The Suffering: Ties That Bind

The Suffering: Ties That Bind is the sequel to The Suffering, and picks up after the ending of that game. Players who have a game save of the different endings of The Suffering can decide with which morality to start with, starting with a different morality changes the dialogue and intro of the game. Ties That Bind features a number of gameplay changes from the original The Suffering.

The player can no longer carry around xombium bottles to refill their health whenever they need to, and instead must rely on stationary pickups located throughout the level. When critically injured, the player may also heal a very small percentage of their health by hiding from the immediate battle to recover. The player is also now limited to only carrying two weapons at a time, which now adds a sense of strategy to the gameplay.