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Trigger warning — this fiend description concerns intrusive thoughts, so if you have concerns about content like that, I suggest you give this creature a miss
Phikkik Sahkil
The Intrusive Thought (CR 12); paranoia, unwarranted fears
Home Planes: Ethereal / Xibalba; Nether
Alignment: Neutral Evil
A phikkik [fih-KICK] sahkil looks some kind of a surgical nightmare made real. Tall as an ogre but ten times as deadly, it have a cone-shaped body with no apparent legs. It drags itself along like a slug, leaving a trail of ectoplasmic slime behind. A horrible vertical mouth splits its torso like an open wound, opening directly into its guts. It drools continuously with acidic saliva. The phikkik’s humanoid torso is corded with muscle, with sinewy arms that end in rake-like claws. Its head looks like a flayed wolf, with its eyes fused shut, and its teeth stuck together in a permanent grimace. Crowning it all, a dozen sinuous eyestalks jitter and swivel, prying into every dark recess.
When a phikkik slips in from the Ethereal, the air curdles with the copper tang of old fear-sweat and you’ll catch its chittering psychic buzz in your skull long before you see the awful thing itself. But it’s the phikkik’s mind games that’ll really make your blood run cold. These sahkil thrive on unearned dread, feeding off paranoid and unwarranted anxiety. They’ll sneak into a burg, spread whispered lies about existential threats, treacherous neighbours, and false conspiracies. They can fire bolts of madness from their writhing eyes, spy on a cutter’s thoughts and plant intrusive suggestions and induce festering paranoia, and rip a berk’s sanity into tatters with their claws. They’ll convince you that the cleric’s healing spells are really stealing your soul, and that the chef is trying to drug and rob you.
When they’re not making mortals mistrust their own shadows, phikkik are often forced to act as long-range attackers in sahkil terror squads, when the fiends launch terrifying assaults on the River of Souls and its psychopomp guardians. The phikkik typically despise this duty, but they know disobeying a tormentor is an even worse idea. The sooner they can drive off the psychopomps and grab some fresh souls, the sooner they can back to the more fulfilling task of driving entire burgs into madness
Source: The Creature Codex [PF1e] here
Other Sources: Jon Winter-Holt. Canonwatch: The sahkil are a fabulously horrid type of fiend from Pathfinder lore, who make a great addition to the Ethereal Plane and Planescape lore generally. The Creature Codex has done an awesome job of expanding the number of sahkil massively too, and I’ve included all their creations here. Organising the sahkil into three sub-types based on their hunting style was my idea, because the list was unwieldy and their names are (deliberately) hard to remember, and this splits them up into bite-sized chunks.