These are all four endings in Withering Rooms. The titles are not the actual names of the endings, just what I felt covered the theme of the ending. Here's how you unlock each ending:

Ending A: After defeating the final boss, speak to Margaret and confirm your intentions.

Ending B: After defeating the final boss, speak to the Filthy Wretch and confirm your intentions.

Ending C: After defeating the Blood Tower boss and collecting all five Night Mother Relics, go back to Lara in the Cholera Clinic. Get her the heart she needs from the boss in the Clinic, then speak to Lara.

Ending D: You must be on a New Game Plus. Defeat the bonus boss after finding the hole in the wall. Grab the Book of Burdens and power up a "guardian" with Dream Offerings. Once it is strong enough, speak to the Vicar.

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