1) Start with a premise that generates mental conflict, not just suspense
A psychological thriller premise should force characters to argue with their own perceptions. Instead of “a person disappears,” aim for “a person disappears, and the protagonist’s explanation for the disappearance keeps changing under pressure.” That creates dread from interpretation. Write the premise as a contradiction you can repeatedly test in scenes. Example premise forms: (a) the narrator insists something happened; the evidence says otherwise; the narrator’s story improves only when they are isolated. (b) two characters share a memory that cannot both be true; each claims the other is lying; the reader discovers later that both are withholding something.