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Gehrman made the Doll.
Gehrman made her to be subservient to himself and other Hunters.
The Doll has unique dialogue after you kill Maria, suggesting they were linked in some way.
Gehrman offers to let you use the Doll inappropriately.
I’d disappear into a nightmare world full of fish people to get away from Gehrman too.
I’ve not played the game myself (can’t, no PS), but I’ve absorbed a fair bit of the lore through the rest of the fanbase.
It was my understanding that the doll was given to him by the Moon Presence. Like, in a disturbing “Oh, you loved this person and want them back? Here, this is the same thing, right?” sort of way.
Gehrman modeled the doll after Lady Maria.