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kamikasei
2011-06-12, 06:49 AM
I'm learning the Eclipse Phase system, which includes a mental stress/trauma/disorder mechanic paralleling the physical health/damage/wounds one. Various experiences - death and resleeving, psychological attacks, exposure to the alien, as well as simple stressful ordeals like failing at a goal close to your heart or watching a loved one die, you take stress; if you take enough stress at once, you accumulate traumas; as traumas pile on, you first suffer temporary derangements of increasing severity, then eventually manifest a full-blown psychiatric disorder. These disorders are real psychiatric conditions such as bipolar disorder, depression, schizophrenia, PTSD and multiple personality disorder.

I don't have any experience with these conditions, but I expect at least one of my prospective players will at least know someone who does, even if they themselves don't. I trust my players to tell me honestly if something is a particular issue for them when I ask, but I don't want to require them to educate me when I can educate myself, and I have to think about other players' actions and not just my own. Even absent anyone in the group having issues with a portrayal themselves, I'd rather we not stigmatize the mentally ill for our entertainment if we can avoid it with a little effort.

So my question is whether anyone can recommend any resources on the portrayal of mental illness in RPGs. Something dealing specifically with RPGs would be great, of course, but guides for writers or actors, takedowns of myths and falsehoods, and in general anything that could help a GM or player show a character's illness without falling in to harmful or lazy stereotypes would be a help.

edit: The game also includes mechanics for treating mental stress and trauma during downtime, just like physical healing, and every character by default has an AI "muse" companion with the necessary skills to act as a (trusted and long-term) psychotherapist. So as well as pointers on portraying mental illness, pointers on recovery and the behaviours someone might exhibit over a course of therapy - for example, exercises or mantras they may repeat to short-circuit the normal illness response to a stimulus, or behaviours they may seek out or avoid to help with healing - would be very useful.

Thanks in advance for whatever help the Playground can provide.

onthetown
2011-06-12, 06:53 AM
There's always the Heroic Blue Screen of Death (http://tvtropes.org/pmwiki/pmwiki.php/Main/HeroicBSOD)...

I can't think of any RPGs that deal with mental illness in the vein of video games, but I believe D&D 3.5's Book of Vile Darkness has some rules for insanity. I think the best way to go would be to educate yourself about mental illness outside of RPGs, like knowing the difference between schizophrenia and multiple personality disorder, and general symptoms of whatever traumas and derangements this system has listed as common. If you foresee a character getting a less common one or it starts to happen or whatever, make sure to read up on it before it becomes a major issue.

kamikasei
2011-06-12, 07:27 AM
I think the best way to go would be to educate yourself about mental illness outside of RPGs
That's what I'm asking about. I'm hoping that there are resources that examine mental illness(es) from the point of view of portraying them respectfully in fiction (including RPGs), and pitfalls to avoid in a "live" environment (as opposed to a creative endeavour where you can go back and edit or rewrite before releasing the result to an audience). A little more focus than "learn all about mental illness in general" would make for a better resource for my own use and to link to players.

Tengu_temp
2011-06-12, 07:44 AM
I remember that there was an article describing some more common mental illnesses and the pitfalls to avoid with them somewhere. Let's see if I can find it.

EDIT: Found Still Not Safe when searching for "mental illness" on these forums. Figures.

Okay, here they are. It's technically DND stuff, but all of it works for other RPGs too.
http://chaoticidealism.livejournal.com/25381.html
http://chaoticidealism.livejournal.com/25614.html
http://chaoticidealism.livejournal.com/25947.html

kamikasei
2011-06-12, 08:05 AM
Thanks Tengu, those look really helpful.

I've added another note to the OP as it's occurred to me that not just developing a mental illness, but perhaps more importantly recovering from it, is relevant to play. (You might take a lot of stress quite quickly if a mission goes south and you have to shoot your possessed lover before blowing yourself up before the virus turns you in to a monster, but recovering from the trauma of that is going to take at least several days of therapy, so characters will generally have a full-blown disorder for less time than they're recovering from it.)

Yukitsu
2011-06-14, 01:54 PM
Acquiring a copy of the DSM IV is a pretty good start. Though 99% of what comes up in fiction should just be PTSD anyway.

Jjeinn-tae
2011-06-14, 02:29 PM
Schizophrenia comes in many varieties, I'm marginally familiar with one with exposure to my uncle. A better source on a different one though:

http://en.wikipedia.org/wiki/A_Beautiful_Mind_%28film%29

That movie is about John Nash, paranoid schizophrenic. If you read too much of that there will definitely be spoilers, not sure if that's important to you here. :smalltongue:

Telok
2011-06-14, 03:16 PM
You need to look into Call of Cthulhu.

The game explicitly deals with the loss of sanity, effects on characters, and recovery. It's a core mechanic of the game.

kamikasei
2011-06-14, 03:49 PM
To clarify, the game has rules (http://dl.dropbox.com/u/7127699/EP_lightweight/epch7.html#x9-7520007.9) for mental health and illness. It has lists of conditions and descriptions of their effects. I don't need pointers on how to represent these things mechanically, though the effort is appreciated.

What I'm hoping to find are guides or perhaps cautionary notes on how to avoid harmful stereotypes in portrayal. To that end A Beautiful Mind is less relevant than, e.g., an FAQ from a schizophrenia awareness group on what the movie got wrong.

Quietus
2011-06-14, 03:56 PM
I was fully ready to come in here with a high-falutin' rant and rave about how you shouldn't even attempt to portray mental illnesses in an RPG, and how not one mental health patient will tell you that their issues are fun... and got trumped by "Hey, the system I'm playing specifically deals with these".

In that light, I will simply say : Best of luck, those sorts of things can be very difficult to boil down into usable pieces that are both believable and fun while being respectful to those suffering the actual thing.

Jjeinn-tae
2011-06-14, 04:05 PM
Hmm, all I can find on that is that Nash's delusions in reality were auditory exclusively, rather than having a visual component, and except for Nash and his wife, no one really represents a real historic person... And scandals, but that's Wikipedia. :smalltongue:

Wikipedia really should link to something like that.... Quick google search doesn't turn anything up either except for the mentioned scandals, and a bit more, still in scandals...


Hmm, not helpful.

Nerd-o-rama
2011-06-14, 04:06 PM
Yeah, CoC is the very obvious one, although it's not exactly what I'd call realistic. It fits the feel of how Lovecraft looked at sanity and insanity, but he was an insane eugenicist writing in the 1920's.

GoblinArchmage
2011-06-15, 02:15 AM
In my experience, most people who don't have a specific mental illness know almost nothing about the illness in question. There are a lot of people, for example, who confuse Schizophrenia with Dissociative Identity Disorder.

Generally, any fictional portrayal is most likely inaccurate, so if it was in a movie, a TV show, a video game, a novel, or some other form of entertainment, then it's probably incorrect. You should probably just stick with legitimate scientific and professional sources. This does NOT include Freud. He was revolutionary about 100 years ago in a time when virtually no scientific information existed regarding mental illness, but his theories are now very much outdated.

By the way, I'm pretty sure that the name "Multiple Personality Disorder" is no longer in use. The illness that you are referring to is Dissociative Identity Disorder.

Also, be careful when using the term "insanity," as it can sometimes be derogatory. I have a mentall illness and I personally don't find it offensive, but that's just me.

Edit: I just realized that the OP never used the term "insanity." Sorry about that.

One final and somewhat off topic note: OCD is a proper noun. It is not an adjective, despite the fact that almost every single person who doesn't have it seems to think otherwise.

Correct Usage: He has OCD.
Incorrect Usage: He is OCD.


Acquiring a copy of the DSM IV is a pretty good start. Though 99% of what comes up in fiction should just be PTSD anyway.

I think that the DSM V is out now, actually. There may be an online version. Later I might try to find a link for it.

Epsilon Rose
2011-06-15, 08:49 AM
Might I point out, that while mental disorders are a real and serious thing, portraying them in a manner that is 100% true to life may not lead to the most enjoyable of games.
There are a lot of components of gaming that are lightened from there real world equivalents (arrows and bullets, for instance, should cause quite a few more problems than they do in most games). I think mental illness is probably a good candidate for that sort of treatment and adopting a policy that since most portrayals of mental illness will come off as either insulting or disruptive to the game it's a better idea to use fictionalised versions of them that are more dramatically and thematically appropriate and less related to real people.

Yukitsu
2011-06-15, 01:20 PM
I think that the DSM V is out now, actually. There may be an online version. Later I might try to find a link for it.

It's not yet, but they have got a preview of it floating around somewhere. That and the DSM IV heading out means you can probably get a cheap copy off Amazon.

DabblerWizard
2011-06-16, 01:54 PM
I'm getting my graduate degree in a mental health field so I should be able to lend some competent insight into this discussion.

TLDR: An earnest portrayal of "recovering" from mental illness would take much longer than "several days"... I wonder how well you could portray these events before they become more than the players want to handle. My suggestion, just don't go there.


"Recovery" from trauma is not like "recovery" from a broken bone. There's no such thing as "perfectly" "getting over" a traumatic event. Unless you literally fry someone's neurons through some terrible experiment, the person will always be capable of recalling the event, and thus, will always be able to experience pain, suffering, emotional distress, from remembering what happened to them.

Assuming we're talking about a person who manifests a mental illness from trauma (which isn't necessarily the case), the mechanisms linking symptoms with event exposure (or mental re-exposure) are definitely hazy.

Suffice to say, your characters might have to deal with (1) the event itself, (2) symptoms that come about as a result of the event, which can be hard to handle on their own, as well as (3) coping with and adjusting to living the rest of their lives while (1) and (2) are happening concurrently.

Add continued "adventurer" stress, delaying therapy because of going on "missions", new stress, and recovery may take a long time.

Now, some more pleasant news. What can therapy help with? Therapy can help with managing symptoms in the short and medium term, hopefully leading to symptom reduction in the long term. That's just a rough outline. I'm not going to type out minute details about expected progress because it's very individual.

All sorts of variables can impact their progress. How well adjusted they are, how they cope with stressful situations, how open they are to new interventions, how quickly they form a trusting connection with their therapist... etc. This is complicated stuff!

If you want to include a realistic, and sensitive portrayal from trauma and treatment, then your players are looking at some hard work.

It would be much easier to just hand wave this element and say you're functionally "back to normal" after a couple months. That comes with the price of being insensitive.

Feriority
2011-06-16, 04:21 PM
Schizophrenia comes in many varieties, I'm marginally familiar with one with exposure to my uncle. A better source on a different one though:

http://en.wikipedia.org/wiki/A_Beautiful_Mind_%28film%29

That movie is about John Nash, paranoid schizophrenic. If you read too much of that there will definitely be spoilers, not sure if that's important to you here. :smalltongue:

I'd just like to point out that the movie is almost completely fictional. It misrepresents Nash's schizophrenia, his mathematical contributions, and his life in general. It's a good movie, and I enjoyed it a lot, but it isn't a good source to learn about schizophrenia from.

The book with the same name, on the other hand, is an actual biography of Nash; it's very well written, and his story is an interesting one, so it's a very good read. It also might provide some interesting insights on schizophrenia and how it impacts a person both directly and indirectly via stigma; the scandal being talked about earlier, if I'm not confused, refers to the fact that the stigma around his mental illness was probably a major factor preventing him from receiving a Nobel prize for his work; it was only after he began continued contribution to the work of other game theorists who then vouched for his recovered mental capabilities that he was able to receive the prize.

(Also, he's still alive, and still doing interesting developments in game theory now. His life story really is pretty exciting, especially if you're interested either in mental illness or mathematics.)

Anxe
2011-06-17, 02:28 PM
I remember GURPS having a system where the character would have to roll a Will save of some kind whenever they would be presented with a chance to do their insane behavior. This is a very simple system for phobias and obsessive behaviors, but it gets more complicated for other diseases.

The SRD also has a very long section for Sanity Rules (http://www.d20srd.org/srd/variant/campaigns/sanity.htm). I think that's mostly designed for doing Clthuluian stuff in D&D. If that's not your thing it should still give you some ideas that you can homebrew or modify.

kamikasei
2011-06-17, 03:06 PM
Thanks, but as I mentioned above (http://www.giantitp.com/forums/showthread.php?p=11207800#post11207800) the system already has rules; rules aren't what this thread is looking for. I've actually found what looks like a decent resource and will link it here if it still seems solid after I've had time to read through it.

Maryring
2011-06-17, 08:47 PM
Something to remember. If you want to portray a mental disorder, it does not have to be extreme. Technically, a disorder is a disorder only when it interferes with your daily life, but even then, one can easily fail to notice that someone has a mental disorder. Making sure that the spoon is exactly five inches to the left of the platter may be a compulsion, or it might just be someone practicing hospitality. You can only see the behaviour, not the mentality behind it.

Unless you can in this game, but still, soft touches for realism. Leave the extreme behaviour for comedy.

RPGuru1331
2011-06-17, 09:55 PM
Maryring, I think, if I understand the OP correctly, it's not about realism, it's about respect. And I'm not entirely sure if portraying them as no big deal is respectful.

Maryring
2011-06-17, 10:00 PM
Playing them as extreme certainly isn't either. Respect and realism are very closely linked. Only by knowing the facts of how things manifest can you make choices that allow you to deal with the issue respectfully. If, as an example, you play someone with schizophrenia, it would not be respectful to rave about seeing spiders everywhere. Can it manifest itself like this? Yes, at times, and with varying degrees of intensity, but portraying that as a gospel truth is not going to give schizophrenia a more positive image in any way.

And honestly, there's a huge difference between a muted, hidden affliction, and an affliction that's no big deal. You're not likely to see on someone that he or she is suffering from a cancer of some sort. Doesn't make it any less devastating.

Asgardian
2011-06-17, 10:10 PM
Have a netflix account?

Some movies and TV that may give you some ideas

United States of Tara - DID
http://www.isst-d.org/education/united_states_of_tara-ISSTD-information.htm

A Beautiful Mind - Schizophrenia
http://www.everydayhealth.com/healthy-living-pictures/a-beautiful-mind-schizophrenia-0225.aspx

As Good as it gets -OCD
http://www.everydayhealth.com/healthy-living-pictures/as-good-as-it-gets-ocd-0225.aspx

RPGuru1331
2011-06-17, 10:47 PM
Playing them as extreme certainly isn't either. Respect and realism are very closely linked. Only by knowing the facts of how things manifest can you make choices that allow you to deal with the issue respectfully.
While I agree with your point that follows, and I am perhaps overworrying, I would point out that I'm not particularly interested in making them extreme. My only concern in my post was not trivializing them, not playing them up at every opportunity.

Still, perhaps I'm overworrying, given that this is already a difficult topic anyway.

Maryring
2011-06-18, 08:51 AM
Ah yes. However, overplaying a mental illness is a far more likely outcome than underplaying it. Assume that the 60% of American population has a mental illness claim is true. (Qualifier: Assume the number to be accurate for where you live). Now, consider those you meet. Consider just how many people you have some sort of relationship towards. Even if it is a mere acquaintance, you'll still have some idea of what kind of person he or she is. Then consider just how many you would think of as having a mental illness of sorts.

You will notice a discrepancy I am sure.

Acting seemingly normal isn't considered a trait of the mentally ill. They are often considered to be hysteric, violent, distant, or in any other way "not normal". But many mentally ill people function very well within society. They act normally, talk normally, but some things are just not fully "right" for them.

Actually, I'm just gonna stop here before it becomes too long. I just wanted to restress that I meant it originally as a warning against overplaying, as that is very easy to do if you're working with the common belief on what mental illnesses are.

kamikasei
2011-06-30, 03:33 PM
Better link the resource I mentioned while I remember and before the thread ages out, in case it'll be of use to others. This site (http://www.errantdreams.com/pages/rpg) seems to have a lot of solid info and advice in general, but the articles on mental illness were just the sort of thing I was looking for.