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That depends, of course, on what you are talking about. If we are talking about teen horror a la I Know What You Did Last Summer and Scream then Gore is semi-necessary. Watching people die in interesting ways is half of the fun.
If we're talking about really scary horror/suspense movies, then no, it's not.
The most horrifying moment for me in the movie Saw is when Dr. Gordon starts to cut his foot off. You see one shot of the blade rasping back and forth on his skin, and then the movie cuts between his face and Adam's. They are both screaming, and inside, you are too.
I don't even think you get to see the hunk of severed foot up close until the second movie.
Good suspense doesn't require gore, but gore well done can add to it. The problem is, there is no way to make gore look 100% realistic. There is always some part of your mind going "oh, that's the tube leading up the side of her dress so she can spew pea soup" or "wow, that would be a lot more painful looking if the skin wasn't obviously latex".
The truth is that the mind can come up with much better, much more horrifying images than can ever be reproduced on celluloid, and a clever director knows that. With the proper mix of on-screen gore and off screen violence, the message is brought across.
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