How to make Touhou the spooks: Reduce player fire rate by approximately 99.9%. Waiting around to shoot does add tension for sure, but eventually it was mostly just dragging my feet as I waited for days to tick by. Other than that, the mechanics works great. The enemies started goofy but the that last hallway literally laughing at my bullets definitely set the unnerving mood. The hidden mechanic is foreshadowed well between the characters, item descriptions, and where you get them. The boss felt appropriate but man I wouldn't want to see that in my dreams. Which is super unfortunate given where they tend to hang out.
Edit: It is much worth it to go for both endings.