Based on the 1989 novel by Russell Banks, the film stars Nick Nolte, Sissy Spacek, James Coburn, and Willem Dafoe.

[4][5] Rolfe Whitehouse begins the film, announcing the story of his brother Wade's "strange criminal behavior" and subsequent disappearance.

After a car chase, a nervous Jack finally pulls over, threatens Wade with a rifle, shoots out his tires, and drives off.

He collects Jill from her mother's house, where his ex-wife furiously castigates him over his plans to sue for full custody.

In response, Wade angrily pushes Jill, giving her a bloody nose, forcing both her and Margie to drive off.

The latent aggression between the men culminates in another fight in which Wade hits his father with the butt of a rifle, accidentally killing him.

Rolfe concludes that someday a vagrant resembling Wade might be found frozen to death, and that will be the end of the story.

[6][7] The director said in an interview with Filmmaker that he identified with the characters in the story: "I had a very strong father and an older male sibling.

[8] According to Schrader, he offered Nolte the part five years before filming began, when the actor had become a bankable star following his success with the box office hits The Prince of Tides and Cape Fear, both released in 1991.

[9] According to Schrader, it was Spacek's husband Jack Fisk who came up with the idea of having the characters of Wade and Glen Whitehouse lick salt off their hands to show how similar the father and son are to each other.

[8] Schrader told Roger Ebert that he gave the part of Glen to James Coburn because he was bigger than and could "convincingly dominate" Nolte.

When Schrader encouraged the actor to prepare for the role, Coburn reportedly said in response, "Oh, you mean you want me to really act?

Although first presented at the Venice Film Festival on August 28 the same year, Affliction did not see a theatrical release until some time later in most countries.

The consensus reads, "Dark and bleak, the 'kick-ass' performances, especially Nolte's 'effective' portrayal of an abused soul, is the reason to see this film.

[11] Janet Maslin in The New York Times wrote "[Nick Nolte] gives the performance of his career in Paul Schrader's quietly stunning new film [...] Like The Sweet Hereafter, a more meditative and elegant but less immediate, volcanic film, Affliction finds the deeper meaning in an all too believable tragedy.