More on breaking the fourth wall

I've posted before about the idea of breaking the fourth wall in different kinds of media. This phenomenon is somewhat common in video games, but I just remembered an extreme and extremely effective instance of this.

Some of my friends went through a phase of playing this really silly video game. The name escapes me, but it involved killing zombies. It was basically a typical kill-all-the-monsters sort of game, with a twist: being in the same room with the monsters lowered your sanity levels. If your sanity got low enough, the game would start playing screaming in the backround, blood would drip from walls, imaginary monsters would start jumping out at you, etc. Everyone got used to these things, and some people even purposely played at low sanity because they found the effects so amusing. However, very late in the game, an additional insanity effect shows up: your computer/tv suddenly exhibits the blue screen of death. You really should have heard the screams that effect elicited.

Most interactive media allow us to enter in to the world story and to influence the outcome of the story, but I'm not aware of very many other things that try to convince you of their ability to effect the real world. How does this work with suspension of disbelief?