The Lying Figure is the first monster James Sunderland encounters, after following trails of blood through Silent Hill. He confronts it in a closed tunnel after retrieving the radio, where it is seen feeding on a corpse.
Their bodies are trapped in what appear to be straightjackets made from their own flesh, covering them from head to toe with feminine legs and buttocks, and platform shoes hidden underneath their flesh. When they scurry across the ground, they make a high-pitched wailing noise that sounds like the scraping of metal against cement.
They attack by spewing a spray of poisonous mist from an opening in their chest which will knock James back and force him to recover for a few seconds before being able to resume his attack. Because of this, it's best to deal with them from range, preferably by using the handgun, as a few good shots can down the creature. However, if melee is the only option, it's advised to use the steel pipe while strafing left/right to avoid the poison.
They are slow moving while standing upright; however, when knocked down, they can easily hit James by skittering very quickly along the ground, easily outrunning the player. It's best to flee if the situation arises.
According to the Book of Lost Memories, the Lying Figure symbolizes a hospital patient squirming in agony. This is a manifestation of James's internal suffering.
In Silent Hill 2, Masahiro Ito designed the Lying Figure as reminiscence of Mary Shepherd-Sunderland in her state of terminal illness, which has been speculated to have something to do with physical distortion, as Mary says, "I look like a monster!" This furthers the evidence that the Lying Figure was meant to be similar to how Mary saw herself. As well, its main means of attack is spitting an acid-like mist at James; this is suggestive of vomiting, alluding further to the theme of illness. However, this may also be suggestive of how Mary spat hateful words at James during her illness. As the creature appears to have its arms restricted, it can be assumed that it represents James's frustration from being unable to touch or hold Mary during her illness. The way that it skitters along the ground and screeches like grating metal also likens it to a pest. This could point to Mary being burdensome and disgusting to James.
The prevalent theme of sexual frustration ties in, as this beast is practically unclothed, trapped, writhing, has effeminate legs and buttocks, has feet that look like platform shoes, and spews a spray from its chest, mirroring male ejaculation. In extension, the Lying Figure could also represent James's disgust with his own growing sexual yearning in the face of Mary's illness, and the figure symbolizes this by having both of its hands thrust down its underwear, easily noticeable in the creature's concept art.
- In the making of Silent Hill 2 video, monster designer Masahiro Ito revealed that his inspiration for the Lying Figure came from watching a programmer friend walk into the office. Ito states that his friend was wearing a hooded sweater with his hands in his pockets, and was walking "in a cool way" as he was listening to his walkman.