- "You seem like you can handle a lot of pain. Like, maybe you could handle some kind of pain related difficulty setting, huh?"
- ―Terry Hintz
Pain Mode is an extra difficulty setting designed as the game's hard mode. It is recommended that players play through Normal Mode at least once before utilizing this setting. Pain Mode includes more difficult elements as well as additional content that cannot be seen in Normal Mode. This includes expendable Save Crows, different enemies, a new area, and a secret ending.
Activating Pain Mode[]
After saving Terry from Cheese Legs, he will claim that you look like someone who can handle a lot of pain, even some pain related difficulty setting. Then two options will appear. Choosing no will let the game proceed in Normal Mode. Choosing yes will activate Pain Mode. If playing on LISA: Definitive Edition's version of LISA: The Painful, Terry will have an additional dialogue option if the player is unaware of Pain Mode's changes to the base game. He specifically notes "encounters you haven't seen before" and "limited save points". There is no additional dialogue if you repeatedly ask him about Pain Mode.
Saving the Game[]
The most notable element in Pain Mode is that Save Crows will now explode after being used. This means you can only use each save point once. Be warned that Save Crows will still explode even after you exit the save menu without saving, but you can still save multiple times in the menu.
- At the Nice Neighborhood, the Joy Mutant that has a save crow on his head has been removed.
- To a more humorous effect, the man dressed up in a crow shaped cloak, past Wally's building, will also explode if you talk to him to save.
Enemies[]
While playing in Pain Mode there are new mini-boss battles to encounter, as well as some that have changed quite significantly from Normal Mode.
- In the Snake Field in Area 1 (just before the Playground) the Man Laying in Grass is replaced by a man in a tree costume simply known as Tree Man.
- In the Area 1/2 Transition (past the campsite), Sweet Tea Rakeem is now aided by another man, similar in stature, named Vic Cherry.
- At the entrance to the EWC, a dual gun wielding enemy named Tex Diablo blocks your way.
- On your way to the Mint Cloth in Holly Wood, you will find that Hawk Hollywood has transformed into a Joy Mutant.
- A new Joy Mutant named Herb appears in Area 3, in the tunnel the leads to the Snow Mountain.
New Areas[]
- In Pain Mode, the player has access to the Joy Lab, which is an area in the Nice Neighborhood that was previously locked in Normal Mode.
Other Changes[]
- The tent in Area 1 Crossroads will remain even after progressing to Area 2.
- This was removed in Definitive Edition, which might indicate it was a bug.
Secret Ending[]
As mentioned above, Pain Mode also features a hidden ending that plays after the credits roll. It should be noted though that this ending will override the Joyful and Joyless endings. Any player who has yet to get either of those two endings must play through the game in Normal Mode.