The lore of the Silent Hill series has always been fertile ground for all sorts of fan speculation. However, recently, in the Silent Hill 2 remake, it was possible to find enough evidence that James Sunderland's past contains many frightening details and partially explains why he treated Mary so cruelly.
In the game, you can also find many clues and symbols, from which one logical conclusion can be drawn — James really was once a patient in a mental hospital, where he experienced cruelty. He managed to take revenge on his abuser using scissors — it is the giant half of which Pyramid Head carries as a sword.
In short, the world of Silent Hill 2 could be built from repressed memories of the abuse James experienced during his hospitalization, which was also hinted at by the developers of the remake, giving the bodies in the locations the appearance of the main character. Even Abstract Daddy has some features of his appearance (the model of the legs).
The fact that James is mentally ill was previously stated by Silent Hill 2 designer Masahiro Ito himself. This could explain both the events of the game itself and the cruel act of the main character towards his wife Mary.
Previously, fans managed to unravel a twenty-year mystery associated with Silent Hill 2 — the developers of the remake confirmed that the guess was correct.