So basically, the darkone becoming the adversary in a nutshell.

It's abusive in all levels. Especially emotionally and physically.

I kind of wish there was a pacifistic way of playing this game.

Depending on what you choose in terms of killing things or allowing them to live.

Killing is normal way of playing Isaac.

Not Killing will lead you to the Atheist/Humanist path (characters start showing cyber modifications instead).