Sekiro: Shadows Die Twice Review - 7 Ups & 3 Downs
Downs...
3. Death Is More Punishing Than Ever
Unlike in Dark Souls and Bloodborne, when you die, you do not leave behind a little puddle of your experience to pick up later, you straight-up lose it entirely. Half of your progress towards your next experience point and half of your Sen (currency) is lost when you die, with no way of recovering it.
This might sound awful, but it's not actually so bad, considering how quickly your experience is banked in the form of a skill point, and sen can be exchanged, for a price, for a safer alternative that you won't lose when you die.
But it is the Dragonrot that makes death so punishing.
Every time you die and resurrect, you are essentially "borrowing" life force from another living being, and you will begin to afflict every friendly NPC you meet with the fatal disease, Dragonrot. It is - eventually - curable, but the means of doing so comes at a great price, and is very limited. The more denizens of the world are afflicted with Dragonrot, the less likely you are to hang onto your experience and sen when you die.
But screw the experience, the worst part is every time you meet a new person, you get a sinking feeling in your stomach knowing that you'll eventually be causing them a great deal of pain. In a way, it just forces the empathetic among us to "get good" more than ever.