Unsurprisingly, runs in this category are rare. Most people opt for bullet adjust x5. There is one on Youtube, but it uses several exploits to get around some challenges. I'm trying for a more candid approach, but getting my butt handed to me in the process.
This game mode is really frustrating, but it seems to be the only mode where it tests your entire knowledge of the game. I'm a bit surprised that more Silent Hill games haven't adopted this mode. It really puts "survival" in "survival horror."
EDIT:
Personal Best:
Ending type: Normal
Action Level: Extreme X (5/5 stars)
Riddle Level: Hard (5/5 stars)
Clear time: 2h 47m 19s (10/10 stars)
Split worm kill time: 1m 24s (2/2 stars)
Missionary kill time: 1m 33s (2/2 stars)
Leonard kill time: 1m 55s (2/2 stars)
Memory of Alessa kill time: 2m 47s (2/2 stars)
The god kill time: 5m 13s (2/2 stars)
Clear number: 30 (5/5 stars)
Save & continue number: 3 (4/5 stars)
Item number: 155 (20/20 stars)
Extra weapon number: 5 (5/5 stars)
Defeated enemy by shooting: 84 (15/15 stars)
Defeated enemy by fighting: 78 (15/15 stars)
Total damage: 725 (4/5 stars)
RANK: 98/100 stars (9 big stars, 8 little stars)