The Suffering: Ties That Bind is am action-horror game that emphasizes the disturbing terror of its predecessor, with new twisted creatures and a few familiar faces. Set in the unforgiving streets and prisons of Baltimore, the player once again controls Torque as he seeks revenge against the mysterious grand manipulator Blackmore, a man somehow tied to the death of Torque's family. Players will explore the tough inner-city, with poverty and urban injustices trapping people just as effectively as a physical prison. The unique morality system returns, as players delve into the perverse world of Torque's sanity to discover his past and struggle to control his future.