This page covers healer-focused strategies for the Theater of Pain dungeon in Shadowlands. While it's tailored for healers, other roles may also find the information useful. If you have any suggestions or feedback, you can leave a comment below or tweet @PrestonDvorak.

This guide has been updated and maintained based on my own experiences as well as Dungeon Journal and combat log information. I'll continue to update it as-needed.

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 Bosses

Below are guides for the bosses in the Theater of Pain, including their abilities, healer notes, and addon settings.

An Affront of Challengers

• Dessia the Decapitator
  • The tank will be dealing with Mortal Strike, which reduces healing received, and Slam.
  • At 40% health, dispel Enrage (enrage) to remove the damage absorption effect and prevent attacks against random players.
• Paceran the Virulent
  • Targets random players with Plague Bolt, dealing light damage.
  • Avoid the locations of Noxious Spore pools.
  • At 40% health, dispel Genetic Alteration (disease) to prevent players from creating Noxious Spore pools.
    • If no Disease dispel is available, keep the resulting pools grouped together to maximize usable space.
• Sathel the Accursed
  • Targets random players with Necromantic Bolt, dealing light damage.
  • When affected by Searing Death, stay at least 3-yards away from other players.
  • Purge Spectral Transference to prevent the healing on the affected boss.
  • At 40% health, One with Death grants a damage absorption shield and grants immunity to interrupts while the shield persists.
• On Mythic, Xira the Underhanded
  • Targets random players with Opportunity Strikes, stunning and dealing heavy damage over time.

 Healing Notes

• If multiple bosses are bought to 40% health at the same time, be prepared for extra healing required on random players.

 Debuffs to Track

• Major: Mortal Strike, Opportunity Strikes
• Minor: Genetic Alteration (dispel, disease)
• Buffs to Purge: Spectral Transference
• Enrages to Dispel: Enrage

 Addons

• Useful addons will be added as they're available.

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Gorechop

• The tank will be dealing with Hateful Strike.
• Avoid the path of Meat Hooks as the move across the area.
  • Players hit will take light damage over time from Jagged Gash.
• Oozing Leftovers are regularly brought in on Meat Hooks.
  • Oozing Leftovers
    • Lose 5% of their health every 1-second due to Oozing.
    • Avoid the impact location of Leaping Thrash.
    • Upon death, avoid the Coagulating Ooze pool left behind.
• On Mythic, move at least 10-yards away from Gorechop after being pulled in by Tenderizing Smash.

 Healing Notes

• The tank may need an external defensive cooldown to survive Hateful Strike.

 Debuffs to Track

• Minor: Jagged Gash

 Addons

• Useful addons will be added as they're available.

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Xav the Unfallen

• The tank will be dealing with Brutal Combo.
• Oppressive Banner reduces all players' movement speed over time in 15% intervals.
• During Might of Maldraxxus, avoid the series of attacks from Xav in the center of the room.
  • Don't stand in the line in front of the boss to avoid Crushing Slam.
  • Don't stand in the hemisphere in front of the boss to avoid Massive Cleave.
• At 100% Energy, Blood and Glory sends two players into the dueling pit.
  • Players have 45-seconds to kill one another, if neither player dies, both are affected by Cowardice, reducing their damage dealt.
  • While in the dueling pit, both players continuously gain stacks of Glorious Combat, increasing their damage taken.
  • The player that dies is affected by Bloodied, reducing their damage dealt.
  • The surviving player gains Glorified, increasing their damage dealt.

 Healing Notes

• The tank may need an external defensive cooldown to survive Brutal Combo.

 Debuffs to Track

• There are no particular debuffs to track.

 Addons

• Useful addons will be added as they're available.

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Kul'tharok

• The tank will be targeted by Spectral Reach (dispel, curse) if not in melee range.
• When affected by Draw Soul, intercept your soul as it moves towards Kul'tharok.
  • While affected, players take light damage over time and are pacified by Soulless. 
  • Upon reclaiming your soul, Reclaimed Soul increases damage dealt.
  • On Mythic, failing to intercept the soul causes the affected player to become mind-controlled with [Possession].
• Dispel
• Avoid the impact locations of Grasping Hands.
• Deals light damage over time to all players for the duration of the encounter with Chill of the Beyond.

 Healing Notes

• Damage can stack up on players depending on who's affected by Draw Soul and

 Debuffs to Track

• Major: Spectral Reach (dispel, curse)
• Minor: Soulless, Grasping Hands

 Addons

• Useful addons will be added as they're available.

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Mordretha, the Endless Empress

• The tank will be dealing with Reaping Scythe.
• Avoid the Dark Devastation beam.
• Run against the pull of Grasping Rift to avoid being affected by Death Grasp (dispel, curse) within the rift.
• Deals light damage over time and then moderate damage to all players within 6-yards of another player with Manifest Death.
  • On Mythic, each player spawns a Deathwalker.
    • Deathwalker
      • Interrupt Death Bolt to prevent the damage dealt.
• On Mythic, at 50% health, Echoes of Carnage deals light damage to all players and then light damage over time for the remainder of the encounter.
  • Ghostly Combatants will periodically join the encounter.
    • Ghostly Combatant
      • Stay at least 8-yards away to avoid Echo of Battle.
      • Avoid the path of Ghostly Charge.

 Healing Notes

• Manifest Death can deal a lot of damage if players are stacked up when the effect expires.

 Debuffs to Track

• Major: Death Grasp (dispel, curse)

 Addons

• Useful addons will be added as they're available.

 Trash Mobs

Below are notes for the trash mobs in Theater of Pain. Theater of Pain is a relatively linear dungeon with a choice between which of two wings to clear before the other. The trash below is ordered as if you're completing the bosses in the order they're listed above.

Entrance thru An Affront of Challengers

• Raging Bloodhorn
  • Deals light damage over time to all players with Raging Tantrum.
• Unyielding Contender
  • Dispel Death Wish (enrage) to remove the increased damage dealt effect.

An Affront of Challengers thru Gorechop

• Diseased Horror
  • Applies stacks of Decaying Strike (dispel, disease) to random players, reducing maximum health.
  • Meat Shield grants a damage absorption shield.
• Putrid Butcher
  • Targets random players within 12-yards with Chop, dealing light damage over time.
  • Heal themselves with Devour Flesh.
• Disgusting Refuse
  • Upon death, avoid the Withering Blight (dispel, disease) impact location.
• Rancid Gasbag
  • Don't stand in front or behind when Vile Eruption is cast.
  • Upon death, avoid the Disease Cloud left behind.

Gorechop thru Xav

• Shambling Arbalest
  • Target random players Jagged Quarrel, dealing light damage over time.
• Nekthara the Mangler
  • Stay at least 10-yards away to avoid Whirlwind.
  • Don't cast spells as the Interrupting Roar cast finishes to avoid the interrupt effect.
  • Avoid the locations of Whirling Blades.
• Heavin the Breaker
  • Don't stand in front when Ground Smash is cast.
  • Applies Colossus Smash to the tank, increasing damage taken.
  • Don't cast spells as the Interrupting Roar cast finishes to avoid the interrupt effect.
• Ancient Captain
  • Stay at least 8-yards away to avoid the interrupt from Shield Bash.
  • Reduces damage dealt by all players with Demoralizing Shout.
• Rek the Hardened
  • Stay at least 10-yards away to avoid Whirlwind.
  • Applies Unbalancing Blow to the tank, reducing dodge, parry, and black chance.
  • While Swift Strikes is active, all attacks deal damage to two additional players.

Xav the Unfallen thru Kul'tharok

• **This section may be missing information as the instance was bugged when I ran it and my group never made it to Kul'tharok.
• Avoid the impact locations of Necrotic Volley during the first portion of this section.
• Shackled Soul
  • Interrupt Bind Soul to prevent the light damage over time and decreased movement speed effect.
• Portal Guardian
  • Deals light damage over time to all players with Soulstorm.
  • Dispel Shadow Vulnerability (curse) to remove the increased shadow damage taken effect.
• The portal behind the Guardian seems to require two orbs to safely activate. While you can travel through the portal with one orb, all players will be pacified on the next platform.
• Nefarious Darkspeaker
  • Dispel Curse of Desolation (curse) or stay at least 3-yards away from other players to prevent the damage dealt.
  • Don't stand in front when Death Winds is cast to avoid the knock back effect, which will likely knock players hit off the platform.

Kul'tharok thru Mordretha

• This section will be updated as soon as possible.

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 Trash Debuffs to Track

• Major: 
  • Curse Dispel: Shadow Vulnerability (dispel, curse), Curse of Desolation (dispel, curse)
  • Disease Dispel: Withering Blight (dispel, disease), Decaying Strike (dispel, disease)
  • Damaging: Colossus Smash, Unbalancing Blow
  • Incapacitating: Vile Eruption
• Minor:
  • Damaging: Bind Soul, Jagged Quarrel, Chop
• Enrages to Dispel: Death Wish
• Buffs to Purge: None

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 Trash Addons

• Useful addons will be added as they're available.

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 Mythic+ Notes

Below are notes that pertain to high mythic+ levels and certain affixes. What constitutes a high mythic+ level will depend on your gear and group, so if you out-gear a particular mythic+ level these notes may not apply. The notes are grouped by affix but are in no particular order.

• **This section is incomplete and will be updated further as soon as possible.
• Tyrannical
  • No exceptional interactions noted yet!
• Fortified
  • Raging Bloodhorn
    • Raging Tantrum may require minor cooldowns to survive.
  • Heavin the Breaker
    • The tank may need external defensive cooldowns while affected by Ground Smash.
  • Portal Guardian
    • Soulstorm may require minor cooldowns to survive.
• Sanguine
  • Battlefield Ritualist
    • Can be difficult to move due to their preference for casting spells. Be ready with knock backs and interrupts.
  • Raging Bloodhorn
    • Will not move while channeling Raging Tantrum.
  • Portal Guardian
    • Will not move while channeling Soulstorm.
• Bolstering
  • Raging Bloodhorn
    • Should probably be killed first, or carefully killed at the same time as other enemies.
• Grievous
  • No exceptional interactions noted yet!
• Raging
  • Raging Bloodhorn
    • Must be dispelled quickly if channeling Raging Tantrum.
  • Heavin the Breaker
    • Should be dispelled quickly to avoid additional damage from Colossus Smash.
  • Rek the Hardened
    • Should be dispelled quickly to avoid additional damage from Unbalancing Blow and Swift Strikes.
  • Portal Guardian
    • Must be dispelled quickly if channeling Soulstorm.

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