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Torque is not a happy man. His wife and two children have been brutally murdered, he's constantly hallucinating, he just escaped from prison, and hellish creatures are constantly trying to impale him or set him on fire.

The Suffering: Ties That Bind is one of those games that truly embraces its 'M' rating. It stands alongside Killer 7 and the Mortal Kombat series as one of the most unapologetically violent games of all time. You'll see children dying in pools of acid, women with blades shoved down the entire length of their bodies, and enough limbless and headless bodies to make Saving Private Ryan look tame. Throw in a healthy dose of F-bombs, and you've got one game that is certainly not meant for the under-18 crowd.

Violence aside, the story is initially very intriguing in its own right. Torque is bent on getting his revenge on a mysterious man named Blackmore (voiced to perfection by The Green Mile's Michael Clarke Duncan). After a brief prison intro, the player is sent to the streets of Baltimore, where most of the game is based. The game plays heavily on the fact that Torque is clearly not a stable man. He'll hallucinate, have flashbacks, and pass out in the middle of gameplay. This lends itself to some truly scary situations, such as when your son is running towards you, only to morph into a 9-foot tall hellbeast with blades for arms. Scripted events occur frequently within the gameplay, and they're usually pretty interesting to stop and watch.

There is some obvious cinematic influence right from the beginning. The opening credits seem like they're taken straight from Seven, and elements of the game mimic disturbing films such as Jacob's Ladder. The uneasiness you feel at certain points is familiar to how it felt to play through Silent Hill for the first time (although this is clearly more action than survival horror). You'll encounter many innocent civilians throughout the course of the game, and your decisions affect your abilities, as well as which of the multiple endings you'll receive. Kill the civilians, and Blackmore praises your malevolence. Help them, and the spirit of your dead wife will praise your decision. Unfortunately, the initially interesting story fumbles at the end of the game, and manages to completely rip off the big twist of a very popular movie from 1999 (hint: it's not The Sixth Sense).

Gameplay in The Suffering isn't spectacular, but it's certainly playable. It's standard Max Payne-esque third person shooting, albeit with the ability to transform yourself into a powerful monster. As you kill enemies, your "insanity meter" will fill up. Press triangle when it's full, and Torque becomes an absurdly powerful beast with several different devastating attacks. This will certainly save your life in many situations, as long as you remember to transform back before the meter is empty. You really do get a sense of power when you transform, as enemies don't stand a chance against the more powerful attacks.

Even with the helpful ability to transform, this game is very difficult. Some of it is intentionally challenging, but other frustrating aspects are more thanks to flaws in the gameplay engine. In some areas, it's almost impossible to tell where enemy fire is coming from. Some levels feature wave after wave of enemies, with very little given to you in terms of ammo or health. Ties That Bind is also filled with many "now where do I go?" moments. The map system is nearly worthless, and there's no objective screen to be found.

If you choose, you can play the game entirely in 1st-person mode. While it's no Halo or Half-Life, the controls are competent, and some gamers may even prefer to play through the entire game in this fashion.

There's not many puzzles, and the large majority of the gameplay is relegated to constantly shooting enemies. Thankfully, all of the enemies are very well designed and interesting to look at. There's many different types too: Bladed humanoids, crawling beasts with needles in their backs, hulking monsters with multiple guns, spider-like creatures, and more. Some of these will actually require Torque to be in his transformed state if you hope to defeat them. In addition to the standard third-person action, there are a couple rail-shooter sections of the game where the player operates a mounted turret.

All of the graphical aspects of Ties That Bind are well designed, but there are some issues in terms of technical execution. Characters, faces, and environments are all interesting, but the actual textures leave a little to be desired. Cutscenes are all extremely well directed, and all of the voice actors fit the parts perfectly. Audio is one of the game's strongest aspects, and really adds to the overall mood of terror and confusion. Voices will whisper in your ear, blades will scrape against the ground, and screams can be heard everywhere. There's never really a moment of relaxation, which is exactly how I'd imagine the designers wished it to be.

The Suffering: Ties That Bind should definitely appeal to fans of ultra-disturbing psychological films, as well as fans of third-person action games in the Max Payne mold. There are 18 average-sized missions, and the multiple endings and abilities should give fans a reason to play through it again.

Graphics: C+

Sound: A-

First Play: B

Last Play: C+

Gameplay: B-

Overall: 80% B-