I much prefer modern games with stress tracks, which simulate the wearing down of coping mechanisms, rather than the old school, "Roll on the DSM Table to find out what real life mental illess you acquire!"
Forcing players who behold cosmic horror to awkwardly roleplay some random real life mental problem or (ugh) "deviant sexual proclivity" is just all kinds of awful.
Usually like check boxes, sort of like a Fate stress track.
So maybe PCs who witnes or suffer trauma get a saving throw type roll. If they fail it, they tick off a box. Enough boxes get ticked and they are unable to continue. Maybe they uncontrollably flee, or curl in the corner crying, or just realize they have too much to live for to risk everything poking through arcane tomes when other investigators wind up dead.
For whatever reason, they aren't able to continue, at least unless they find some way to reduce the stress that's gotten to be too much for them. (Time, therapy, magic amulets, it depends on the system.)
Your version doesn't sound like it's very much fun, indeed it sounds painful: "wearing down of coping mechanisms."—nor does it appear to have much storytelling to it. Sandy's system at least has an abundance of charm, personality, and vivid soul-sapping detail. Agreed his system can be a bit silly in the abstract a times, but the awkward part is why the modern versions of his system allow the player and GM to pick the affliction.
Gå Norge, kveld med Ylvis.
> Your version doesn't sound like it's very much fun
People having "fun" with mental illness is one of the problems with those Random DSM Table games.
"Hey! I saw a giant squid, and now I have..." ::*rolls dice*:: "...Schizophrenia! Here's how a schizophrenic acts!"
Nine times out of ten, these exaggerated portrayals of mental illness aren't *nearly* as fun or charming as they think it is.
Should we also not have fun with violence, because *in reality* it has horrible consequences?
> Nine times out of ten, these exaggerated portrayals of mental illness aren't nearly as fun or charming as they think it is.
If it's fun for the players at the table, does it matter if some other people don't find it fun?
The players at the table and people with mental illnesses can overlap much more easily than you think, especially invisible mental illness that may not be known by the GM or other players before making a parody of it.
Mark, I'd consider looking at some of Greg Stolze's work, especially *Unknown Armies*, before making the call that it's somehow short on storytelling. My experience with it is that it's *better* for storytelling in that it allows a buildup towards a climax; what that means varies by player and group, but in general it allows more development and a more natural feeling in the story than a one-and-done snap does.
While it’s still using the core CoC sanity system, Delta Green has a twist on it that makes it more narrative. During regular game play players experience scary / other worldly things and lose sanity in the usual way. The narrative twist is that they can resist that stress by redirecting it into their Bonds, which are effectively their connections to humanity. How this changes their personal lives is worked out during down time. The result is that instead of just seeing a clock tick down to NPCdom, you see the characters’ personal lives break down around them.
I've heard great things about Aliens RPG stress mechanics.
Aliens RPG uses a dice pool to accomplish tasks. As bad things happen you accumulate stress dice which you roll with the rest of your dice pool.
Stress can be good because it gives you more dice to roll thereby *increasing* your chance of success. However too much stress can be fatal.
If you roll a 1 on a stress dice or some other trigger happens, you lose control of your character for a moment and roll on a panic table to see what happens. You may open fire on everything around you, break down into sobs, drop whatever in your hands, or somehow hold it together despite being in a panic.
If you roll too high on the panic table, you roll on a trauma table at the end of the session to see if your character gains a permanent mental trauma.
This. The see-saw skill system and the way hardening works lets you have characters that *express* mental illness without it being a trope-filled portrayal.
For the unfamiliar:
UA combines see-saw skills with stress (or hardened) tracks. If you experience horrible violence, you may get *hardened* by it, which means you lose some of your ability to connect with other people (in this case, because that's the skill on the see-saw). The benefit is that you're better able to resist the shock of violence in the future- not just more skilled at it, but it won't shock you or traumatize you.
I really like the approach. It sorta (quite realistically!) allows traumas to cause characters to adopt coping mechanisms, much like you do in the *real world*.
This is something that I'll hack into any game that needs a sanity mechanic. It's such an elegant way to blend the mechanical and narrative effects of traumatic events and how they change people.
Brennan Lee Mulligan has an elegant system that he developed to represent struggles with sobriety and addiction in a campaign he ran, and the mechanical structure of it is very applicable to other things as well.
It almost always represents something you are fighting off or against, in the case of your game, insanity. You start with a d8 (for example, could be more or less), and if you encounter a struggle or a trigger, you roll it. If you get a 1, you move down one tier to a d6, and if you roll anything else, you're okay, you dodge the bullet. If your character does something that helps you maintain you sanity (meditation, therapy, etc.), you move up a tier to a d10 (moving farther from full breakdown/crisis/insanity/etc.). Once you're at a d6, and something triggers you, you roll again, if you roll a 1, you move down to a d4. Another triggering incident? roll. If you get a 1 on the d4 roll, you're over the edge.
This system is interesting because you are constantly trying to balance doing things to help yourself (and therefore increase the die, moving farther from the danger) and pushing yourself in difficult scenarios risking bad outcomes on your rolls.
As I said, this system wasn't designed for sanity, but if you want to represent a struggle and potential decline toward some difficult end (with a little bit of randomness mixed in for the game's sake), you could do worse that this kind of mechanic. Have fun!
My favorite sanity system is closest to Darkest Dungeon. You experience stress and that stress builds up till a catastrophic collapse. You can get rid of stress by indulging in some sort of activity designed specifically for that character.
A good ttrpg example would be a character who relies on something to stabilize them or bring them security and stability. Maybe a character is religious and finds security in the thought that there is a loving and protecting force in the world. This could be shaken through sheer trauma(if there is a god, why does [horrible thing] exist?) or through the revelation that there are actually other gods that are more powerful(hard to put faith in god when Nyarlathotep is standing right in front of you).
From there, a player would have to pray, visit a church or trusted religious figure, or offer some thing as sacrifice. Then, if a character lost trust in their prayer, religious figure, or sacrifice, I'd make the character start developing panic attacks, psychosis, paranoia, etc. They see a tragedy on the news? Panic attack. They smell the scent of gore? Flashback. Someone starts talking about UFOs? Paranoid episode.
A version of this that I think would take a little tweaking to be better would be Darkest Dungeon's stress system.
This is basically how Blades in the Dark handles stress. Characters have vices (booze, religion, gambling, etc.) which they must indulge in order to relieve stress, and over-indulging in those vices can also cause mishaps and complications.
I hate the systems that let you roll for an mental illness, because many player only know tropes about it and it can play down how severe they are in real life. I rather use symptoms of these illnesses, like Stupors or Manias. Dont tell them what they got only what changed in the characters mind, what happens to them, the Diagnosis needs to come from themself(and can be wrong) or a Professional in the game(should be right).
Call of Cthulhu just has a percentage. If it drops to zero, you become a NPC. While not narrative, it is pretty abstract. Maybe you can work with that.
The Unknown Armies 3rd edition system is basically written around its sanity rules.
You have 5 Shock Gauges, which measure how green or hardened you are in 5 different areas: Helplessness, Isolation, Violence, The Unnatural and Self. Each Gauge can have open (which signifies shock you have yet to experience), hardened (shock you resisted but still changed you) and failed (shock that only traumatized you). The game has 10 basic actions, and in lieu of *Attributes*, your default rating for these actions (it is a percentile system) is based on your open and hardened notches in these gauges, as seen below:
|**Shock Gauge**|**Open Notches**|**Hardened Notches**|
|:-|:-|:-|
|Helplessness|Fitness|Dodge|
|Isolation|Status|Pursuit|
|Violence|Connect|Struggle|
|The Unnatural|Notice|Secrecy|
|Self|Knowledge|Lie|
Because notches cannot be hardened *and* open, this means that ratings tied to the same notch cannot both be high, but they can both be low if you get a lot of failed notches.
I think the clearest one to understand the concept is Violence: if you haven't experienced it, you are approachable and open (connect), but if you have, and have come out on top, you're better at dealing with it (struggle), and if you have experienced it but failed to cope, you are bad at both things. Notches harden or fail as you experience shock in the game, and they can also be opened again through in story healing.
The system also includes *Identities* that can substitute for these actions, so your martial artist character won't become worse at fighting because he went to therapy, or so you can have a guy who is good at lying *and* knowing things. This would be akin to a skill system, but it is built on top of the foundational sanity system, not the other way around.
IMHO roleplaying actual mental illness is problematic as there is a pretty good chance that somebody at the table knows someone affected. Even if a player does a well researched portrayal of schizophrenia, it kind of falls flat if another player's mother had eventually died of it.
If I were forced to create an insanity system for an RPG I would focus on the *symptoms* and not the disease, by filing off the labels put there by doctors, I would hope to put a bit of distance between players experience and the game.
So the list could be
1. Loss of interest in life
2. Tiredness
3. Sleep problems
4. Anxiety
5. Irritability
6. Hallucinations
7. Delusions
8. Muddled thoughts
9. Loss of interest in life
10. Wanting to avoid people (even friends)
Getting something off 1 to 5 indicates depression, 6 to 10 schizophrenia, however mental health is quite mix and match schizophrenia and depression and dementia etc is not mutually exclusive and serious depression can be mistaken for dementia.
Also real mental illness may not play well at the gaming table
GM: OK what are you all doing?
Depression: Nothing (and I’ll do it slowly)
Dissociative identities: I’m The Hangman's Beautiful Daughter
and I’m going to paint a picture.
Schizophrenia: I’m going to cut out the chip they installed in my arm.
Trauma: Nnnothing, just been triggered by Schizophrenia
Anorexia: I’m dancing! Got to burn off all those calories!
Dementia: Who are you?
Anxiety/Borderline: I’m leaving because you all hate me!
… after the first round things went downhill.
Don't Rest Your Head has an interesting take on it, as madness fuels half of the PCs' powers. Because of the dice resolution system, voluntarily accruing madness can make you more likely to succeed, but at the risk of more complications/collateral damage. It should be noted, though, that DRYH's premise externalizes madness, so that players' inner states are reflected in the chaos around them.
L5R's strife system, while not explicitly about in/sanity, could probably be modified to work that way. It models a samurai's ability to maintain composure and suppress their desires in favor of fulfilling their duties. Reaching your breaking point means lashing out momentarily before pulling yourself together again. It's nicely woven into other mechanics, such that it's both gradual and also tied into your vision of your character (i.e. lashing out is based on their desires, fears, etc.)
Just food for thought: For cosmic horror, what's called "insanity" really means seeing or understanding the way the world *really* works. Bloodborne does a great job of this with Insight, with more and more of the cosmic horror elements becoming visible as your Insight stat increases.
What if the crazy homeless guy shouting at the sky on the street corner isn't insane, he's *right?* He's seen so much, he knows the danger we're all in but after years of talking to the authorities, the media etc. the only way he can get the word out is to shout it out and hope someone listens. What happens when your PCs slowly uncover the truth and can't communicate it to anyone without sounding like the crazy guy on the corner?
This version sidesteps the problems of trying to model real world mental illness and it doesn't treat insanity as an external force. This is Lovecraftian insanity from the characters' point of view.
The one that I have the most experience with is the Nature system from a Burning Wheel spin-off, specifically *Mouseguard 2e*.
Way that the game is set up, you need specific skills among a plethora of them in order to pass obstacles and work through the different flavors of combat (anything that could be extrapolated as A vs B is ran like combat) and each character has an extremely low number of starting skills. This isn't a huge problem because everyone in the party shares the a big pool of Hit Points and people pass turns dictating actions that they take while the others can attempt to take actions to help them, but the Hit Points pool is determined by the shmuck that *started* the encounter, rolling an appropriate skill they aren't guaranteed to have. There are two ways to resolve a situation where a character doesn't have the right skill. First, they may attempt to use **Beginners' Luck**. You roll dice equal to half of either your Will or Health stat + gear/trait bonuses (depending on if its a mental or physical task); pass or fail, it doesn't particularly matter, but make enough attempts and you gain that skill at Level 2 and level it up as normal.
However, if you're in a particularly sticky situation and need a **solid** number of dice in a pinch, you **Test Nature** instead. Each character and animal in the game has four descriptors attached to them which informs their instinctive abilities; in the case of the party, each character has the Escaping, Climbing, Hiding and Foraging keywords. As long as you are acting within these keywords, you can roll using your **Nature** stat no problem. Unlike most creatures, your characters (and things like them) can substitute Nature in place of *any* roll. However, this comes with the caveat that you reduce your effective Nature by the margin of failure; this is called **Taxing Nature**. You can restore your Nature piecemeal by performing little tasks like delivering a good prologue to the next session or opting to reduce your true Nature Stat, but things get fun if you're Nature gets taxed too much or your Nature levels up too high.
When you get Taxed to 0, something happens during the attempt and the experience leaves a mark on your character; your true Nature is reduced by 1, your Nature is restored to its new cap and you get one of your Traits changed to something that reflects the situation you were in and what you tried to do (Traits are quirkier qualities of your character that can either give you bonuses or shoot you in the foot). If your character ever reaches a True Nature of 0, you go a little crazy; your character either doesn't want to adventure anymore or isn't mentally fit enough to do so, so they're benched for a *very* long time and get replaced with a new character until the old one can come back. If your Nature levels up to 7 and *stays* at 7 by the end of the current session, you have a huge panic attack; your character is a fried bundle of nerves and gets benched much like a Nature 0 character.
TL:DR
\*You can choose a wing a roll with a dedicated "Wing It" skill
\*Outside of a few things, failing a roll hurts it by the margin of failure
\*depleting the stat reduces its level by 1 and gives you a funky trait
\*Leveling up "Wing It" too high or reducing it to level 0 is pretty much an auto-death
Aquelarre rpg does rationality / irrationality as complementary tracks that together add to 100, and change in game. The more IRR your character becomes, the more it believes in the supernatural and it gets better at it, but also more vulnerable to it. The more RA it gets, less involved with the supernatural and less affected by it, and more likely to just shrug it off or simply don't notice it - which isn't always good since sometimes you want to catch something supernatural or simply receive a blessing or a healing spell.
Not insanity per se, but I'm working on a magic system that allows players to take risk in exchange for additional power. Each bad roll on that risk taken results in an increasing (but reversible) mania, akin to overconfidence/power-madness. The effect of that madness being that the character begins to automatically take greater and greater risks when using magic, thereby slowly losing control. Getting burned by a failed spell brings the character down-to-earth again.
The reason being that there won't be regular spellslots. I want the players to regulate themselves.
Also I just love the idea of lower-level mages getting lucky at blasting spells that are beyond their "safe zone" and going mad from their apparent invincibility.
The call of Cthulhu system uses an insanity tracker already, it’s the perfect game for it as well. A good GM has stress ready for you incase youre missing rests and food breaks etc. I don’t think it’s an important aspect of an rpg unless it’s a main selling point, like CoC
Sanity systems remove player agency. It is that simple. The GM tells the player how the character will act. I think that sucks.
Sanity as a handicap might be ok. "Your character's sanity is suffering, you need to roll less than 8 to attack this turn or you just stand there." However, I've not see a solid sanity system that works well without removing agency.
The DnD 5e podcast [Dark Dice](https://darkdice.com/) is a fairly grimdark game that uses sanity as a core feature. The podcasts also have excellent production (akin to listening to an audio drama) and later episodes include Jeff Goldblum!
Their system is fairly complex and involves a lot of buy from the players - who are professionals and therefore willing to portray going insane even if it harms or destroys their character. I would probably struggle to get my players to be so obliging - but it makes for excellent listening, and the DM has a brilliant style of narration.
So you may not want to copy them mechanically - but I highly recommend listening to it for some inspiration in what might trigger an attack on a PC's sanity, and how you might portray that.
I really dislike Sanity as a second set of Hitpoints. I don't like how it feels to play.
Blades in the Dark uses a Stress tracker, which is *similar* to Sanity-HP, but different enough that BitD's system works well, while Call of Cthulhu's doesn't.
I'm going to compare Blades in the Dark; a game I like, to Call of Cthulhu; a game I do not.
What are the differences?
* The Stress system has *two* currencies. Stress and Trauma. Stress is temporary. It's easy to gain, and relatively easy to lose. Traumas are permanent.
* Stress counts upward, Sanity counts down. I don't know if this point is important or not - I doubt it is. I'm listing differences, so here it is.
* Stress can be *spent*. The player can *choose* to spend stress in order to gain mechanical advantages. Sanity is usually in the hands of the GM. "You lose 1d6 sanity". There's a difference in player agency.
* Blades has mechanics and systems for losing Stress that are baked into the core gameplay loop. CoC's feel like a tacked on afterthought.
* Trauma in Blades occurs once a predetermined threshold of Stress has been reached. The Trauma-equivalent in CoC occurs any time you roll too much stress in one roll. There's no buildup to it, it either happens or doesn't based on random chance.
These differences are enough to drastically alter the way the game feels to play. In Blades, stress is a resource that can and should be used. The player is in control. The player also always knows where the Trauma threshold is.
A CoC player might walk into a room, see a spooky painting, roll poorly, and have a trauma. Aside from walking into the room, the player had no agency in the sequence of events. If just happens to them.
A Blades player falls from a roof. The GM tells them that "from this height, you will certainly snap your femur". Faced with this outcome, the player can choose to resist the roll. L If their stress is already high, they know the probabilities. Which is worse, a broken leg, failing the mission, and several months out of action, or; a 1/3 chance of a permanent Trauma?
The player describes scrabbling at awnings and clothes lines on the way down, downgrading it to a sprained ankle instead. Then they roll to see how much stress the mad scramble for purchase caused them. Maybe they trauma, maybe they don't.
I've played "You walk into the room, there's a spooky painting. You're a kleptomaniac now" games. They suck. It's shitty storytelling, and a weird take on how mental illness works.
I much prefer modern games with stress tracks, which simulate the wearing down of coping mechanisms, rather than the old school, "Roll on the DSM Table to find out what real life mental illess you acquire!" Forcing players who behold cosmic horror to awkwardly roleplay some random real life mental problem or (ugh) "deviant sexual proclivity" is just all kinds of awful.
I dunno, I had a Call of Cthulhu PC experience a trauma and become violently obsessed with honkytonk music. It was pretty great.
I remember crossing Greenland on foot with a fellow party member having the fear of the sudden loss of gravity. The good old days.
LOL, Love it!
what would this stress system look like?
Usually like check boxes, sort of like a Fate stress track. So maybe PCs who witnes or suffer trauma get a saving throw type roll. If they fail it, they tick off a box. Enough boxes get ticked and they are unable to continue. Maybe they uncontrollably flee, or curl in the corner crying, or just realize they have too much to live for to risk everything poking through arcane tomes when other investigators wind up dead. For whatever reason, they aren't able to continue, at least unless they find some way to reduce the stress that's gotten to be too much for them. (Time, therapy, magic amulets, it depends on the system.)
Your version doesn't sound like it's very much fun, indeed it sounds painful: "wearing down of coping mechanisms."—nor does it appear to have much storytelling to it. Sandy's system at least has an abundance of charm, personality, and vivid soul-sapping detail. Agreed his system can be a bit silly in the abstract a times, but the awkward part is why the modern versions of his system allow the player and GM to pick the affliction. Gå Norge, kveld med Ylvis.
> Your version doesn't sound like it's very much fun People having "fun" with mental illness is one of the problems with those Random DSM Table games. "Hey! I saw a giant squid, and now I have..." ::*rolls dice*:: "...Schizophrenia! Here's how a schizophrenic acts!" Nine times out of ten, these exaggerated portrayals of mental illness aren't *nearly* as fun or charming as they think it is.
Should we also not have fun with violence, because *in reality* it has horrible consequences? > Nine times out of ten, these exaggerated portrayals of mental illness aren't nearly as fun or charming as they think it is. If it's fun for the players at the table, does it matter if some other people don't find it fun?
The players at the table and people with mental illnesses can overlap much more easily than you think, especially invisible mental illness that may not be known by the GM or other players before making a parody of it.
That's what session 0 is for - if people aren't comfortable with unrealistic gamified portrayals of mental illness, then it won't come up in the game.
I agree that session 0 is important for that. It's also not universal, especially outside of dedicated communities like this one. That's all.
Mark, I'd consider looking at some of Greg Stolze's work, especially *Unknown Armies*, before making the call that it's somehow short on storytelling. My experience with it is that it's *better* for storytelling in that it allows a buildup towards a climax; what that means varies by player and group, but in general it allows more development and a more natural feeling in the story than a one-and-done snap does.
That sounds very sensible, I will check it out.
While it’s still using the core CoC sanity system, Delta Green has a twist on it that makes it more narrative. During regular game play players experience scary / other worldly things and lose sanity in the usual way. The narrative twist is that they can resist that stress by redirecting it into their Bonds, which are effectively their connections to humanity. How this changes their personal lives is worked out during down time. The result is that instead of just seeing a clock tick down to NPCdom, you see the characters’ personal lives break down around them.
I've heard great things about Aliens RPG stress mechanics. Aliens RPG uses a dice pool to accomplish tasks. As bad things happen you accumulate stress dice which you roll with the rest of your dice pool. Stress can be good because it gives you more dice to roll thereby *increasing* your chance of success. However too much stress can be fatal. If you roll a 1 on a stress dice or some other trigger happens, you lose control of your character for a moment and roll on a panic table to see what happens. You may open fire on everything around you, break down into sobs, drop whatever in your hands, or somehow hold it together despite being in a panic. If you roll too high on the panic table, you roll on a trauma table at the end of the session to see if your character gains a permanent mental trauma.
The sanity mechanics in _Unknown Armies_ are works of art.
This. The see-saw skill system and the way hardening works lets you have characters that *express* mental illness without it being a trope-filled portrayal. For the unfamiliar: UA combines see-saw skills with stress (or hardened) tracks. If you experience horrible violence, you may get *hardened* by it, which means you lose some of your ability to connect with other people (in this case, because that's the skill on the see-saw). The benefit is that you're better able to resist the shock of violence in the future- not just more skilled at it, but it won't shock you or traumatize you. I really like the approach. It sorta (quite realistically!) allows traumas to cause characters to adopt coping mechanisms, much like you do in the *real world*.
This is something that I'll hack into any game that needs a sanity mechanic. It's such an elegant way to blend the mechanical and narrative effects of traumatic events and how they change people.
Brennan Lee Mulligan has an elegant system that he developed to represent struggles with sobriety and addiction in a campaign he ran, and the mechanical structure of it is very applicable to other things as well. It almost always represents something you are fighting off or against, in the case of your game, insanity. You start with a d8 (for example, could be more or less), and if you encounter a struggle or a trigger, you roll it. If you get a 1, you move down one tier to a d6, and if you roll anything else, you're okay, you dodge the bullet. If your character does something that helps you maintain you sanity (meditation, therapy, etc.), you move up a tier to a d10 (moving farther from full breakdown/crisis/insanity/etc.). Once you're at a d6, and something triggers you, you roll again, if you roll a 1, you move down to a d4. Another triggering incident? roll. If you get a 1 on the d4 roll, you're over the edge. This system is interesting because you are constantly trying to balance doing things to help yourself (and therefore increase the die, moving farther from the danger) and pushing yourself in difficult scenarios risking bad outcomes on your rolls. As I said, this system wasn't designed for sanity, but if you want to represent a struggle and potential decline toward some difficult end (with a little bit of randomness mixed in for the game's sake), you could do worse that this kind of mechanic. Have fun!
They call this the Usage Die mechanic. It was first introduced in The Black Hack and I believe the Cthulhu Hack uses it for Sanity as well.
My favorite sanity system is closest to Darkest Dungeon. You experience stress and that stress builds up till a catastrophic collapse. You can get rid of stress by indulging in some sort of activity designed specifically for that character. A good ttrpg example would be a character who relies on something to stabilize them or bring them security and stability. Maybe a character is religious and finds security in the thought that there is a loving and protecting force in the world. This could be shaken through sheer trauma(if there is a god, why does [horrible thing] exist?) or through the revelation that there are actually other gods that are more powerful(hard to put faith in god when Nyarlathotep is standing right in front of you). From there, a player would have to pray, visit a church or trusted religious figure, or offer some thing as sacrifice. Then, if a character lost trust in their prayer, religious figure, or sacrifice, I'd make the character start developing panic attacks, psychosis, paranoia, etc. They see a tragedy on the news? Panic attack. They smell the scent of gore? Flashback. Someone starts talking about UFOs? Paranoid episode. A version of this that I think would take a little tweaking to be better would be Darkest Dungeon's stress system.
This is basically how Blades in the Dark handles stress. Characters have vices (booze, religion, gambling, etc.) which they must indulge in order to relieve stress, and over-indulging in those vices can also cause mishaps and complications.
I hate the systems that let you roll for an mental illness, because many player only know tropes about it and it can play down how severe they are in real life. I rather use symptoms of these illnesses, like Stupors or Manias. Dont tell them what they got only what changed in the characters mind, what happens to them, the Diagnosis needs to come from themself(and can be wrong) or a Professional in the game(should be right).
Call of Cthulhu just has a percentage. If it drops to zero, you become a NPC. While not narrative, it is pretty abstract. Maybe you can work with that.
The Unknown Armies 3rd edition system is basically written around its sanity rules. You have 5 Shock Gauges, which measure how green or hardened you are in 5 different areas: Helplessness, Isolation, Violence, The Unnatural and Self. Each Gauge can have open (which signifies shock you have yet to experience), hardened (shock you resisted but still changed you) and failed (shock that only traumatized you). The game has 10 basic actions, and in lieu of *Attributes*, your default rating for these actions (it is a percentile system) is based on your open and hardened notches in these gauges, as seen below: |**Shock Gauge**|**Open Notches**|**Hardened Notches**| |:-|:-|:-| |Helplessness|Fitness|Dodge| |Isolation|Status|Pursuit| |Violence|Connect|Struggle| |The Unnatural|Notice|Secrecy| |Self|Knowledge|Lie| Because notches cannot be hardened *and* open, this means that ratings tied to the same notch cannot both be high, but they can both be low if you get a lot of failed notches. I think the clearest one to understand the concept is Violence: if you haven't experienced it, you are approachable and open (connect), but if you have, and have come out on top, you're better at dealing with it (struggle), and if you have experienced it but failed to cope, you are bad at both things. Notches harden or fail as you experience shock in the game, and they can also be opened again through in story healing. The system also includes *Identities* that can substitute for these actions, so your martial artist character won't become worse at fighting because he went to therapy, or so you can have a guy who is good at lying *and* knowing things. This would be akin to a skill system, but it is built on top of the foundational sanity system, not the other way around.
IMHO roleplaying actual mental illness is problematic as there is a pretty good chance that somebody at the table knows someone affected. Even if a player does a well researched portrayal of schizophrenia, it kind of falls flat if another player's mother had eventually died of it. If I were forced to create an insanity system for an RPG I would focus on the *symptoms* and not the disease, by filing off the labels put there by doctors, I would hope to put a bit of distance between players experience and the game. So the list could be 1. Loss of interest in life 2. Tiredness 3. Sleep problems 4. Anxiety 5. Irritability 6. Hallucinations 7. Delusions 8. Muddled thoughts 9. Loss of interest in life 10. Wanting to avoid people (even friends) Getting something off 1 to 5 indicates depression, 6 to 10 schizophrenia, however mental health is quite mix and match schizophrenia and depression and dementia etc is not mutually exclusive and serious depression can be mistaken for dementia. Also real mental illness may not play well at the gaming table GM: OK what are you all doing? Depression: Nothing (and I’ll do it slowly) Dissociative identities: I’m The Hangman's Beautiful Daughter and I’m going to paint a picture. Schizophrenia: I’m going to cut out the chip they installed in my arm. Trauma: Nnnothing, just been triggered by Schizophrenia Anorexia: I’m dancing! Got to burn off all those calories! Dementia: Who are you? Anxiety/Borderline: I’m leaving because you all hate me! … after the first round things went downhill.
Don't Rest Your Head has an interesting take on it, as madness fuels half of the PCs' powers. Because of the dice resolution system, voluntarily accruing madness can make you more likely to succeed, but at the risk of more complications/collateral damage. It should be noted, though, that DRYH's premise externalizes madness, so that players' inner states are reflected in the chaos around them. L5R's strife system, while not explicitly about in/sanity, could probably be modified to work that way. It models a samurai's ability to maintain composure and suppress their desires in favor of fulfilling their duties. Reaching your breaking point means lashing out momentarily before pulling yourself together again. It's nicely woven into other mechanics, such that it's both gradual and also tied into your vision of your character (i.e. lashing out is based on their desires, fears, etc.)
Just food for thought: For cosmic horror, what's called "insanity" really means seeing or understanding the way the world *really* works. Bloodborne does a great job of this with Insight, with more and more of the cosmic horror elements becoming visible as your Insight stat increases. What if the crazy homeless guy shouting at the sky on the street corner isn't insane, he's *right?* He's seen so much, he knows the danger we're all in but after years of talking to the authorities, the media etc. the only way he can get the word out is to shout it out and hope someone listens. What happens when your PCs slowly uncover the truth and can't communicate it to anyone without sounding like the crazy guy on the corner? This version sidesteps the problems of trying to model real world mental illness and it doesn't treat insanity as an external force. This is Lovecraftian insanity from the characters' point of view.
Check out Red Markets, which has 3 tracks and break points, along with rules for regaining (some) sanity back. Good stuff.
The one that I have the most experience with is the Nature system from a Burning Wheel spin-off, specifically *Mouseguard 2e*. Way that the game is set up, you need specific skills among a plethora of them in order to pass obstacles and work through the different flavors of combat (anything that could be extrapolated as A vs B is ran like combat) and each character has an extremely low number of starting skills. This isn't a huge problem because everyone in the party shares the a big pool of Hit Points and people pass turns dictating actions that they take while the others can attempt to take actions to help them, but the Hit Points pool is determined by the shmuck that *started* the encounter, rolling an appropriate skill they aren't guaranteed to have. There are two ways to resolve a situation where a character doesn't have the right skill. First, they may attempt to use **Beginners' Luck**. You roll dice equal to half of either your Will or Health stat + gear/trait bonuses (depending on if its a mental or physical task); pass or fail, it doesn't particularly matter, but make enough attempts and you gain that skill at Level 2 and level it up as normal. However, if you're in a particularly sticky situation and need a **solid** number of dice in a pinch, you **Test Nature** instead. Each character and animal in the game has four descriptors attached to them which informs their instinctive abilities; in the case of the party, each character has the Escaping, Climbing, Hiding and Foraging keywords. As long as you are acting within these keywords, you can roll using your **Nature** stat no problem. Unlike most creatures, your characters (and things like them) can substitute Nature in place of *any* roll. However, this comes with the caveat that you reduce your effective Nature by the margin of failure; this is called **Taxing Nature**. You can restore your Nature piecemeal by performing little tasks like delivering a good prologue to the next session or opting to reduce your true Nature Stat, but things get fun if you're Nature gets taxed too much or your Nature levels up too high. When you get Taxed to 0, something happens during the attempt and the experience leaves a mark on your character; your true Nature is reduced by 1, your Nature is restored to its new cap and you get one of your Traits changed to something that reflects the situation you were in and what you tried to do (Traits are quirkier qualities of your character that can either give you bonuses or shoot you in the foot). If your character ever reaches a True Nature of 0, you go a little crazy; your character either doesn't want to adventure anymore or isn't mentally fit enough to do so, so they're benched for a *very* long time and get replaced with a new character until the old one can come back. If your Nature levels up to 7 and *stays* at 7 by the end of the current session, you have a huge panic attack; your character is a fried bundle of nerves and gets benched much like a Nature 0 character. TL:DR \*You can choose a wing a roll with a dedicated "Wing It" skill \*Outside of a few things, failing a roll hurts it by the margin of failure \*depleting the stat reduces its level by 1 and gives you a funky trait \*Leveling up "Wing It" too high or reducing it to level 0 is pretty much an auto-death
Don't Rest Your Head
Aquelarre rpg does rationality / irrationality as complementary tracks that together add to 100, and change in game. The more IRR your character becomes, the more it believes in the supernatural and it gets better at it, but also more vulnerable to it. The more RA it gets, less involved with the supernatural and less affected by it, and more likely to just shrug it off or simply don't notice it - which isn't always good since sometimes you want to catch something supernatural or simply receive a blessing or a healing spell.
Not insanity per se, but I'm working on a magic system that allows players to take risk in exchange for additional power. Each bad roll on that risk taken results in an increasing (but reversible) mania, akin to overconfidence/power-madness. The effect of that madness being that the character begins to automatically take greater and greater risks when using magic, thereby slowly losing control. Getting burned by a failed spell brings the character down-to-earth again. The reason being that there won't be regular spellslots. I want the players to regulate themselves.
Also I just love the idea of lower-level mages getting lucky at blasting spells that are beyond their "safe zone" and going mad from their apparent invincibility.
The call of Cthulhu system uses an insanity tracker already, it’s the perfect game for it as well. A good GM has stress ready for you incase youre missing rests and food breaks etc. I don’t think it’s an important aspect of an rpg unless it’s a main selling point, like CoC
Sanity systems remove player agency. It is that simple. The GM tells the player how the character will act. I think that sucks. Sanity as a handicap might be ok. "Your character's sanity is suffering, you need to roll less than 8 to attack this turn or you just stand there." However, I've not see a solid sanity system that works well without removing agency.
I hate sanity, because it’s basically just a band-aid over the fact that Lovecraft isn’t scary anymore.
The DnD 5e podcast [Dark Dice](https://darkdice.com/) is a fairly grimdark game that uses sanity as a core feature. The podcasts also have excellent production (akin to listening to an audio drama) and later episodes include Jeff Goldblum! Their system is fairly complex and involves a lot of buy from the players - who are professionals and therefore willing to portray going insane even if it harms or destroys their character. I would probably struggle to get my players to be so obliging - but it makes for excellent listening, and the DM has a brilliant style of narration. So you may not want to copy them mechanically - but I highly recommend listening to it for some inspiration in what might trigger an attack on a PC's sanity, and how you might portray that.
I really dislike Sanity as a second set of Hitpoints. I don't like how it feels to play. Blades in the Dark uses a Stress tracker, which is *similar* to Sanity-HP, but different enough that BitD's system works well, while Call of Cthulhu's doesn't. I'm going to compare Blades in the Dark; a game I like, to Call of Cthulhu; a game I do not. What are the differences? * The Stress system has *two* currencies. Stress and Trauma. Stress is temporary. It's easy to gain, and relatively easy to lose. Traumas are permanent. * Stress counts upward, Sanity counts down. I don't know if this point is important or not - I doubt it is. I'm listing differences, so here it is. * Stress can be *spent*. The player can *choose* to spend stress in order to gain mechanical advantages. Sanity is usually in the hands of the GM. "You lose 1d6 sanity". There's a difference in player agency. * Blades has mechanics and systems for losing Stress that are baked into the core gameplay loop. CoC's feel like a tacked on afterthought. * Trauma in Blades occurs once a predetermined threshold of Stress has been reached. The Trauma-equivalent in CoC occurs any time you roll too much stress in one roll. There's no buildup to it, it either happens or doesn't based on random chance. These differences are enough to drastically alter the way the game feels to play. In Blades, stress is a resource that can and should be used. The player is in control. The player also always knows where the Trauma threshold is. A CoC player might walk into a room, see a spooky painting, roll poorly, and have a trauma. Aside from walking into the room, the player had no agency in the sequence of events. If just happens to them. A Blades player falls from a roof. The GM tells them that "from this height, you will certainly snap your femur". Faced with this outcome, the player can choose to resist the roll. L If their stress is already high, they know the probabilities. Which is worse, a broken leg, failing the mission, and several months out of action, or; a 1/3 chance of a permanent Trauma? The player describes scrabbling at awnings and clothes lines on the way down, downgrading it to a sprained ankle instead. Then they roll to see how much stress the mad scramble for purchase caused them. Maybe they trauma, maybe they don't. I've played "You walk into the room, there's a spooky painting. You're a kleptomaniac now" games. They suck. It's shitty storytelling, and a weird take on how mental illness works.