Ten Piedad is a boss in Blasphemous and part of a trifecta of bosses along Our Lady of the Charred Visage and Tres Angustias which can be visited in any order.Ten Piedad is a combination of demon and plant with the body of a human and the skeletal head of a goat. According to the relevant item descriptions, he was once a man who was haunted by visions of the Miracle. He became very tired and slept in the arms of the statue he is found in, but then woke up, realizing he had been transformed, trapped within a beast of constant anger and pain.
The official art book states that when the creature is asleep, the man inside awakes within the creature's dreams.