Samson's default perk is 'blood lust', which means that when he takes damage, his damage output from tears increases slightly for the current floor. This makes him really good at maximizing on things that are trapped behind floor spikes, spike chests, and spiked doorways. and it's available to you from floor 1 room 1.

this also means that soul hearts have extra value. pray you don't need them, but the more you end up needing them, the higher your damage output. making him great if you kinda suck at avoiding damage.

purposeful damage taking is a legitimate although risky strategy, but becomes less risky if you can regenerate. Mom's locket+locks purposefully not opened until just before the boss is an unexpected sweet spot.

so basically if you do it right, you can completely break your overall damage output and next to nothing can stop you.