Place it at the climax of a boss montage, then follow it with the FNAF jumpscare scream for a second shock, or open with No God Please No before the fight begins to set up the encounter.
About this sound
This is a full minute of raw, high-pitched screams from the Orphan of Kos during its boss fight in Bloodborne, with no dialogue or music to soften the noise. It feels frantic, painful and overwhelming, like a creature in constant distress, and it works as a jolt of horror tension for anyone who recognises the fight.