The emote can be used to express sadness or sorrow on Twitch.tv in the chat room of given streamer, while they are doing a live broadcast.
The emote has been sampled straight from the game “The Binding of Isaac” in 2012 and added to the streaming website Twitch.tv as part of the original Twitch.tv emotes set the same year.
Due to the popularity of the game “The Binding of Isaac” and the early upload date of the emote to the website, it has become a daily driver for most viewers on Twitch.tv.
The emote/reaction image has also spawned a website in 2013. which is based on a flash animation of these emotes falling on the screen, while sad violin music is playing.
As of 10/12/2019 according to the website StreamElements, BibleThump is the 11th on the list of most popular/used emotes on the website Twitch.tv, making it one of the most popular emotes.