This ruleset is a variant of the Sanity mechanics from Unearthed Arcana and the d20 Call of Cthulhu campaign setting.
Sanity is the natural mental state of ordinary life. Normal mental balance is endangered when characters confront horrors, entities, or activities that are shocking, unnatural, and bewildering. Such encounters cause a character to lose points from his Sanity score, which in turn risks temporary, indefinite, or permanent insanity. Mental stability and lost Sanity points can be restored, up to a point, but psychological scars may remain.
Insanity occurs if too many Sanity points are lost in too short a time. Insanity does not necessarily occur if Sanity points are low, but a lower Sanity score makes some forms of insanity more likely to occur after a character experiences an emotional shock. The character's Sanity may be regained after a few minutes, recovered after a few months, or lost forever.
A character may regain Sanity points, and even increase her Sanity point maximum.
Sanity points measure the stability of a character's mind. This attribute provides a way to define the sanity inherent in a character, the most stability a character can ever have, and the current level of sane rationality that a character preserves, even after numerous shocks and horrid revelations.
Sanity is measured in two ways: current Sanity and maximum Sanity. Current Sanity cannot exceed maximum Sanity.
A character's starting Sanity equals his Wisdom score multiplied by 5. This score represents a starting character's current Sanity. After creation, a character's current Sanity often fluctuates considerably and might never again match starting Sanity.
A character's current Sanity can never be higher than 5× her Wisdom score or 99, whichever is lower. Certain situations may reduce this limit. Anything that permanently reduces a character's maximum sanity, such as Wisdom drain (but not damage), also reduces her current sanity by the same amount.
A character's current Sanity score can fluctuate almost as often as his hit points, though that isn't common.
When a character encounters a gruesome, unnatural, or supernatural situation, the GM may require the player to make a Sanity check using percentile dice (d%). The check succeeds if the result is equal to or less than the character's current Sanity.
On a successful check, the character either loses no Sanity points or loses only a minimal amount. Potential Sanity loss is usually shown as two numbers or die rolls separated by a slash, such as 0/1d4. The number before the slash indicates the number of Sanity points lost if the Sanity check succeeds (in this case, none); the number after the slash indicates the number of Sanity points lost if the Sanity check fails (in this case, between 1 and 4 points).
A character's current Sanity is also at risk when the character reads certain books, learns certain types of spells, and attempts to cast them. These Sanity losses are usually automatic (no Sanity check is allowed); the character who chooses to undertake the activity forfeits the indicated number of Sanity points.
Special: If a character has a feat that allows her to substitute a different ability for Wisdom when making will saves, she may use that ability to calculate an effective Sanity when making Sanity checks. For example, if a character posesses the Force of Personality feat, she is considered to have a Sanity score of 5× her Charisma minus any points lost previously for the purpose of making the check only.
Losing more than a few Sanity points may cause a character to go insane, as described below. If a character's Sanity score drops to 0 or lower, she begins the quick slide into permanent insanity. Each round, the character loses another point of Sanity. Once a character's Sanity score is reduced to a point below zero equal to her Wisdom score, she is hopelessly, incurably insane. Only greater restoration, heal (the spell), limited wish, wish, or miracle can restore her to a stable mental state. The Heal skill can be used to stabilize a character on the threshold of permanent insanity; see The Heal Skill and Mental Treatment, below, for details.
Characters ordinarily lose Sanity in a few types of circumstances: when encountering something unimaginable, when suffering a severe shock, after casting a spell or when learning a new spell, or when being affected by a certain type of magic or a particular spell.
Character insanity is induced by a swift succession of shocking experiences or ghastly revelations, events usually connected with dark gods, creatures from the Outer Planes, etc.
Horrifying encounters can result in one of three states of mental unbalance: temporary, indefinite, and permanent insanity. The first two, temporary insanity and indefinite insanity, can be cured. The third, permanent insanity, results when a character's Sanity points are reduced to -10 or lower. This condition cannot be cured.
Whenever a character loses Sanity points equal to one-half her Wisdom score from a single episode of Sanity loss, she has experienced enough of a shock that the GM must ask for a Sanity check. If the check fails, the character realizes the full significance of what she saw or experienced and goes temporarily insane. If the check succeeds, the character does not go insane, but she may not clearly remember what she experienced (a trick the mind plays to protect itself).
Temporary insanity might last for a few minutes or a few days. Perhaps the character acquires a phobia or fetish befitting the situation, faints, becomes hysterical, or suffers nervous twitches, but she can still respond rationally enough to run away or hide from a threat.
A character suffering from temporary insanity remains in this state for either a number of rounds or a number of hours; roll d% and consult Table 6-8: Duration of Temporary Insanity to see whether the insanity is short-term or long-term. After determining the duration of the insanity, roll d% and consult either Table 6-9 or 6-10 to identify the specific effect of the insanity. The GM must describe the effect so that the player can roleplay it accordingly.
Successful application of the Heal skill (see The Heal Skill and Mental Treatment, below) may alleviate or erase temporary insanity.
Temporary insanity ends either when the duration rolled on Table 6-8 has elapsed, or earlier if the GM considers it appropriate to do so.
After an episode of temporary insanity ends, traces or even profound evidence of the experience should remain. No reason exists why, for instance, a phobia should depart from someone's mind as quickly as a warrior draws his sword. What remains behind after a brief episode of temporary insanity should exert a pervasive influence on the character. The character may still be a bit batty, but her conscious mind once again runs the show.
As a variant rule, if the amount of Sanity lost exceeds the character's current Wisdom score, consider the temporary insanity to always be of the long-term variety.
| d% | Temporary Insanity Type | Duration |
|---|---|---|
| 01-80 | Short-term | 1d10+4 rounds |
| 81-100 | Long-term | 1d10×10 hours |
| d% | Effect |
|---|---|
| 01-20 | Character faints (can be awakened by vigorous action taking 1 round; thereafter, character is shaken until duration expires). |
| 21-30 | Character has a screaming fit. |
| 31-40 | Character flees in panic. |
| 41-50 | Character shows physical hysterics or emotional outburst (laughing, crying, and so on). |
| 51-55 | Character babbles in incoherent rapid speech or in logorrhea (a torrent of coherent speech). |
| 56-60 | Character gripped by intense phobia, perhaps rooting her to the spot. |
| 61-65 | Character becomes homicidal, dealing harm to nearest person as efficiently as possible. |
| 66-70 | Character has hallucinations or delusions (details at the discretion of the GM). |
| 71-75 | Character gripped with echopraxia or echolalia (saying or doing whatever those nearby say or do). |
| 76-80 | Character gripped with strange or deviant eating desire (dirt, slime, cannibalism, and so on). |
| 81-90 | Character falls into a stupor (assumes fetal position, oblivious to events around her). |
| 91-99 | Character becomes catatonic (can stand but has no will or interest; may be led or forced to simple actions but takes no independent action). |
| 100 | Roll on Table 6-10: Long-Term Temporary Insanity Effects. |
| d% | Effect |
|---|---|
| 01-10 | Character performs compulsive rituals (washing hands constantly, praying, walking in a particular rhythm, never stepping on cracks, constantly checking to see if crossbow is loaded, and so on). |
| 11-20 | Character has hallucinations or delusions (details at the discretion of the GM). |
| 21-30 | Character becomes paranoid. |
| 31-45 | Character gripped with severe phobia (refuses to approach object of phobia except on successful DC 20 Will save). |
| 46-55 | Character develops an attachment to a "lucky charm" (embraces object, type of object, or person as a safety blanket) and cannot function without it. |
| 56-65 | Character develops psychosomatic blindness, deafness, or the loss of the use of a limb or limbs. |
| 66-75 | Character has uncontrollable tics or tremors (-4 penalty on all attack rolls, checks, and saves, except those purely mental in nature). |
| 76-85 | Character has amnesia (memories of intimates usually lost first; Knowledge skills useless). |
| 86-90 | Character has bouts of reactive psychosis (incoherence, delusions, aberrant behavior, and/or hallucinations). |
| 91-95 | Character loses ability to communicate via speech or writing. |
| 96-100 | Character becomes catatonic (can stand but has no will or interest; may be led or forced into simple actions but takes no independent action). |
| d% | Mental Disorder Type |
|---|---|
| 01-15 | Anxiety (includes severe phobias) |
| 16-20 | Dissociative (amnesia, multiple personalities) |
| 21-25 | Eating (anorexia, bulimia) |
| 26-30 | Impulse control (compulsions) |
| 31-35 | Mood (manic/depressive) |
| 36-45 | Personality (various neuroses) |
| 46-50 | Psychosexual (sadism, nymphomania) |
| 51-55 | Psychospecies |
| 56-70 | Schizophrenia/psychotic (delusions, hallucinations, paranoia, catatonia) |
| 71-80 | Sleep (night terrors, sleepwalking) |
| 81-85 | Somatoform (psychosomatic conditions) |
| 86-95 | Substance abuse (alcoholic, drug addict) |
| 96-100 | Other (megalomania, quixotism, panzaism) |
If a character loses 20% (one-fifth) or more of her current Sanity points in the space of 1 hour, she goes indefinitely insane. The GM judges when the impact of events calls for such a measure. Some GMs never apply the concept to more than the result of a single roll, since this state can remove characters from play for extended periods. An episode of indefinite insanity lasts for 1d6 game months (or as the GM dictates). Symptoms of indefinite insanity may not be immediately apparent (which may give the GM additional time to decide what the effects of such a bout of insanity might be).
Table 6-11: Random Indefinite Insanity is provided as an aid to selecting what form a character's indefinite insanity takes. (The mental disorders mentioned on this table are explained later in this section.) Many GMs prefer to choose an appropriate way for the insanity to manifest, based on the circumstances that provoked it. It's also a good idea to consult with the player of the afflicted character to see what sort of mental malady the player wishes to roleplay.
The state of indefinite insanity is encompassing and incapacitating. For instance, a schizophrenic may be able to walk the streets while babbling and gesticulating, find rudimentary shelter, and beg for enough food to survive, but most of the business of the mind has departed into itself: She cannot fully interact with friends, family, and acquaintances. Conversation, cooperation, and all sense of personal regard have vanished from her psyche.
It is possible for characters with indefinite insanity to continue to be played as active characters, depending on the form their madness takes. The character may still attempt to stumble madly through the rest of an adventure. However, with her weakened grasp on reality, she is most likely a danger to herself and others.
As a general rule, a character suffering from indefinite insanity should be removed from active play until she recovers. At the GM's discretion, the player of the character might be allowed to use a temporary character until the end of the story. Whether this "stand-in" character is an incidental NPC in the adventure, a character of the same level as the rest of the group, one or two levels below the rest of the characters, or even a 1st-level character, is up to the GM. Different GMs have different ways of handling this transition.
If a character goes indefinitely insane near the end of an adventure, the GM may decide to set the next adventure to begin after the insane character has recovered.
Characters suffering from indefinite insanity are in limbo, unable to help themselves or others. The Heal skill can be used to restore Sanity points during this period, but the underlying insanity remains.
After recovery, a victim retains definite traces of madness. For example, even though a character knows he is no longer insane, she might be deathly afraid of going to sleep if her insanity manifested itself in the form of terrifying nightmares. The character is in control of her actions, but the experience of insanity has changed her, perhaps forever.
A character whose Sanity score falls below zero goes permanently insane. The character becomes an NPC under the control of the GM unless powerful magic is used to cure her.
A character with permanent insanity may be reduced to a raving lunatic or may be outwardly indistinguishable from a normal person; either way, she is inwardly corrupted by the pursuit of knowledge and power. Some of the most dangerous cultists in the world are characters who have become permanently insane, been corrupted by forbidden knowledge, and "gone over to the other side."
A character might be driven permanently insane by forces other than dark gods or forbidden knowledge. In such cases, moral corruption need not necessarily occur. The GM might decide to consider different sorts of permanent insanity, rolling randomly or choosing from among the mental disorders on Table 6-11: Random Indefinite Insanity, above.
A character who has gone permanently insane can never be normal again (without the aid of powerful magic). She is forever lost in her own world. This need not mean a lifetime locked away from society, merely that the character has retreated so far from reality that normal mental functions can never be restored. She might be able to lead, within restricted bounds, a more or less normal life if kept away from the stimulus that triggers strong responses in her individual case. Yet a relapse may come quickly. Her calm facade can be destroyed in seconds if even the smallest reminder of what it was that drove her mad disturbs her fragile equilibrium.
A character's Sanity score can increase during the events of a campaign. Although a character's Sanity score can never exceed 5× her Wisdom score, her maximum Sanity and current Sanity can exceed her starting Sanity.
A character's current Sanity can increase as a result of gained levels: Whenever a character gains a new level, she adds a number of points equal to her Wisdom bonus (ignore effect of magic items, ability damage/drain, or other modifiers) to her current Sanity. A character always regains at least one point, even if she has no Wisdom bonus.
The GM may decide to award increases in character's current Sanity if they foil a great horror, a demonic plan, or some other nefarious enterprise.
The Sanity rules presented here provide a new use for the Heal skill, allowing trained healers to help characters recover lost Sanity points. The DC and effect of a Heal check made to restore lost Sanity depend on whether the therapist is trying to offer immediate care or long-term care.
When someone suffers an episode of temporary insanity, a therapist can bring him out of it—calming his terror, snapping him out of his stupor, or doing whatever else is needed to restore the patient to the state she was in before the temporary insanity—by making a DC 15 Heal check as a full-round action.
A therapist can also use immediate care to stabilize the Sanity score of a character whose current Sanity is between -1 and permanently insane. On a successful DC 15 check (requiring a full-round action), the character's Sanity score improves to 0.
Providing long-term care means treating a mentally disturbed person for a day or more in a place away from stress and distractions. A therapist must spend 1d4 hours per day doing nothing but talking to the patient. If the therapist makes a DC 20 Heal check at the end of this time, the patient recovers 1 Sanity point. A therapist can tend up to six patients at a time; each patient beyond the first adds 1 hour to the total time per day that must be devoted to therapy. The check must be made each day for each patient. A roll of 1 on any of these Heal checks indicates that the patient loses 1 point of Sanity that day, as she regresses mentally due to horrors suddenly remembered.
To give useful mental therapy, a therapist must have at least 5 ranks in the Heal skill. Intensive treatment can return Sanity points to a troubled character. However, Sanity points restored in this manner can never cause the patient's Sanity score to exceed her starting Sanity or maximum Sanity, whichever is lower. A character can have only one healer at a time. See The Heal Skill and Mental Treatment sidebar for a detailed description of how this works.
Such treatment can also be used to help a character snap out of an episode of temporary insanity (for example, from an acute panic attack). It does not speed recovery from indefinite insanity, but it can strengthen a character by increasing her Sanity points.
Recovery from indefinite insanity only comes with time (typically, 1d6 months). It is not dependent upon the character's Sanity points and is not connected to them. A character can be sane with 24 Sanity points and insane while possessing 77 Sanity points.
Some magic spells have added or alternate effects when dealing with sanity.
Although this spell does not usually restore Sanity, it can be used in those rare cases when a character's own actions inadvertently lead to an evil act that causes the character to lose Sanity points. If a quest or geas is combined with the atonement spell, Sanity points are not restored until the task is completed. A successful use of the atonement spell can restore all Sanity lost through the direct result of the evil acts for which the character atones.
This spell cannot restore Sanity directly, but it can temporarily mitigate the effects of temporary or permanent insanity. While the spell is in effect, the targets act calmly and ignore behavior changes caused by Sanity loss.
In addition to its normal effects, this spell removes all forms of temporary insanity.
While the spell is in effect, the subject is immune to Sanity loss. Some permanent effects (like gaining kowledge from a book) may still cause sanity loss when the spell wears off, however.
If the caster chooses, this spell can remove one form of temporary insanity plaguing the subject.
If the caster chooses, this spell can restore one point of lost sanity per caster level to a character instead of having its normal effect. This use of the spell costs 100XP per point restored, and cures all forms of temporary insanity plaguing the subject.
If the caster chooses, this spell can restore the target creature to half of its maximum Sanity and cure all temporary insanity instead of having its normal effect.
This spell can restore a character to half of her maximum Sanity and cure all temporary and indefinite insanities.
This spell can restore a character to maximum Sanity and cure all forms of insanity (including permanent insanity).
This spell can restore a character to maximum Sanity and cure all forms of insanity (including permanent insanity).