Mind Games

Many horror, and horror-adjacent, games feature mechanics that track a character’s mental state. Over the last forty years, these mechanics have changed and been refined, moving away from more dated conceptions of insanity and simpler mechanics into more nuanced, complex and thematic examinations of mental health and what it means to lose it.

The loss of sanity is the subversion of the power fantasy inherent in most roleplaying games, replacing a character’s customary progression with a downward spiral. It is, in part, a solution to the intrinsic problem of all horror RPGs; the medium is defined by choice, freedom and power whereas horror is about the loss of choice, freedom and power. The heroes in horror stories are usually unsung, their victories, if they win at all, often pyrrhic, fleeting or inconsequential. For those lucky enough to find any meaning or heroism in what they do, they must give of themselves for others. They die in the dark so that others may live in the light. 

Any discussion of sanity mechanics must begin with Call of Cthulhu. Based upon the fictional universe created by H. P. Lovecraft, the ur-example of cosmic horror, the game’s sanity mechanic reflects the deteriorating mental state of Lovecraftian protagonists. Characters start with a set sanity value and lose it, point by point, as they encounter horrors beyond mortal imagining.

The enemies in Call of Cthulhu often cannot be meaningly fought and even when they are defeated this seldom matters; what is dead can never die and the stars will soon be right. In addition, the monsters you face aren’t dangerous simply because they might kill you. Each and every one is physical evidence that everything you know is wrong, they are unreality given form. The universe is infinitely more strange and cruel than you ever imagined and you are nothing. In Call of Cthulhu and its derivatives, improving their understanding of the occult often reduces a character’s maximum possible sanity rating and reading books with these truths can drive them mad. 

While most editions do have some ways to restore lost sanity, these are generally small; this is a game about losing your mind and, in many ways, it treats sanity as a secondary health pool. Losing too many points at once generally triggers a panic response. As sanity points dwindle, characters may start to “go mad”. Players are encouraged to portray real mental illnesses such as schizophrenia or bipolar disorder and, should a character’s sanity ever hit zero, the character is no longer playable. They are irrevocably insane. 

Unfortunately, this system is largely built on outdated concepts of mental health and feeds into stereotypes about neurodivergent people being dangerous, out of control or otherwise disconnected from reality. In addition, this game and many others impose conditions real, debunked and/or misunderstood upon the characters. Game mechanics that randomly give characters mental illnesses, or that push players into depicting neurodivergence they may have no experience of, can too easily lead to a shallow or derogatory portrayal, or one that undermines the intended tone through bathos. 

It can be argued that the Lovecraftian protagonist is not simply going insane. Instead they are gaining insight into the true nature of reality, perceiving and experiencing real things others cannot. This is the model used by Cthulhu Dark and while the distinction may seem subtle, it is, if anything, more true to the cosmic horror genre. 

An optional rule in more recent editions of Call of Cthulhu gives those with low sanity values moments of insight into the horrible truth of the universe. This is a direction ripe for further exploration in tabletop RPGs. One of the best examples of this is the video game Bloodborne; when characters reach sufficient insight, enemies change appearances, use new attacks and some creatures, previously invisible, can at last be perceived.  

While sanity mechanics began with cosmic horror, it is not their only place within RPGs; in many ways personal horror games are an even better fit to explore those themes. In most World of Darkness games characters are no longer human and gradually devolve into some flavour of monster. While usually not directly analogous to sanity, there is often considerable overlap. The titular bloodsuckers in Vampire: The Masquerade had to watch their Humanity, but even human beings could become (less literal) monsters in the World of Darkness setting as they slid down some form of morality track, picking up troubling behaviours and literal psychological disorders on the way. 

It is difficult to discuss sanity mechanics and Vampire: The Masquerade without mentioning the Malkavian Clan. The clan’s unique gimmick is a prophetic insight that is, to an outside observer, indistinguishable from madness. It manifests differently in each, often bearing a resemblance to real neurodivergence, such as sociopathy or borderline personality disorder. 

Malkavians occupy the societal role of seers and jesters, known for their pranks. Well-written Malkavians often make the most compelling characters in the Masquerade setting. They have also, inevitably, been the worst. Too many players approach the clan’s unique curse and propensity towards satire through wacky, random antics or lurid excess, taking refuge in audacity. Too often the Malkavian – and by extension mental health – is a joke or grounded in stereotypes. 

With morality and sanity bundled together in Vampire and most of its spinoffs, immoral acts lead to mental illness, which is an unfortunate, unrealistic implication and an uninspired way to model a character growing increasingly divorced from their human self. Newer editions have moved away from this by removing or reworking these mechanics entirely. In the Chronicles of Darkness, Morality was replaced by Integrity, which is lost through traumatic events rather than immoral acts, and instead of gaining permanent ‘derangements’  – a dated term  – characters acquire Conditions. None of these are named for real diagnoses and can be removed by meeting particular criteria or after a period of time. Vampire: The Requiem’s most recent edition has Humanity loss impose similar temporary conditions as well as mechanical penalties entirely divorced from mental health.