Silent Hill 2's art director, Masahiro Ito, has confirmed that the Misty Day painting of Pyramid Head in the Historical Society is actually real and not something that's distorted by the Fog World.
One of the most interesting things about Silent Hill 2 (and the series as a whole, really) is how much of its story and themes are up to interpretation. If you just want to believe that James is running into a bunch of otherworldly monsters, you can, but if you dive deeper and realise they're all manifestations of his mental state, that works too.
The comic sans Silent Hill Ranch sign shows up that early?!
Perhaps the most interesting example of this is Pyramid Head, one of the main antagonists in Silent Hill 2 and one who has gone on to become a sort of mascot for the series. That's something that a lot of fans have contested as the triangular scissor-wielder is apparently only supposed to be seen by James and not something everyone who wanders into Silent Hill can encounter.
For decades now, fans have theorised about how James Sunderland came up with Pyramid Head and why he looks the way he does...
