The Anathema (aka Doctor Cloud) is an alternate version of The Rake, as it appears in OH GOD THE RAPTURE IS BURNING. It exists as an entropic and paradoxical monster behaving more like a broken video game model. It first appears at the end of Act II and spends Act III actively trying to bring about the arrival of The Neonate, and by extension the ending of the world by The Pacific, until it is ultimately defeated by Jordan Dooling at the end of the act.
The Anathema was originally an ordinary human known as Doctor Cloud who worked as a scientist for the Topography Genera Center. Before Rapture, he was experimenting with something he called FT-HOMUNCULI (which may have been the original clockwork Neonate). However one day the experiment went horribly wrong and Doctor Cloud underwent the grotesque transformation that turned him into the Anathema and he was reborn as a Fear.
An Indisen successor is rumored to have taken The Anathema's place in Act IV but has not been shown.