• Madness, Insanity, Derangement: Mental Illness in RPGs, Part I

    by  • August 24, 2012 • Essays • 13 Comments

    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):

    1. fear and exclusion: persons with severe mental illness should be feared and, therefore, be kept out of most communities;
    2. authoritarianism: persons with severe mental illness are irresponsible, so life decisions should be made by others;
    3. 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.)



    Dymphna posts frequently on Google Plus as Dymphna C.

    13 Responses to Madness, Insanity, Derangement: Mental Illness in RPGs, Part I

    1. avatar
      August 24, 2012 at 17:25

      A lot of players seems to see mental illness as an excuse for being a jerk or to get away with outrageous behaviour. Oh, and as a nice way to get extra XP. Like the Malkavian who had an phobia of (I kid you not) whipped cream and daisies.

      As someone who plays a lot of Cthulhu and who loves Malkavians (old WoD), I’ve played a lot of mental illness and it should never be easy. I’m fine with tweaking the symptoms a bit to make the character playable, but being mentally ill should mean problems for my character, not something merely done for XP.

      I’m looking forward to reading this series.

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      • avatar
        August 25, 2012 at 19:53

        As anachronistic as it may be (though with the Onyx Press thing happening, who knows), the Malkavian problem may very well be getting a post of its very own. I keep trying to fit it into other posts but it sort of takes over everything else in the post.

        And I’m glad that you enjoyed it!

        • avatar
          August 26, 2012 at 20:03

          Ooooh, please, do make a Malkavian post! That would be brilliant. I think the old WoD is far from dead (or being kept in a state of undeath or whatever) and I’ve seen so many horrible Malkavian characters, far from than from any other clan. Definitely worth its own post.

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    2. avatar
      August 25, 2012 at 01:22

      Great post! I’m looking forward to seeing the rest of the series. It’s going to be interesting looking at this dynamic!

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    3. avatar
      August 30, 2012 at 13:10

      Well my head hurts just thinking about where this series could go. Looking forward to reading it.

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    4. avatar
      August 31, 2012 at 17:19

      I’m really looking forward to reading this series. As someone who has struggled with when/if/how to present issues of this sort, I am always looking for more resources.

      I have seen too often that people tend to take shortcuts that misrepresent the complexities of real mental illness. Some, like the random action rolls in D&D, are so ridiculous as to be inoffensive, but others can be quite off-putting if played poorly.

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    5. avatar
      August 31, 2012 at 21:22

      I agree with a previous commenter. A Malkavian post would be very interesting indeed, especially in relation to this series of articles. I’m really looking forward to seeing the rest of them. This is a great introduction to the subject.

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    6. avatar
      September 19, 2012 at 16:43

      I know a couple systems which tackle this pretty well. One of them escapes me for the moment, but the other is Eclipse Phase. (Eclipse phase is open source, so check out the rules here: http://dl.dropbox.com/u/7127699/EP_lightweight/epch7.html#x9-7520007.9 )

      It does a lot of things well both from a game- and mental-health viewpoint, but I think the best thing it does is that for long-term disorders it says: here’s what it’s like, here’s a suggested general effect, roleplay it. It doesn’t do what WoD or GURPS or whatever try to do and just slap you with some -2 penalty to social rolls if you fail a willpower test or whatever, it treats it as a facet of the characterisation and recognises that it’s nuanced and complex.

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      • avatar
        October 21, 2012 at 20:14

        Oh my goodness this thing is so much worse than GURPS. I don’t recommend reading it, especially if you are trans* or if you have brain problems.

        Not everyone responds to trauma in the same or similar ways. Not all brain problems are trauma responses, some are cognitive or chemical malfunctions. “Disorders should not be glamorized as cute role-playing quirks. They represent the best attempts of a damaged psyche to deal with a world that has failed it in some way” is really, really ableist and also false. Sometimes crazy people are crazy because bad things have happened to us, yes, but I object strongly to describing those huge swaths of my community as damaged psyches. Sometimes most of your relatives have a strain of crazy and you get panic attacks from the same place you got your natural hair color. Sometimes you’re just not wired to parse the same data in the same ways as other people. Brains are complicated, and so are their problems.

        Also – the way this thing talks about BDD and GID needs a serious cissexism & gender dysphoria warning. You can take your “internal psychiatric gender” and shove it up your jumper. Gross, gross, gross, gross.

        Lesser failures that are still fails: inclusion of “hysteria,” descriptions for most disorders as weird exaggerations of the DSM version of that disorder and/or some similar disorders, and totally awful description of multiplicity/DID/MPD.

        All GURPS does is describe worst-case versions of fairly common conditions and then suggest ways to mechanize them. I feel like by not trying to dictate where people like me come from and by not including controversial labels in source material, GURPS made me way more comfortable. GURPS never tried to tell me how I function the majority of the time in really stigmatizing ways, or made the hilarious suggestion that all brain problems – ADHD explicitly included – come from the collection of trauma points.

        Oh man the healing section is even funnier. Did you know you can fix your own brain problems with willpower? That’s not like it’s one of the most toxic ableist tropes or anything, that people who have brain problems just aren’t strong-willed enough to solve them, that we’re only screwed up because we’re weak. “Disorders can linger for years until resolved with actual psychotherapy” but you know, competent people can cure their own problems (any of them) with 3 months of relatively low stress. *This* is doing a good job? Oh, dear, if this is doing well don’t tell me about people doing badly.

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        • avatar
          October 22, 2012 at 02:23

          I don’t have quite as intensive of knowledge as you do, but I know their section on bipolar is not quite accurate (mania only for a few days at most?).

          I haven’t seen many games that handle it well.

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    7. avatar
      September 24, 2012 at 22:34

      I’m looking forward to this series. Will you be addressing PTSD? It seems that most of the games I’ve played in are such that a character could realistically develop it in play.

      I think for a lot of mental illness, roleplaying it would be better done by not roleplaying it. The majority of the mentally ill function just fine in society and don’t have a lot of outward signs. I’m bi-polar and unless I’m in a manic or depressed state (which is about 5% of the time) when you talk to me, you wouldn’t be able to tell and most people don’t know. Even if I am manic I can usually just dismiss it by saying, “I’ve had a lot of caffeine” or if I am depressed I dismiss it as “being tired”. I doubt any rules that anyone tries to write to capture that experience will do so effectively.

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    8. avatar
      October 21, 2012 at 19:26

      I have a rule for people who want to write LARP that involves anyone who is Other in some way: assume they’re going to be in your game, as players. Assume they’re not going to be your gay friend or anything but a total stranger who signs up for game on a whim and has zero reasons to trust you or give you the benefit of the doubt.

      Because it happens, and assuming none of the Other are in your community is a recipe for disaster. I mean, this post assumes that gamers may have been impacted by mental illness or the mentally ill – which is as absurd a framing as “gamers may have been impacted by gender issues or female people.” If you write for a large enough audience you will have players with every kind of identity. None of which are monoliths, by the way – a game that handles queerness awkwardly and has three queer players may have one of them not care, one of them quietly deeply uncomfortable, and one of them shouting in your face.

      I’m morbidly curious about where this is going, but I have low expectations for this series. It looks like you’re trying to write about writing the Other (in this case, mentally ill/brain problems people) without acknowledging that they’re present, nevermind including their perspectives. There’s a handy little rule of thumb for whether stuff is unlikely to be helpful that comes, I believe, from ASAN and the autistic community – “Nothing about us without us.” I’m allistic and otherwise neuroatypical and I think it’s a fantastic rule – do not speak about the experiences of the Other (women or PoC or trans* people or whoever) without listening to them and including their perspectives.

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      • avatar
        October 21, 2012 at 21:05

        I assure you that St. Dymphna has our* perspectives in mind and is listening to us in this instance. The Gaming as Women community is not without “Others”, and everyone has the opportunity to review the posts. Just because she is writing with an academic tone doesn’t mean she’s not including the perspectives of the people affected. By framing it as “gamers may have been affected” it removes the assumption that they have not without saying that they explicitly have, because some people may not have been affected or don’t consider it even if they have. Just like with gender issues, sometimes the obvious needs to be pointed out.

        If you have more specific input about how you think this should be handled, feel free to share.

        *I am bipolar, with a handy little associated list of issues.

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