I have an undergraduate and a graduate degree in Psychology. I spent three years working at a facility for the mentally ill that were trying to integrate back into society. Most never had a chance in hell of doing this, but they still worked towards it.So naturally you might think that I would like to see mental illnesses represented in RPGs.
Well that would be wrong.
I think Call of Cthulhu does it right. I think the True20 "Shadows of Cthulhu" also does a good job on representing them and does a great job with their mechanics. Many horror games make a good attempt, but others fall short.
Here are some of the things I hate the most.
1. Most severe mental illnesses are debilitating if not treated and cared for. In today's world we have doctors, medicines and support systems so people with mental illnesses can live a relatively normal life. That is not the case in many games. In Call of Cthulhu for example characters often go shit-eating crazy and that is the end game. But in other games people use it as an excuse to act like an idiot or an asshole, or both. Often both.
2. Schizophrenia is NOT "Split Personality". They are not even close. Having schizophrenia is grounds for a character to removed from play. Split Personality, or Dissociative Identity Disorder is so rare that I can count the case I have know about on one hand and still have enough fingers left over to give you the thumbs up, the peace sign and show you my wedding ring. A lot of games use this as an excuse to allow characters to do thing they could not otherwise do. In that case, multi-class.
3. Chaotic Neutral is not "Insane". In my games Chaotic Neutral is not insane. Nor should it be in anyone's game. Chaotic Neutrals should be loners, often anti-social, often assholes. OR they could be happy go lucky, but if they are on the happy side then why are they not Chaotic Good? Alignment is a moral and ethical stance, not a mental stability one.
4. Most games should not have Insanity Rules. Players don't know how to use them, Game masters don't how to run them and I'll go a step further and say most designers don't know how to write them. A rule of thumb. If you are playing in a time period that lacked mental health care then there is no such thing as insanity. Yes there are mental illnesses, but insanity is a legal definition and often a societal one.
Fantasy RPGS like D&D should never have insanity rules. Horror games should, but handled correctly. Modern games can have them, but should avoid them; games like Spycraft and James Bond they might make good plot points, but avoid using them as a means to get points.
5. If you are going to use them, use them in the time they are given. I said games like D&D should not have them and that is correct. People were not insane, they were possessed by evil spirits. A cleric with Remove Curse or something will clear that up. If you are playing in a Victorian age game, then use Victorian notions of mental illness. Talk about "floating organs" and then apply to appropriate remedy.
Now full disclosure time.
I have written a number of different takes on Psychoses for games over the years. I have never been totally satisfied with any of them. Most recent was one for Mutants and Masterminds based book that sadly will not see publication. I like the mechanics of that one, but the representation was not my best work. I did one for Ghosts of Albion too. I tried to fit it to the Victorian ideas of mental illness the best I could AND still make it compatible with Eden's other books.
I also did one for Ravenloft that I liked at the time, but now see it as coming up very, very short of the mark.
And lets be honest here. Player Characters are all insane anyway.
Rushing into dungeons, killing monsters in their lairs to get a gold piece here or there. Digging through obscure and forgotten texts to discover not only are we insignificant specs in the universe but the universe is so freaking dangerous we should just hide under the covers or any of the other 100 things we have our characters do.
We don't need a game version of the DSM-IV, we all need therapists.
Thanks for the insights. I don't think I've ever been in a game where someone was trying to play someone who was mentally ill, it's just never come up. Although I've often thought it could be useful. I've often thought I'd remove the person from the game, but again, it's never come up.
ReplyDeleteI'm working towards my B.S. in Psych with an eye towards my Ph.D in Clinical Psych, so the thought that the PCs are nuts for adventuring has been something I've thought about for a while now. I'd be curious on some of your more detailed thoughts on the subject.
ReplyDeleteI have worked on the ground floor you could say of psychiatric medicine. I worked at a psychiatric facility that was part of the department of corrections.
ReplyDeleteI used schizophrenia only once in a game. It was my only real run at running call of Cthulhu. The player was in a psych hospital. Since the GM is the eyes and ears of a character I would describe what the player saw and could hear. And the player would discern what was real. If the character was on his meds and was calm and thoughtful I would allow a simple roll to discern some things as reality or delusions. If the character was off his meds and stressed I would give penalties. If the character could not discern reality he would have to play as if it was reality.
In the course of the game the character was using the patients for experimentation. But Because of the illness it was hard for the player to figure out what the Doc was up to.
For example in one scene he saw the doc go into a room with a girl from the next ward that was really nice to him. He saw blood come from under the door. Lots of blood. He freaked out and got violent. Only later to find out it never happened. She was fine and there was never any blood.
As the player got more stressed the penalty to discern reality got harder and little by little the delusions and voices became more the reality to the character.
Since his eye witness accounts of the doctors misdeeds were peppered with delusions no one would take his serious. Causing more stress and making the illness worse.
This is also the last time I ran COC. I pepper mythos in my games here and there I have never tried again to run a game like this. I think it hit a little too close to home. While interesting and fun to run at the time. I'm in no hurry to do something like it again.
I found the different classing of mental disorders really interesting here but what are RPG's??
ReplyDeleteI posted something similar to RPG.NET, suggesting what most characters would end up with PTSD, since all of the things they list as disorders are genetically/biologically based, so its unlikely that they would be "tripped" (activated by the environment). I was booed down, but, I don't know, PTSD sounds pretty spot on. You could have a game mechanic for it that was pretty nifty and gritty (berzerk, fear, etc.) and the character could be heroic in dealing with it. Note that I'm not making fun of PTSD, I'm just suggesting that if you're going to have disorders, this is what most characters in RPG's would get.
ReplyDeleteA very cool and righteous post...and good stuff to think about. Thank you!
ReplyDeleteTim, thanks for speaking to something that has bothered me (as a psychiatrist) as well. If often thought about what would be a better game system for mental illness, but then I think real mental illness isn't mostly the sort of thing to be useful in rpgs.
ReplyDeletePTSD probably should come up, and personality disorders would be rampant (and maybe normative among adventures), but psychotic disorders and mood disorders, not so much.
While I don't have the technical competence to properly judge mental illness issues (I've a degree in literature, not anything even remotly related to psych) but I do agree that 9 games out of 10 handles the mental element very poorly. Aside from the use of wrong definitions and generally "modern" attitude toward the problem there's also the setting factor.
ReplyDeleteI a setting that is trying to emulate the real world as close as possible it makes sense that people will go nuts in front of something like a demon or a vampire, but does it have to be the same in every setting?
I think not. Horror and mental sanity are relative terms, in a world were vampires are the norm they won't be much more terrifying than being run down by a truck is for us.