You must find all 5 Moura's Tears found through out the game, and the twist, you MUST use at least 4 continues.
Refer to my solution for locations of the Tears:
Now proceed through the game dying and continuing as much as you want. When you die and use your 4th Continue, Death will fly down and a message will appear about using 4 continues and you can only go on with the cost of your soul.
Now once you see this message, die and continue as much as you like until you finish the game. You will get the "not bad, but not good" ending and this achievement will pop.