A Keeper's discussion (& house rules) on applying Insanity in CoC

[Son-of-the-Furies]

Hello fellow CoC gamers,

What follows is one Keeper's view and discussion on the subjects of Insanity (sanity), Bouts of Madness, Delusions, Hallucinations, Phobias and Manias. Although this discussion is related to the official Call of Cthulhu 7th Edition Keeper's Guide rules, it is not a reflection of them, but an adaptation I have developed and applied in my Call of Cthulhu 7th Edition campaign.

Let's start with insanity, or types of insanity as applied in the game. By this I don't mean "temporary", "indefinite" or "permanent insanity". Furthermore, I'm not talking about phobias or manias here either, because these are treated differently and separately to the underlying insanity, for example, it might be possible to cure an investigator of the underlying insanity with psychotherapy while the phobias and manias remain in game effect - so let's just put phobias and manias to the side for a brief moment and address insanity. What I'm discussing here are real world types of mental illness or disorders. 

When addressing each subject I will begin with a basic definition around which much of this discussion and my house rules are based upon:

• Insanity: Mental illness or derangement (derangement = disorder). (n.b. the term "insanity" is no longer in scientific use)

Keeping in mind the exceptions I made above, the Keeper's Guide does not specify any types of real world metal illness or disorder (i.e. insanity types) that manifest as the underlying insanity when a character "goes insane" - it's simply applied as ... "underlying insanity". To me, that looked like a great opportunity to expand and enhance the in-game possibilities when a character goes insane. Consequently, I developed a table that lists a variety of real-word mental illness and disorder types. When an investigator becomes temporarily or indefinitely insane, I roll on that table to see what category the insanity falls within, then refer to that category table to determine the specific type of mental illness or disorder. The insanity can take many forms and the tables were compiled from real-world online sources. So, for Keepers that wish to add a specific flavour to the underlying insanity they apply in the game, and be capable of providing their players with more direction on how it should be role-played for an afflicted character, it is suggested that they apply a real-world mental illness or disorder type as the underlying insanity.

Next, the Call of Cthulhu 7th Edition Keeper's Guide includes content involving "delusions" and "hallucinations", usually as a symptom of insanity. The Keeper's Guide appears to use these terms interchangeably when in fact, these are two distinct phenomena. Again, just to be clear from the outset, here are the definitions:

• Delusion: A false belief or opinion (in other words, a mistake, based on something that does exist in reality)
• Hallucination: Perception of visual, auditory, tactile, olfactory, or gustatory experiences without an external stimulus and with a compelling sense of their reality, usually resulting from a mental disorder or as a response to a drug (in other words, perceiving something that does not exist in reality)

Even the definition of Delusion provided in Ch. 16 Appendix I: Glossary (p.387) of the Keeper's Guide specifically states the investigator will "...be subject to hallucinations...". One body-text example of the merging of these two phenomena can be seen in the Keeper's Guide page 162 - "...an investigator suffering underlying insanity with delusional sensory information. The only way for the player to sure of what his or her insane investigator is seeing, hearing, touching, or smelling is to make a "Reality Check"." with this notion being carried forward in the next paragraph where the provided example delusion is an investigator's late spouse calling on the telephone.

Now, if a Keeper chooses to apply a distinction between the two, it would make a big in-game difference. If the telephone call was really taking place, it would be a delusion if the investigator mistakes the voice on the other end of the line for that of his late spouse, but it would be a hallucination if no telephone call was taking place at all. It is easy to see what a difference this would make for other investigators observing the event taking place.

Although the game still works great without needing to distinguish between the delusions and hallucinations, and the "Reality Check" rule is equally applicable for both, I believe that a Keeper who acknowledges the distinction has better direction in what game effect they should be relating to the affected investigator, and also has a broader range of possible effects to draw upon, enhancing the game playing experience for their players.

Just as a side note - there are a number of real-world mental illnesses or disorders that only exhibit delusions. The only mental illness type that may exhibit both delusions and hallucinations is schizophrenia.

Now, back to phobias and manias. Again, let's start with some definitions:

• Phobia: A persistent, abnormal, and irrational fear of a specific thing or situation that compels one to avoid it, despite the awareness and reassurance that it is not dangerous. (i.e. a phobia is a type of delusion - discussed above)
• Mania: An excessively intense enthusiasm, interest, or desire.

Phobias usually only have an in-game effect when the afflicted investigator is confronted with the real (in-game) object of their phobia, or they hallucinate that object (in which case the investigator would need to have an underlying insanity type, and further, being a type of schizophrenia that exhibits both delusions and hallucinations - in other words, comparatively rare). The in-game effect of manias on the other hand tend to be more perpetual.

And just briefly on Bouts of Madness, I just thought a little expansion and re-jigging of the table would help avoid repetition in in-game effects. Some effects I dropped from the table because I didn't think they played too well in a pre-combat situation (for example, amnesia - the investigator might have forgotten how they got where they are, but when confronted by a monster they will still try to run, fight or defend them self, so it might usually be inconsequential to game play) or merged into a similar effect under a different name.

With those foundations for the house rules out of the way, how can a Keeper introduce these considerations into Call of Cthulhu 7th Edition without rewriting the Keeper's Guide? With some new tables of course!

Minor changes to interpreting the Keeper's Guide: All the Keeper's Guide content remains valid, with these exceptions:

• when the Keeper reads "delusion" in the Keeper's Guide, it should be interpreted as delusion or hallucination, or possibly both in the case of a relevant type of schizophrenia. And the Keeper's Guide-defined "Delusions" shouldn't be universally applied whenever a character has underlying insanity, rather, the game effects of "Delusions" are only applied when the character has an underlying insanity of a type that includes the word 'delusions' in it's description (refer to the tables in the attachment).
• Phobias and Manias remain largely unchanged; however, you will note that on the new tables (attachment), if a phobia or mania is stated (in brackets), then it is an integral component of the underlying insanity type - it is one and the same with that underlying insanity - curing the underlying insanity also cures the integral phobia or mania associated with it.

Note: Some phobias, mania, or other mental illnesses (only a few) don't appear in the Keeper's Guide - if this is the case for one that pops up for you, just look it up online for a definition. But all the new underlying insanity types are defined within the tables. Each underlying insanity type has its own unique 3 or 4 letter code that the Keeper should have the players record on their character sheet - a simple electronic search using that code will bring you straight to where you need to go (for future referencing).

So, I've compiled an alternative Table VII - Bouts of Madness, a new table for Underlying Insanity types, and 11 new category tables each listing the specific types of real-world insanity within that category.

P.S. I realise core rule game expansions like this are not for everyone so please - no hater comments! Otherwise, remark, adopt or ignore this post at your pleasure. For anyone that uses these adaptations in their game, please return and post some feedback. The tables are a work in progress but I think have been developed far enough to share - make any alterations as you see fit. However, any suggestions would be greatly appreciated! And as a final disclaimer, I'm not a mental health professional or anything like that, what I have compiled is the result of 2 days internet searching/reading. This content is only intended as an optional gaming aid. I intend on writing some more in the tables, e.g. on the in-game related effects (duration of drug effects, effects on die rolls, credit rating, if any, etc) and will post an update in the future depending on the response.

Thanks.

 

Bouts of Madness & Underlying Insanity Tables.docx

Edited April 16, 2019 by Son-of-the-Furies
syntax

[EricW]

My view insanity should if possible be worked into the game narrative, without getting too worried about strict definitions. 

For example if someone starts experiencing paranoia, don't tell them they are paranoid - instead, play the paranoia. All their senses should be warped by their illness. If they roll a spot hidden on one of their fellow party members, they should see some kind of hint that the person is a traitor - a scrap of coloured thread which suggests the other party member has had illicit contact with an adversary. "you suddenly remember that thread looks like the cloth of the jacket wicked henchman was wearing". If they try to denounce the other member, all good - but warn them other members of the party have been behaving strangely lately, perhaps more than one member of the party is under some kind of malign influence. It could be dangerous to speak openly - who to trust?

If they become insanely obsessed with magic, tell them weaving Cthulhu magic doesn't seem to be upsetting them anymore. Tell them they have the impression their last insight somehow armoured them against further san loss. Don't make them roll san checks anymore. Naturally all their sanity is withering away behind the false calm of their obsession, but they don't need to know this.

All sorts of wicked fun to be had.

Edited April 19, 2019 by EricW

[Son-of-the-Furies]

I agree, insanity should be worked into the game narratively, but...which insanity?

Of course, Keepers can fabricate their own insanity-type as they go along (noting that each time a Keeper does so, they are in effect defining the insanity - so, in any case, they are working toward something similar to what I have done above), or they can use a foundation around which to base that narration right from the start, to avoid later self-contradiction (or detailed record-keeping of what effects this undefined insanity type has exhibited in the past). Both approaches work.

But if the Keeper needs to narrate the effects of the insanity for an ongoing period of time because it is undefined, that tends to depower the player - the Keeper is playing their investigator for them. At some point (sooner rather than later), the player needs to 'take over' the task of role playing the insanity themself - afterall, this is a role playing game and not just for the Keeper - portraying the effects of the insanity shouldn't be left as an ongoing burden on the Keeper. And for this to happen, the Keeper will need to define the boundaries of the insanity anyway, so the player knows how far they can take it....

Edited May 2, 2019 by Son-of-the-Furies
typo

[Poe]

I wonder this situation; what happens if an investigator is insane (a bout of madness summary) and on other side there is a situation that him needs to face a combat, because is present an enemy?

Following the rulebook said: ""while experiencing a bout of madness, the investigator loses all self-control. In game terms this means that control of investigator is handed from the player to the Keeper". 

So the combat couldn't happen because it's up to the Keeper that manages the investigator. isn't it?

Can you please clarify it?

Thank you.

Edited December 26, 2019 by Poe

[EricW]

On 12/26/2019 at 10:36 PM, Poe said:

I wonder this situation; what happens if an investigator is insane (a bout of madness summary) and on other side there is a situation that him needs to face a combat, because is present an enemy?

Following the rulebook said: ""while experiencing a bout of madness, the investigator loses all self-control. In game terms this means that control of investigator is handed from the player to the Keeper". 

So the combat couldn't happen because it's up to the Keeper that manages the investigator. isn't it?

Can you please clarify it?

Thank you.

A player who is insane might think the other players are now enemies. Or they might not interpret the situation is threatening. Or the might attack the wrong person, or act wildly inappropriate to the situation, like ask the hat stand to help save them, or scream and run around in circles. I think taking away control is an option, but not necessarily the only option.