Yeah, you can choose the path to go down that way for sure. Obviously extra health and proficiency matter, but I've never really been an item user in games either I just forget most of the time. So in this, I barely care what items/perks I get, I don't look for a build. Same with the guns, I pretty much ignore their mods.
I think for me it's mainly because I try everything in the likes of this/soulsbourne games. Or any game for that matter. Dying isn't really ever been a concern when I first play games so I'll explore, mess around, test the limits. For example in this, as soon as I got the blade I'm all charging in and now it's actually used a huge amount in my runs. Even on bosses I'll get in close and get some hits off. This is not really any different to other shooter/action games in that if you work on your character movement and sense of where you are and what is around, then the shooting/enemies becomes far less important. If in any game you play you work on your use of the controls and what your character can/can't do, then you'll be in much better stead.
That being said, this still throws up plenty that gets me. I just got about 10 of those kamikaze flying robots in a room I was new to and got my arse handed to me