The Ludovico Technique

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Treasure Room Icon.png
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Item icon
Item altar

Character appearance
Tear appearance
Item Pool Treasure Room.png Treasure Room
Added in AfterbirthGreed mode onlyItem Pool Treasure Room.png Treasure Room
Added in Afterbirth (page 3, column 4, line 5)
Removed in Afterbirth (page 4, column 4, line 3)

The Ludovico Technique is a special passive item.


  • Instead of firing tears, Isaac controls one floating tear that hovers over obstacles. This tear deals constant damage when held in place over an enemy.


  • Ludovico tear movement speed is determined by the Shot Speed stat.
  • Ludovico tear hits per second are determined by the Tears stat.
  • When Death uses his The Hourglass attack, the tear is slow to respond but then moves so quickly that it is nearly impossible to use effectively.


  • 20/20 20/20: One smaller tear orbits the main tear.
  • Added in Afterbirth 8 Inch Nails 8 Inch Nails: The tear becomes a nail, increases in size, damage, and provides minor knockback in the direction the tear moves.
  • Added in Afterbirth † Apple! Apple! / Added in Afterbirth † Euthanasia Euthanasia / Tough Love Tough Love: The tear can gain the damage multiplier from each of the items, using the appropriate appearance when it happens. Euthanasia retains its instant kill ability against non-boss enemies.
  • Blood Clot Blood Clot: The tear steadily cycles between red and "normal," dealing more damage when red.
  • Brimstone Brimstone: Tear takes the shape of a very large laser ring. Shot speed is ignored. The Tears stat is ignored and damage is dealt very rapidly at a rate equivalent to 2 tear delay. This ring will always be present and doesn't need charging up like normal Brimstone would.
    • Brimstone Brimstone + A Lump of Coal A Lump of Coal: The ring increases in diameter, but not damage, the farther away it gets from Isaac.
    • Brimstone Brimstone + Spoon Bender Spoon Bender: The ring reaches out to attack enemies near it, reforming into a ring when no enemies are present.
    • Brimstone Brimstone + Technology Technology: The ring is visually identical to a normal Brimstone ring, but the 1.5x damage multiplier applies.
    • Brimstone Brimstone + Wiggle Worm Wiggle Worm: The ring takes the shape of a star.
  • Azazel: Same effect as with Brimstone, but damage is halved.
  • Chemical Peel Chemical Peel: Tear will alternate between "normal" and red, dealing more damage when red.
  • Chocolate Milk Chocolate Milk: No damage increase, but results in -1 tear delay.
  • The Common Cold The Common Cold: The tear pulses green, poisoning enemies.
  • Added in Afterbirth † Compound Fracture Compound Fracture: Shoots out smaller tears when attacking an enemy.
  • Added in Afterbirth Dead Eye Dead Eye: Damage bonus increases until it hits the max of 2x. Since the controllable tear never hits the ground or wall, the bonus cannot be lost.
  • Death's Touch Death's Touch: The tear becomes a scythe (vanity), but increases in size and damage
  • Dr. Fetus Dr. Fetus: The bomb can be controlled until it explodes.
  • Godhead Godhead: The tear homes towards nearby enemies and gains a large damaging aura.
  • Guppy transformation: A large number of flies is rapidly deployed whilst controlling the Ludovico tear.
  • Added in Afterbirth Incubus Incubus: Isaac gains a controlled tear while also being able to shoot normally with Incubus. Incubus's tears gain piercing and spectral properties.
  • The Inner Eye The Inner Eye: Two smaller tears orbit the main tear.
  • Lost Contact Lost Contact: Tear will block enemy tears without disappearing.
  • A Lump of Coal A Lump of Coal: The tear becomes larger the further away it is from Isaac, increasing in damage.
  • Mom's Contacts Mom's Contacts: Tear randomly alternates colors, which randomly petrifies enemies.
  • Mom's Perfume Mom's Perfume: Tear gains a chance to give the fear effect.
  • Mom's Wig Mom's Wig: The item causes spiders to spawn rapidly when moving the tear.
  • Monstro's Lung Monstro's Lung: Tear turns red and does more damage.
    • Added in Afterbirth Tear becomes a cluster of variously sized tears spread over a small area. The tears move at the same speed when controlled but constantly move around each other.
  • Mutant Spider Mutant Spider: Three smaller tears orbit the main tear.
  • My Reflection My Reflection: The tear moves much faster.
  • Number One Number One: The tear deals damage to enemies much faster, with the range penalty having no effect.
  • The Parasite The Parasite: Shoots out smaller tears when attacking an enemy.
  • Added in Afterbirth † Pause Pause: The tear deals damage, even if the enemies are stopped. Moving the tear unpauses the enemies.
  • Pulse Worm Pulse Worm: The tear pulsates in midair, expanding and contracting. This works with normal tears as well as Brimstone Brimstone.
  • Spoon Bender Spoon Bender: Tear will slightly gravitate towards enemies near it
  • Strange Attractor Strange Attractor: Enemies, items and even most bosses will be sucked to the single floating tear, dealing constant damage while keeping Isaac well away from harm, making this combination extremely effective in almost all scenarios.
  • Technology Technology: The tear becomes a large laser ring, which visually looks like a shot fired by Tech X Tech X. Shot speed is ignored. The Tears stat is ignored and damage is dealt very rapidly at a rate equivalent to 2 tear delay.
  • Added in Afterbirth Tear Detonator Tear Detonator: The tear explodes into six smaller tears, then reappears next to the player.


  • ???'s Only Friend ???'s Only Friend / Robo-Baby 2.0 Robo-Baby 2.0: The tear and familiar(s) travel together, as they are controlled in the same way. Because the familiars' travel speeds are not affected by Isaac's shot speed, they only travel in the same spot when Isaac has exactly the amount of shot speed to sync them up.
  • Anti-Gravity Anti-Gravity: Overridden by The Ludovico Technique.
  • Cricket's Body Cricket's Body: Overridden by The Ludovico Technique.
  • Cursed Eye Cursed Eye: No effect.
  • Epic Fetus Epic Fetus: Overrides The Ludovico Technique.
  • Added in Afterbirth Explosivo Explosivo: Tear will alternate between "normal" and black. If it touches an enemy, it will stick to it, grow in size, then explode. The tear can not damage anything or be controlled when stuck to an enemy.
    • Added in Afterbirth † The tear will grow and explode very quickly when stuck to an enemy, instead of the normal Explosivo delay.
  • Fire Mind Fire Mind: Tears retain the ability to ignite enemies and explode. Tears respawn at Isaac's location after exploding.
  • Added in Afterbirth † Ghost Pepper Ghost Pepper: Fires created from Ghost Pepper will destroy the tear and cause it to respawn on Isaac.
  • Homing Tears: The tear slowly homes toward the nearest enemy. Once locked in an enemy moving the tear somewhere else becomes harder.
  • Hook Worm Hook Worm: Tear moves in a zig-zag pattern while controlled.
  • Invulnerability: Tear cannot be moved while in effect, but will still do damage.
  • Ipecac Ipecac: Overridden by The Ludovico Technique. (No damage increase or explosion.)
    • Added in Afterbirth † +4 damage bonus, no explosion.
  • Loki's Horns Loki's Horns: The Ludovico tear will sometimes shoot 4 smaller tears in each direction.
  • Mom's Eye Mom's Eye: The Ludovico tear will sometimes shoot smaller tears behind it.
  • Mom's Knife Mom's Knife: The tear becomes a controllable knife that deals double Isaac's damage. Effective shot speed is lowered. Tears stat is ignored and damage is dealt at a rate equivalent to 5 tear delay.
    • Mom's Knife Mom's Knife + Godhead Godhead: Replaces the Ludovico tear with Mom's Knife but removes the Godhead aura.
    • Added in Afterbirth Mom's Knife Mom's Knife + Technology Technology: Creates an uncontrollable laser ring centered on Isaac. The knife becomes stuck under Isaac and cannot be fired.
  • Added in Afterbirth Multidimensional Baby Multidimensional Baby: No effect.
    • Added in Afterbirth † An additional Ludovico tear is spawned when it passes through Multidimensional Baby, at the start of every room, and persists like the Ludovico tear itself.
  • Notched Axe Notched Axe: The Ludovico tear cannot be moved while Notched Axe is held up.
  • Proptosis Proptosis: The closer the tear floats to Isaac, the larger it is. The farther away, the smaller.
  • Added in Afterbirth Pupula Duplex Pupula Duplex: Decreases the tear size by taking the form of a Pupula Duplex tear; however, it travels faster.
  • Red Candle Red Candle: The tear disappears upon contact with a flame created by the candle and reappears near Isaac, slightly shrinking the flame.
  • Ring Worm Ring Worm: The tear spins rapidly in small circles.
  • Added in Afterbirth † Sinus Infection Sinus Infection: The tear can occasionally stick to an enemy. If the enemy does not die quickly, the tear pops and a new one spawns.
  • Tech.5 Tech.5: The tear controls as usual, and Isaac fires the laser towards the tear relative to his position, rather than in the direction the player is moving the tear.
    • Tech.5 Tech.5 + Added in Afterbirth † Analog Stick Analog Stick: Laser is fired directly at the tear while it is being moved, instead of being limited to cardinal directions.
  • Added in Afterbirth Tech X Tech X: Overrides The Ludovico Technique.
  • Technology 2 Technology 2: The tear controls as usual, and Isaac fires the laser towards the tear relative to his position, rather than in the direction the player is moving the tear. Technology 2's damage penalty still applies.
    • Technology 2 Technology 2 + Added in Afterbirth † Analog Stick Analog Stick: Laser is fired directly at the tear while it is being moved, instead of being limited to cardinal directions.
  • Tiny Planet Tiny Planet: The tear controls strangely. It orbits Isaac slowly when not controlled, and when controlled, the tear's movement is distorted. Additionally, the tear's range becomes limited to Tiny Planet's orbit distance.
  • Added in Afterbirth Tractor Beam Tractor Beam: The Ludovico Technique overrides the beam's effect.
  • Trinity Shield Trinity Shield: The controls of the tear and the shield overlap, making it impossible to consistently control both.
  • Added in Afterbirth The Wiz The Wiz: A smaller Ludovico tear will spawned and revolves round the main one. Also, the Ludovico tear now moves in a very unusual way, up is up-right, down is down-left, left is left-up, right is right-down. This can be counteracted by holding the keys or d-pad in its associated path (up-right to make it go up and so forth with the other keys).

In-game Footage


  • The Ludovico Technique is a reference to Anthony Burgess' novel A Clockwork Orange and Stanley Kubrick's film adaptation, where it was referred to as "Ludovico's Technique." The technique involved headgear which forced the patient's eyelids open (hence "Controlled Tears") while watching violent films under nausea-inducing drugs, conditioning them against violence.


 PC  KPRZ M83V (First floor treasure room)

 PC  ZYS1 ONMS (Treasure room adjacent to spawn)

 PC  VLZW 7CJ8 (Treasure room adjacent to spawn)

 PS4  S11S E632 (First floor treasure room)

 Vita  0H0T MKNS (First floor treasure room)

 3DS  DQBE T9RH (First floor treasure room)

 3DS  GEYN TXS7 (First floor treasure room)

 3DS  KK92 7DTD (First floor treasure room)

 PC  Added in Afterbirth MX26 V47J (treasure room adjacent to spawn) (both modes)

 PC  Added in Afterbirth KYSL MRKZ (treasure room adjacent to spawn)

 Switch  191Z NVJA (Treasure room adjacent to spawn)

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