In the work of the successful Dutch artist Ronald Ophuis, extreme violence takes center stage. His paintings of scenes of murder and rape are often of considerable size, which makes the impact on the beholder even greater. "Am I also capable of such acts?" is the reaction of those who keep looking, but they also might ask themselves, "Why does this guy makes this sort of thing?" In Painful Painting, the filmmaker attempts to answer the latter question, by interviewing the artist and following him during the creation of a new work. During a trip to Sierra Leone, he talks with former child soldiers, showing them his work and having them explain what they've been through. One of their awful tales, about men who cut a pregnant woman open to see if the baby is a boy or a girl, forms the source of inspiration for a new painting. Back in his studio, Ophuis reenacts the moment just before this heinous act. He takes photos of the reenactment and uses them as a basis for his painting. The painter explains why he believes the styling of violence in the form of art can make a better contribution to audience insight and awareness than a photo in the media.