-->"I have been emotionally ravaged by a total of two games: the first is Silent Hill 2. Iíve been to enough conventions and talked to enough people about it that I know I am not alone in this. There are many ways to interface psychologically with the game, but if [[spoiler: you are a sentimental husband with a young, beautiful wife,]] the game is precisely calibrated to annihilate you."
* Room 312. The conversation you hear between [[spoiler:Mary and James]] in the hallway, where you begin to understand how sympathetic James ''really'' is, [[spoiler:how hard it must've been for her, and for James to take her abuse and mixed messages]]. The In Water/Leave endings are heartbreaking when finally James confesses, guiltily and tearfully: [[spoiler:"The truth is...I ''hated'' you. I wanted you out of the way. I wanted my life back!" The In Water ending is, of course, much worse, because despite Mary's urge for James to move on...he doesn't.]]
** [[spoiler: The In Water ending even changes Mary's final message. In the other endings, there are a few lines after Mary tells James to do what's best for him. In the In Water ending, it ends after "Do what's best for you, James." Think about that.]]
* Angela's final scene in the game.
-->[[spoiler:'''Angela''': For me, it's always like this.]]
* The hospital basement segment wherein [[spoiler:James is helpless to save Maria when the elevator doors trap her outside, but remain open just enough for him to see Pyramid Head brutally murder her.]] James slumps to the ground with a look of utter defeat while the most somber music in the game fades in.
* Any and all scenes with Angela, the video tape at the hotel, the conversation in the pseudo-EndlessCorridor, Mary's letter...
** Particularly tough for some is when Angela [[spoiler:calls James out for WhiteKnighting]]. If the player really has been seeing her as someone to help, the rebuff rings humiliatingly true.
* [[spoiler: "You killer! I hate you, I hate you, I hate you!"]]
* The scene where you find out [[spoiler:what ''really'' happened to Mary]], and the infamous In Water ending [[spoiler:in which James commits suicide by driving his car into the lake so that he and his beloved wife can be together again]].
* [[spoiler:''"James... You made me happy."'']]
* The scene when Maria dies in Brookhaven Hospital and very sad music is heard.
* [[spoiler:"Look! I'm ''disgusting''! I don't deserve flowers. [...] Are you still here? I told you to go! Are you deaf!? Don't come back! ... ''James''... Wait. Please don't go... Stay with me. Don't leave me alone, I didn't mean what I said. Please, James. ... Tell me I'll be okay. Tell me I'm not going to die... ''Help me...''"]]
* Maria's entire story in ''Born From A Wish''. She starts out as just another person lost in a town filled with fog and monsters, contemplates suicide, and somehow finds the strength to go on; displaying her kind personality in helping someone who's only dismissive of her, she discovers what she really is. It's hard to say if she was looking for revenge on James [[spoiler:since she had Mary's memories of being killed by him]] or if she was still somehow hoping for a happy ending.
* Going back to Room 312, the song True is such an amazing song. it mixes all of the elements that the game is; mystery, sadness, pain, etc. It is a perfect song for the perfect scene that even listening to it without the game's context makes you feel somewhat empty.
* Guy Cihi (original voice for James) has confirmed the In Water ending to be canon.
** [[WordOfGod The creative director]] for ''Silent Hill 2'', meanwhile, says the canon ending is whatever the player chooses it to be. So if that's the ending that affected you the most, then that's the one that happened.
* Most of the (serious) endings fall into this category.
** [[spoiler:In Water: James succumbs to his despair, and, in spite of Mary's tearful plea for him to move on, he cannot, and commits suicide.]]
** [[spoiler:Maria: Despite his experiences in Silent Hill, James isn't ready to accept that Mary is gone, and latches onto Maria. What drives it into tear-jerker territory is that the cough at the end shows that history is doomed to repeat, and just like Mary did, she will get sick, and die.]]
** [[spoiler:Rebirth: James cannot accept that Mary is truly gone, and is willing to invoke the dark forces of Silent Hill to try and resurrect her.]]