So in our game about self-discovery, we have an MC talk to an alternate version of themselves in their mind. We did this by having the same sprite for both but making one red using Unity's option to tint.
I also made an object that shakes with a Trail Renderer to put over the alt MC's face, so instead of seeing her face, we just see scratches happening in real-time. This is also done fully with code/Unity's capabilities. But we are unsure if it is completely legal...