An investigator opens a dusty tome with an ominous occult symbol on it; the writings therein could give her unfathomable power, or they could drive her utterly insane… The evil wizard from Pandemonium casts insanity on the party’s fighter. The fighter’s player fails her Will save. She grumbles and rolls the dice each round to see how her character will act… An Unknown Armies PC witnesses a friend’s violent death, and is deeply troubled by the experience…. A player is making a New World of Darkness character, and she thinks a derangement could add an interesting dimension to her character….
One of the many fun things about role playing is using it as a tool to explore different identities and realities. Sometimes, we play characters who perceive the world much as we do in our own day-to-day lives — such as when our PCs are modern-day humans of similar backgrounds ours who live in a realistic setting. Sometimes, the differences between the player and the character’s perceptions are huge — such as a modern-day human playing a five thousand year-old elf who lives in a world of magic, or a hyper-intelligent shade of the color blue, or an alien from beyond the stars who perceives the world as having five dimensions, and so on.
Many players wish to explore identities that are different from their own in less fantastic ways. They may play a character who has a strongly different personality from their own. They may play a character who has a different gender, ethnic or cultural background, social class, sexual orientation, and so on. And as you can see from the examples I’ve listed in the categories above, mental illness (played to various levels of realism) is a popular theme for exploration in RPGs.
The subject shows up across a variety of different genres, but it is presented quite differently across games. But despite our fascination with mental illness, there are many aspects of mental illness that RPGs (and popular culture in general) consistently get wrong. Before I get into a deeper discussion of the issue, I’d like to focus a bit on the “why.” Why should we care about how mental illness is portrayed in RPGs?
There is enormous social stigma against mental illness. Western society generally stigmatizes mental illness in one of three ways (Corrigan & Watson, 2002):
fear and exclusion: persons with severe mental illness should be feared and, therefore, be kept out of most communities;
authoritarianism: persons with severe mental illness are irresponsible, so life decisions should be made by others;
benevolence: persons with severe mental illness are childlike and need to be cared for.
As one might expect, there is evidence that the mentally ill have also internalized these attitudes, causing additional trouble for them in addition to whatever challenges their illness poses (ibid).
It is likely that someone at your gaming table has been strongly impacted by mental illness, and unless you’re very close to them, it’s unlikely that you know about it. They may have had a friend, family member, or loved one who suffers from mental illness. They may have been directly affected by mental illness (the mentally ill do not generally wear t-shirts with their diagnoses on them) in the past or in the present. Consider, for example, that suicide is one of the leading causes of death in the USA. As such, it behooves the considerate GM to treat mental illness as a sensitive subject. (For some strategies on dealing with sensitive subjects in your game, I encourage you to read Elin Dalstål’s excellent post on the matter.)
Of course, some players may not care strongly about the issue, even though it has impacted their lives. For example, the insanity spell in Dungeons and Dragons requires that players roll dice to randomly determine how their character acts round by round. Some players may see this spell as bearing so little resemblance to the struggles of actual mental illness that they may not feel offended; other players may see it as a gross mischaracterization of a commonly misunderstood and marginalized group of people.
As you can see, the issue is complicated. As such, this is the first of a series of posts on the subject of mental illness in RPGs. Future posts will focus on the role of mental illness in fantasy worlds, common misconceptions surrounding mental illness and how to avoid them, and some thoughts on how role-playing can help us grapple with difficult issues in own lives.
(The author is deeply indebted to Elin Dalstål for her feedback on this subject.)