Binding of Isaac: Rebirth Wiki

The Ludovico Technique is a 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.


  • Removed in Repentance The Ludovico Technique is a special item.
  • Ludovico tear is piercing and spectral by default.
  • Ludovico tear movement speed is determined by the shot speed stat.
  • Ludovico tear hits per second are determined by the tears stat, maxed out at 30 ticks per second.
  • When Death Death uses his The Hourglass The Hourglass attack, the tear is slow to respond but then moves so quickly that it is nearly impossible to use effectively.
  • Removed in Repentance When there are no enemies in a room, the tear slowly floats towards the player.
    • The Brimstone Brimstone ring still follows when the player is outside of it.
  • If multiple Ludovico Techniques are acquired (via Added in AfterbirthDiplopia Diplopia, Added in Afterbirth †Crooked Penny Crooked Penny or on a victory lap), then additional smaller tears will orbit the main tear.
    • A maximum of 15 smaller tears can orbit the main tear.
  • The Ludovico tear is larger than normal, but does not gain size from damage as much as normal tears.


  • 20/20 20/20 / The Inner Eye The Inner Eye / Mutant Spider Mutant Spider: Smaller tears orbits the main tear.
  • Azazel Azazel: The same effect as with Brimstone, but the damage is halved.
    • Azazel + Brimstone Brimstone: Full damage of the laser ring is regained.
  • Added in Repentance Tainted Azazel Tainted Azazel: The same effect as Brimstone, dealing full damage (Tainted Azazel's default laser damage is halved unless Added in RepentanceHemoptysis Hemoptysis is used first). Tainted Azazel can no longer use Hemoptysis.
  • Added in Afterbirth †Angelic Prism Angelic Prism: While the tear is in contact with the prism, it will fire 4 additional tears in cardinal directions at Isaac's tear rate.
  • Added in Afterbirth †Backstabber Backstabber: Much easier to inflict bleeding and double damage on most enemies.
  • Added in RepentanceBerserk! Berserk!: The tear can't be controlled while berserking but it can be batted around the room until the effect ends.
    • Tainted Samson Tainted Samson: uses a passive form of Berserk! that works the same way.
  • Added in Afterbirth †Bookworm Bookworm: Causes an additional smaller tear to constantly appear and disappear, teleporting from Isaac's location to the main Ludovico tear in a glitchy manner.
  • Brimstone Brimstone: Tear takes the shape of a very large laser ring. Removed in Repentance The shot speed is ignored. The Tears stat is ignored and the damage is dealt very rapidly at a rate equivalent to 1 tear delay. This ring will always be present and doesn't need charging up like normal Brimstone would.
    • Brimstone + Added in AfterbirthIncubus Incubus: Incubus' Brimstone laser is not affected by Ludovico Technique.
      • Added in Repentance Adds a smaller controllable laser ring in addition to the main one.
    • Added in Repentance Brimstone + Ipecac Ipecac: +2 damage, beam explodes when colliding with enemies and obstacles.
    • Brimstone + A Lump of Coal A Lump of Coal: The ring increases in diameter, but not the damage, the farther away it gets from Isaac.
    • Brimstone + Spoon Bender Spoon Bender: The ring reaches out to attack enemies near it, reforming into a ring when no enemies are present.
    • Brimstone + Technology Technology: The ring is visually identical to a normal Brimstone ring, but the 1.5x damage multiplier applies.
    • Brimstone + 20/20 20/20/The Inner Eye The Inner Eye/Mutant Spider Mutant Spider: no effect.
  • Added in Afterbirth †Compound Fracture Compound Fracture: Turns tear into a large bone, which shoots out smaller tears when attacking/touching an enemy. Scattered tears are spectral and piercing.
  • Added in AfterbirthDead 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.
  • Dr. Fetus Dr. Fetus: A bomb is shot out at high speed and can be controlled, another bomb cannot be shot until the previously shot bomb has detonated.
    • Added in Repentance Causes your tears to act like Epic Fetus Epic Fetus and now inherits all synergies Epic Fetus has.
  • Added in RepentanceEye of the Occult Eye of the Occult: While holding a direction key, the Ludovico tear will constantly shoot out controllable tears in random directions. The air time of these tears scales with the range stat.
  • Added in AfterbirthFate's Reward Fate's Reward: The familiar gains spectral and piercing tears.
  • Added in Afterbirth †Flat Stone Flat Stone: The tear starts bouncing at a rate somewhat below Isaac's fire rate, each bounce dealing splash damage.
    • Flat Stone + Ipecac Ipecac: Causes a poisonous explosion when it bounces instead of plain splash damage, as per normal Ipecac. The first bounce when entering a room does not explode, allowing moving the tear with less risk of self-damage.
  • Added in Afterbirth † The Forgotten The Forgotten: The tear follows the Forgotten when in its skeleton form. It can be hit with its melee attack to propel it, making it do more damage. When switching to the Soul, the tear behaves as normal.
    • The Forgotten + Added in AfterbirthMultidimensional Baby Multidimensional Baby: The second tear acts exactly like the first and can also be hit to propel it.
    • The Forgotten + Multi-shot: Switching back from the Soul to the Forgotten will only remove the main tear, thus creating infinitely persisting tears on the screen. Repeating this process allows suspending arbitrarily high amount of tears.
  • Godhead Godhead: The tear homes towards nearby enemies and gains a large damaging aura. However, the aura cannot damage an enemy that is in contact with the actual tear; barring a high tear rate, it may be better to keep the aura on the enemies instead of the tear.
  • Removed in Afterbirth † Guppy Guppy: A large number of flies is rapidly deployed whilst controlling the Ludovico tear.
  • Added in AfterbirthHoly Light Holy Light: The Ludovico tear will release holy beams on itself periodically while touching an enemy.
  • Added in Afterbirth / Removed in RepentanceIncubus Incubus: Isaac gains a controlled tear while also being able to shoot normally with Incubus. Incubus's tears gain piercing and spectral properties.
    • Added in Repentance Incubus creates a second smaller Ludovico Technique tear instead, which can both be controlled by Isaac. The second tear is slightly delayed/ outside of the main tear. This may cause it to not hit enemies sometimes.
    • Added in Repentance Lilith Lilith: Lilith's incubus will fire a smaller Ludovico Technique tear. For each doubled incubus caused by Added in AfterbirthBox of Friends Box of Friends, there will be an additional Ludovico Technique tear that spawns on Lilith's location.
  • Added in Afterbirth † / Removed in RepentanceLead Pencil Lead Pencil: The tear blinks red, but the effect is entirely cosmetic.
    • Added in Repentance Tear barrages are launched in cardinal directions, even when not controlling the tear. Proc rate depends on fire rate.
  • Added in RepentanceLodestone Lodestone: The single floating tear will flash grey to indicate that the magnetism might apply on hit. Like Strange Attractor, enemies tagged with magnetism will also draw the floating tear towards said enemy.
  • Loki's Horns Loki's Horns: The Ludovico tear will sometimes shoot 4 smaller tears in each cardinal direction.
  • 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 Eye Mom's Eye: The Ludovico tear has a chance on each damage tick to fire a smaller tear in a random direction. This chance scales with luck and goes up to 100% at 10 Luck.
  • Removed in Afterbirth † Mom's Wig Mom's Wig: The item causes spiders to spawn rapidly when moving the tear.
    • Added in Repentance Causes Spiders to rapidly spawn until the cap of 5 is reached.
  • 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.
  • Mysterious Liquid Mysterious Liquid: Creep continuously oozes from underneath the tear.
  • My Reflection My Reflection: The shot speed multiplier causes the tear to move significantly faster, allowing it to catch up to any fast-moving enemies.
  • The Parasite The Parasite: Shoots out smaller tears when attacking an enemy. Scattered tears are spectral and piercing.
  • Added in Afterbirth †Pause Pause: The tear deals damage, even if the enemies are stopped. Moving the tear unpauses the enemies.
  • 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.
  • Added in AfterbirthTear Detonator Tear Detonator: The tear explodes into six smaller tears, then reappears next to the player.
  • 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 the damage is dealt very rapidly at a rate equivalent to 1 tear delay.
  • 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.


  • Overrides The Ludovico Technique:
  • Overridden by The Ludovico Technique:
  • Overridden by The Ludovico Technique, other than stat changes:
  • ???'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.
  • Added in RepentanceAlmond Milk Almond Milk The tear will rapidly teleport in a small area around it, making it difficult to aim.
  • Added in RepentanceBird's Eye Bird's Eye: Isaac will occasionally shoot a flame towards the Ludovico tear.
  • Blood Clot Blood Clot / Chemical Peel Chemical Peel: The tear steadily cycles between red and "normal," dealing more damage when red.
  • Removed in RepentanceChocolate Milk Chocolate Milk: The tear can't be charged, but reduces Isaac's tear delay by 20%.
  • The Common Cold The Common Cold: The tear pulses green, poisoning enemies.
  • Removed 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 † / Removed in Repentance The tear will grow very quickly when stuck to an enemy and pop without dealing damage, instead of the normal Explosivo delay and explosion.
      • Added in Repentance The Ludovico Tear will not get stuck on an enemy, instead a duplicate Tear gets stuck on the enemy, grows and explodes.
  • Removed in Afterbirth †Fire Mind Fire Mind: Tears retain the ability to ignite enemies and explode. Tears reappear at Isaac's location after exploding.
    • Added in Afterbirth † Tears do not explode on contact with an enemy.
  • Removed in RepentanceGhost Pepper Ghost Pepper / Removed in RepentanceRed Candle Red Candle: Fires created from Ghost Pepper will destroy the tear and cause it to reappear at Isaac's location.
    • Added in Repentance Fires generated by both items do not interact with the Ludovico tear. However Ghost Pepper will create fires quickly when the Tear is moved.
  • Homing Tears: The Ludovico tear will slowly move towards an enemy. This can make it harder to control towards a different enemy or for enemies that hide underground.
  • 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 the damage is dealt at a rate equivalent to 4 tear delay.
  • Removed in Afterbirth †Multidimensional Baby Multidimensional Baby: No effect.
    • Added in Afterbirth † / Removed in Repentance An additional Ludovico tear is created when it passes through Multidimensional Baby, at the start of every room, and persists like the Ludovico tear itself. However, it cannot be controlled; it instead slowly follows Isaac.
      • Added in Repentance The extra tear stays completely still where it appeared.
  • Removed in RepentanceNotched Axe Notched Axe: The Ludovico tear cannot be moved while Notched Axe is held up.
    • Added in Repentance The tear can be moved by swings, without any special effect happening to it.
  • Proptosis Proptosis: The closer the tear floats to Isaac, the larger it is. The farther away, the smaller.
  • Added in AfterbirthPupula Duplex Pupula Duplex: Decreases the tear size by taking the form of a Pupula Duplex tear; however, it travels faster.
  • Removed in RepentanceSinus Infection Sinus Infection / Removed in RepentanceNose Goblin Nose Goblin: The tear can occasionally stick to an enemy. If the enemy does not die quickly, the tear pops and a new one appears.
    • Added in Repentance Like Explosivo, no longer sticks the original Tear to the enemy, instead places a replacement booger, which deals the same damage.
  • Added in Afterbirth †Sulfuric Acid Sulfuric Acid: The Ludovico tear occasionally becomes acidic and can destroy objects.
  • Added in Repentance Tainted Lilith Tainted Lilith: Gello Gello shoots a smaller Ludovico tear which disappears if he retreats back into Lilith.
  • Removed in RepentanceTechnology 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. The laser becomes spectral.
    • Added in RepentanceTechnology 2's tears penalty applies instead of damage.
      • 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.
  • Added in Afterbirth †Technology Zero Technology Zero: No effect without additional items. Extra tears orbiting the main one or familiar tears will generate arcs to the controlled tear.
  • Tiny Planet Tiny Planet: Tear orbits around Isaac, however, the orbit can be grown or shrunken, sped up or slowed down by using the firing keys.
  • Tough Love Tough Love: Tear occasionally flicks to being a tooth, which deals 3.2x Isaac's tear damage, before immediately returning to being a normal tear. The frequency at which the tear very briefly transforms into a tooth increases with Luck, permanently becoming a tooth at 9 Luck.
  • Trinity Shield Trinity Shield: The controls of the tear and the shield overlap, making it impossible to consistently control both.
  • Added in AfterbirthThe Wiz The Wiz: A smaller Ludovico tear will appear and revolve around the main one. Also, the Ludovico tear moves diagonally, 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.
  • It is possible to control the tear with the mouse, just open the options.ini file in C:\Users\USER\Documents\My Games\Binding of Isaac Repentance and change MouseControl=0 to MouseControl=1.
  • The sound of firing a tear with The Ludovico Technique can be heard in the splash screen of a boss room, before it is possible to control your character.



PC KPRZ M83V (First floor Treasure Room)

PC ZYS1 ONMS (Treasure Room adjacent to spawn)

PC VLZW 7CJ8 (Treasure Room adjacent to spawn)

PC Added in Afterbirth Normal and hard modes only MX26 V47J (Treasure Room adjacent to spawn)

PC Added in Afterbirth KYSL MRKZ (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)

Switch 191Z NVJA (Treasure Room adjacent to spawn)

Switch PNWHFSMH (First floor Treasure Room)


Bug Bug! Added in Afterbirth / Removed in Repentance Mom's Knife + Technology Technology: Creates an uncontrollable laser ring centered on Isaac. The knife becomes stuck under Isaac and cannot be fired.
Bug Bug! Added in Repentance Inside any crawlspace, including the Rotgut fight or the Beast and Ultra Harbingers fight, the tear generated by Ludovico Technique will disappear and reappear on top of Isaac occasionally.
Bug Bug! Added in Repentance At exactly 30.00 fire rate, the tear can only tick once on an enemy, potentially causing softlock due to lack of dps.