The Suffering centers on the story of Torque, a prisoner on death row for murdering his ex-wife and two children, a crime that he possesses no memory of committing.

The game features three endings which depend on the players' gameplay choices throughout, each of which reveals a different version of the murder of Torque's family.

Other items which can be found during the game are Xombium tablets (which restores the player's health), paperwork with story content, maps, ammo, and flashlight batteries.

[14] Infernas are the trapped spirits of three children who accused eleven innocent people of being witches during the time of a Puritan settlement on the island.

He then gets a phone call from his dead wife, Carmen (Rafeedah Keys), telling him the island is more than a prison, that it brings out evil in everyone, and advising him to escape as soon as he can.

[21] Hermes T. Haight (John Patrick Lowrie) was the executioner in Abbot for twenty-seven years, before he committed suicide in the gas chamber.

They head through the eastern cellblock, where Torque has a vision of Carmen, who explains why she left him; when he was incarcerated for the second time, she knew she needed to make a change to her life.

Torque heads back to Abbot by way of the beach, where he encounters Clem (Ross Douglas), an elderly inmate who was in the middle of an escape when the earthquake struck.

Clem has a small one-person boat ready to sail, but needs Torque's help fighting creatures emerging from a wrecked slave ship before he can leave.

To accomplish this, we made a number of key design decisions, from the player's ability to effect the world in a believable way (killing friendly humans), to the storytelling techniques we used, to the morality system that leads to the distinct endings.

Inspired by some of the imagery from Stanley Kubrick's The Shining, this technique was our most innovative and also proved to be fairly frightening [...] the story is kept mysterious enough that players will still be left with numerous unanswered questions.

My hope is that players will fill in the blanks with their own imagination, following the tradition of great horror films such as The Birds, The Shining, The Blair Witch Project, and The Ring.

Thus the storyline is suffused with the darkest elements of American history, including prison life and culture, slavery, racism, unethical medical experimentation, mob-mentality executions, and the death penalty.

[5]An important element in the design process was what Rouse refers to as "player-empowerment;" allowing players a great deal of freedom within the game world.

However, with the release of successful console third-person shooters such as Max Payne, Halo, Medal of Honor: Frontline, and SOCOM, all of which "eschewed target-lock in favor of double-stick control schemes that simulated the mouse/keyboard experience from the PC", the team decided to scrap their target-lock system and go with a free aim system; "looking at the sales for these titles, we concluded the installed base of players who were familiar with these controls was now large enough that we could take the risk of turning off a few newbies.

In the game, Abbot had been built from the remains of a World War II army base, whereas Alcatraz was originally a military prison.

We did a pass on horror elements to make the game more frightening, including adding our real-time environmental flashes that are so key to the final experience.

A defunct gothic prison that is supposedly haunted, game journalists spent the night in the facility with representatives from Midway and Surreal Software.

[43] On October 28, Midway announced the GameCube version had been cancelled, explaining "we want to concentrate on the leading platforms in the marketplace when it comes to launching original product.

[38]Erik Aho further explains, In any given level or boss battle, the music would be composed using only objects found in that environment or associated with a specific character.

In the asylum level, the whispers and cries of the insane were combined with the faint, sinister droning of the Victrola coming from Dr. Killjoy's office.

The battle with Hermes, who appears as green gas in the shape of a man, is scored using violent rhythms created from compressed air.

Although he praised the morality system and the general gameplay, he concluded "I felt the psychological elements and the morality-play overtones were largely wasted on what is at its most fundamental level a fairly run-of-the-mill shooter.

He concluded that "although The Suffering tends to rely more on startling you with visual effects and sudden attacks than on actually trying to scare you, it's still a pretty refreshing take on horror-themed games.

"[58][59][60] GameSpy's David Hodgson scored the PlayStation 2 and Xbox versions 3 out of 5, calling the game "Oz meets Clive Barker, drenched in the entrails of Stephen King.

"[62][63] Scott Osborne scored the PC version 4 out of 5, writing "The Suffering offers a smooth blend of survival horror and shooter action."

Of the PC port, he wrote "you'll find a few bugs, clipping problems, and occasional clunky moments when a character's important dialogue is interrupted by that of a scripted event, creating an audio muddle.

Still, with its well-designed levels, fluid pacing, and hyper-violent combat in eerie locales, The Suffering is a fun way to safely tap into your dark side.

It is, however, filled with tons of gore, vulgarity, and offensive material [...] If you think Peter Jackson's true masterpiece is Dead Alive, you'll be right at home with The Suffering.

Midway CEO David Zucker stated "The positive market reception to The Suffering illustrates our ability to successfully develop and release entirely new properties that resonate strongly with the growing audience of sophisticated, mature gamers.