The Psych Profile gives us enough variations to have three different endings... plus a joke ending too, as we're used to have in a Silent Hill game, and that will be ignored here. The endings have never been oficially named, though they're popularly known by names I don't really like; so instead of using them here, I'm naming them "Good", "Bad" and "Medium" endings. Please, I'm not referring to the Good Ending as my favorite one, but I just have the feeling the "Good" ending would be the one in which Cheryl learns, accepts, and faces the truth after all.
GOOD ENDING: All the endings will begin with Harry finally arriving at the Lighthouse Clinic, and overhearing Kaufmann's last therapy session, in which he finally reveals the truth. Harry looks at Cheryl and the camera, at last, reveals her, sitting on the couch. She stands up and, finally realizing nothing that happened was her fault, screams that to her father. Harry raises his hand and tries to touch her, but she pushes it away, saying that someone has to take the blame. Taking a step behind, Harry's last words before turning into ice and falling in pieces are "Forget me." Cheryl cries.
In this ending, we get rid of the weak, passive, quiet and introspective woman we've been watching (and searching for) through the whole game. In this ending, the therapy is effective and she manages to get rid of her guilt and clings to her fantasy world no more. She doesn't need her fake dad and can live knowing the real one, besides, she finally understands her mother and that she's felt the same pain as her. As she walks out of the clinic, Dahlia appears and they embrace, proving that, from now on, Cheryl will leave reality and leave her childish fantasies behind.
MEDIUM ENDING: We watch the regular "Harry walks in the therapy room." What changes in this medium ending is that Harry will kneel before Cheryl, and she will say happilly "You've been with me for so long," to what Harry will answer "I always will be." Cheryl shakes her head and Harry freezes.
This ending shows us that the therapy was 50% effective. Cheryl will still loves the fake dad she has created, she still can't understand all of her own pain. The difference being she now knows the truth and accepts it. By denying her father's last words, she is saying that, though she loved him and he was special, she would move on with her life. Harry not shattering, as in the Good Ending, shows that she doesn't mean, however, to leave everything behind; she wants to keep the perfect memories, even if she is about to dive into reality. The Medium Ending gives us a stronger and less passive woman, meaning that Cheryl has evolved during the therapy, though not entirely.
BAD ENDING: This is my favorite ending, in some ways. After seeing the usual, Cheryl calls for her father, who comes and kneels before her. "You are a hero. The man who died, that wasn't my father. That isn't who I remember. Those memories are all I have - you're all I have." Harry replies sadly, saying that he's not even a ghost. But Cheryl embraces him as he freezes one last time.
In this ending, Cheryl hasn't learnt anything. She may even know the truth now, but she doesn't accept that it's the reality she must live in. She is completely dependent of the fantastic and perfect world and father she has created and that has been with her for so long. She isn't willing to face the pain yet -- if ever. Cheryl will keep living in the fantasy, and probably will remain the introspective, quiet and incapable woman she has been shown as through the whole game.