I've never played painkiller so can't really compare.
The plot thus far (I'm only on the third level) is you play a psychiatrist who has the ability to enter people's dreams with the aim of curing phobias. Its a first person shooter and basically you shoot anything that moves, can pick up weapons, killing phobias increases special skills or health, and one of the first weapons you get is a minigun with a built in rpg launcher - nice
No multiplayer mode yet as you have to unlock it (annoyingly) but it is there.
Graphics are as you would expect absolutely superb, the game does mess around with the screen a lot too such as subtley changing the colourscheme or game speed a tiny bit for a short period, presumably to make it feel a bit more like a hostile dream world. Works fairly well tbh, I'd recommend if you have a HDTV playing it on that in a dark room and turn your sub up - quite intense
Loadsa different enemies, few of human form, mainly spiders so far (aracnophobia - sp?? being the first phobia i cured) and like i said shoot anything that moves or it will attack you.
Having fun so far, in fact off to have a bash now!