard in the corridor coming towards you.
Step 4: Showing Horror
This is the fruit of your labor, the climax. Now the danger attacks. The Ghost disappears and is now behind you, the NPCs all collectively turn, their faces distorted to those of some kind of fish hybrid, the doll runs wildly fast with a big knife towards you. Initiative. Release of tension.
Conclusion
So in summary: you should create normalcy to contrast it against the horror later. Then use out of place things that make players go “huh… weird” (unease). Hint at vague danger (dread). Let the danger come slowly towards the players, maybe chase them (terror). Let the players fight it (Horror). If you want an excellent article written by Ash Law that made this post possible, then check out her Trajectory of Fear.