Fear is silver Tarot Card obtainable in Leningrad and in Village Of The Damned. When it is equipped all monster's health points are dropped to 90% their initial health. It costs 1000 gold. To acquire it, player has to finish the level with over 200 health (in Leningrad) or finish the level using only Razor Cube and Bonegun (in Village Of The Damned).
In Painkiller Hell & Damnation this card can be obtained after completing DLC Medeival Horror and doesn't cost any gold.