Wednesday, May 11, 2016

Frayed Ends of Sanity(Rules for Sanity in Pathfinder RPG)

Outside of a few special sources, the Pathfinder Role Playing Game (PFRPG) as with most fantasy RPG's doesn't really deal with the idea of sanity. While I have heard rumors the next adventure path will have sanity rules, the game I currently run on Thursday nights needs those rules now. Considering this fact and given my general interest in the role of mental trauma and insanity in RPG's I have decided to create my own sanity rules.

What is Insanity?

The definition of sanity is "the state of being seriously mentally ill, madness". While this is indeed the definition of sanity, the question is how does that work as a system in a role playing game. How do we accurately reflect sanity in a game that has ability stats, skill checks, combat modifiers etc. For insanity to work as a mechanic in a RPG it has to have some kind of balance. This can be a bit tricky given the entire concept of insanity is about unbalance. This might be why there are not a lot of rules regarding sanity in RPG's outside of Call of Cthulu (where it's a foregone conclusion that someone, if not everyone, is going to go insane). Considering all of this I am going to define Insanity in the following way.

Insanity is an ability score used to reflect a characters reaction to mental trauma and exposure to realities beyond their ability to comprehend. This score will give a player an idea of how sane their character is and what kind of effects loosing sanity over time will have. The sanity score will work as a means of giving a character modifiers to various actions where a persons sanity would have a potential effect on the outcome.

Why Sanity and Insanity?

I am sure some people will wonder why I am bothering with these rules in the first place. The reason I am creating sanity rules is there are times when the characters will encounter things that are simply more than their minds can grasp. When this happens the character is forced to confront a reality that their mind is not prepared for. No matter who a character is there are just some things that you shouldn't confront. When a character confronts those things there is a consequence.

While I believe that insanity is best handled by role-playing, it can be difficult for some players to do this without some idea of what they should be doing. While any system will have it's flaws, in my experience having a system to cover this particular situation is a benefit both to myself as a Game Master and to my players. By having these rules both the GM and players have a set of guidelines that they can use to mechanically reflect an important element to some stories.

If you don't feel like sanity is a necessary part of a campaign that's fine, you don't have to use these rules. However, if you have ever given thought to including concepts from things such as Lovecraftian stories, extreme horror encounters, and the like than you might like what I have come up with.

Measuring Sanity
To measure a characters sanity a player will add their Wisdom and Charisma modifiers plus 10. As with all other ability scores sanity will have a modifier based on the score as follows.

0 and below - The character is permanently insane and can no longer be played as a PC.
1:         -5
2-3:      -4
4-5:      -3
6-7:      -2
8-9:      -1
10-11: +0
12-13: +1
14-15: +2
16-17: +3
18-19: +4
20-21: +5
22-23: +6
24-25: +7

The Sanity Check
A sanity check is a roll of a d20 with the sanity score modifier added or subtracted from the result. Each sanity check will have an assigned DC. Note, some sanity checks will be automatically failed with no chance of success.

When to use Sanity Checks

A sanity check should be used anytime a PC or NPC is confronted with mental trauma or something that challenges their understanding of the base nature of their world. For example a PC trapped in a room of half eaten corpses would need to make a sanity check.

Sanity Check DCs

Sanity checks should only be done on circumstances that are 15 or higher unless the Game Master feels a need to have a character make a sanity check of a lower DC. The following list is not all inclusive.

Some examples of instances that would require a sanity check

Watching a friend be tortured: DC 15
Causing the death of a friend: DC 15
Committing cold blooded murder: DC 15
Torturing someone for information: DC 15
Malicious betrayal: DC 15 (see below)
Witnessing the harm of an innocent: DC 15
Enduring torture: DC 15

Enduring sadistic torture: DC 20
Watching a family member or loved one be tortured:  DC 20
Causing the death of a family member or loved one: DC 20
Witnessing the death of an innocent: DC 20

Contact with an alien mind: DC variable (see below)
Encounter with an alien being: DC variable (see below)
Being exposed to profane information: DC variable (see below)
Being possessed: DC variable (see below)

Being Betrayed: The GM should not require a sanity check on every betrayal a character suffers through. However, when the betrayal is both malicious and pre-meditated and the PC is left in a very bad situation, then a sanity check should be required. An example of a malicious betrayal would be an NPC gaining the trust and confidence of a PC then leading them into a deadly situation and turning on the PC. The DC of this sanity check should be based on the level of trust gained by the NPC and the situation in which the PC is betrayed.

Contact with an alien mind: This is meant to reflect mind to mind contact with an alien being. While a GM can choose to include mental contact with beings such as devils and demons, it is more intended for contact with Lovecraftian outsiders and other unimaginable horrors. The DC of the sanity check should be based on the relative power of the being being contacted. For example a character contacting a member of a servitor race is going to be a relatively low DC, but if a PC were to contact an Elder God the DC would be nearly impossible to pass.

Being exposed to profane information: The GM should not require a check for a character being exposed to run of the mill profane information such as texts written by devils. This check is meant to be for times when a PC reads or learns of something truly horrifying. An example would be attempting to read a tome containing rites which would summon a being from beyond time and distance. The difficulty of the DC should be based on the relative power of the information being read or learned.

Being Possessed: Any time a character is possessed it creates a chance for the character to loose a part of themselves and thus requires a sanity check. However, not all possessions are equal. To calculate the DC of a sanity check caused by possession start at a base of DC 15 and add a +1 modifier for every two hit dice the possessing creature has above the characters level. For example a 4th level fighter is possessed by an 8 HD ghost. The base sanity check is DC 15 with a +2 modifier because of the difference between the character level and monster's hit dice.

The Effects of Sanity Loss:

Eventually a character is going to fail a sanity check. When this happens their mind becomes a little bit fractured. While one sanity loss is not likely to affect someone very much, repeated sanity check fails will start to take a toll on even the most sane characters. There are three levels of sanity loss, temporary, long term, and permanent. Each level has different effects on the character. The determination of which level of sanity loss the character suffers is determined by the amount the sanity check was failed by.

Sanity check was failed by less than five points: A loss of 1d2 points of sanity

Sanity check was failed by more than five points but less than 10: A loss of 1d4 points of sanity and the character gains a temporary insanity effect.

Sanity check was failed by more than ten points but less than 15: A loss of 1d6 points of sanity and the character gains a long term insanity effect.

Sanity check was failed by more than 15: A loss of 1d8 sanity points and the character gains a permanent insanity effect.

temporary insanity effects:
Temporary insanity effects are short lived and overcome in a short period of time.

To determine the temporary insanity effect roll a d6 and consult the following table;

1 - The character is stunned for 1d4 rounds
2 - The character is dazed for 1d4 rounds
3 - The character is confused (as per the spell) for 1d4 rounds
4 - The character is sickened for 1d4 rounds
5 - The character is immobile for 1d4 rounds
6 - The character falls prone and is unable to get up for 1d4 rounds

long term insanity effects:

Long term insanity effects last until the character is able to succeed on a daily sanity check. A daily sanity check to recover from a long term insanity effect can not be made until twenty four hours has passed. A daily sanity check can only be attempted once in a twenty four hour period.

To determine the long term insanity effect roll a d6 and consult the following table;

1 - The character suffers from nightmares.

A character suffering from this affliction is cursed with terrifying and unusual dreams that deprive the character of sleep.

A character afflicted with this insanity effect is unable to rest well and thus unable to regain lost spells, heal from wounds naturally, and unable to regain special class abilities that give a daily allotment of uses (such as a Barbarians rage). Another effect of the lack of sleep is a cumulative -1 penalty per day to Will Saves and wisdom based skill checks(-1 day 1, -2 day 2, etc).

2 - The character suffers from acute paranoia.

A character afflicted with this insanity finds it difficult to put their trust in other people. This causes the character to question everyones motives and to respond to even the closest ally with distrust and hostility.

A character afflicted with this insanity effect is unable to trust other people. This lack of trust results in a -4 modifier to all charisma based skills. Along with the penalty to charisma based skill checks the character must pass a Will save of DC 15 in order to either eat or drink. For every twenty four hour period in which the character was not able to eat or drink they receive a cumulative -1 penalty to all die rolls (-1 day 1, -2 day 2, etc)

3 - The character becomes easily enraged.

A character suffering from this effect is easily irritated and feels their temper rise for little reason at all. A character with this insanity effect is often quick to snap at people and can fly into a mindless rage.

When a character suffering from this effect encounters a situation in which they fail at a skill check or combat roll by more than 10, they fly into a rage. When the character is enraged they are not capable of doing anything but attacking the nearest enemy. If an enemy is not present randomly determine which one of the nearby people (including other PCs) they attack. If no one is present the character will mindlessly attack inanimate objects until they are able to regain their composure.

The character will be enraged until they succeed in a will save of DC 15. During the rage the character will not be able to use weapons or cast spells. The character also suffers a -2 penalty to all combat checks and is unable to make skill checks.

4 - The character suffers from acute depression.

A Character suffering from acute depression finds little joy in life. The character feels a sense of deep and unrelenting melancholy that effects their entire life. A character suffering from this effect sees no point in preparing spells, praying to gods, or even helping their friends.

While under the effect of acute depression the character is -2 to all die rolls. Along with this penalty the character is unwilling to memorize spells or pray to a deity.  Along with being unable to prepare spells or pray a character suffering from acute depression is not able to use any ability that has a daily reset such as ki, rage, and similar abilities.

5 - The character becomes manic.

A Manic character is the exact opposite of a depressed character. Where the depressed character finds little to no joy in life, the manic character is filled with positive feelings for nearly everything. A manic character will speak faster, move faster, and respond faster than everyone else.

While the character is manic they find it nearly impossible to concentrate or sleep but has an unusual amount of stamina and energy.While under the effects of mania, the character receives 10 temporary hit points that come off the bottom and gains a +2 bonus to all saves and skill checks that are based on constitution. Conversely because of the characters inability to rest or concentrate they receive a cumulative penalty of -1 on all die rolls daily (-1 day one, -2 day two, etc.) until the manic effect ends. Along with the -1 penalty to all die rolls the character must succeed at a DC 15 concentration check in order to memorize spells or regain granted abilities.

6 - Hallucinations.

A character suffering from hallucinations sees and hears things that do not exist. The line between reality and fantasy become difficult for the character to discern which affects their ability to rationally interact with the real world.

While a character is affected by hallucinations they are unable to interact with the real world appropriately. Because the character can not tell what is real from what is a hallucination they must make a will save of DC 15 to take any action that requires a roll. The inability to see the world the way it really also incurs a -2 penalty to all intelligence based skills and a -2 penalty to all combat die rolls.

Permanent Insanity Effects:

Permanent insanity effects occur when a character suffers from a catastrophic mental trauma. This event fractures a characters personality and reality to such a high degree that any chance of recovering from the insanity is incredibly difficult requiring weeks of rest and some kind of treatment (see recovering from sanity loss below).

Before a GM uses permanent insanity effects they should consider whether or not they are right for the campaign. While permanent insanity effects can add a great deal to the role playing element of the game, they can also create an incredible challenge for some players.

Permanent Insanity effects have few mechanical penalties as using numbers to reflect such a deep mental wound is difficult. Instead when a player has a character suffering from a permanent insanity the character must succeed in a daily will save. A fail on the save indicates that the player is under the control of the GM for the next twenty four hours. For groups who do not wish to use this rule, it is suggested that the player do their best to role-play the insanity correctly.

Permanent Insanity Table

1 - Multiple Personalities
2 - Borderline Personality
3 - Addiction
4 - Paranoia
5 - Amnesia
6 - False Innocence

Multiple Personality.

In a character with multiple personalities the character's mind becomes so fractured that it invents several personalities as a means of coping with the trauma. When a character is stricken with this insanity they roll a 1d4 and create that many new characters. These characters can be of any race, class, and gender. Once the player has the characters created any future failed sanity checks results in one of the new personalities taking over. Not only does the character believe that they are someone completely different their entire body changes to match the concept of the new personality.

Bill is playing a human fighter that gains a permanent insanity effect. When this happens bill rolls 1d4 and gets the result of 2. This means Bill has to create 2 new characters. Bill then creates a female halfling thief and a male half orc sorcerer. From this point forward whenever Bill's character fails a sanity check Bill randomly determines which personality is now in charge of the character.

Borderline Personality

Borderline personality is often described as Jekyll and Hyde syndrome. When a character is afflicted with this insanity in essence they become two different people. While the character may act as two different people, they differ form those with multiple personalities in the fact that they are fully aware of the actions of the other "half".

When a character gains this sanity the player chooses an alignment on the evil moral axis. Whenever a character with borderline personality fails a sanity check they act as though they are of the new alignment. The player will stay this way until they either are able to rest or fail another sanity check.


When some people suffer a mental trauma they turn towards substances or certain behaviors as a means of dealing with things. When a person become reliant on these substances or behaviors it is known as addiction. When a character is addicted they can not function properly unless they are under the effect of their chosen addiction. When they can not use the preferred addiction a character will begin to suffer withdrawal symptoms.

When a character first gains the addiction insanity they must roll on the addiction table below. Once the addiction is chosen the character must find a source to feed that addiction by succeeding in a knowledge (local) check of DC 15 each day or begin to suffer the effects of withdrawal (see below). Once the character engages in the addictive behavior they may appear and act normal.


While a character is suffering the effects of withdrawal they receive a daily cumulative penalty of -1 to all die rolls (to a maximum of -5) It is possible for a character to resist addiction by succeeding on a will save of DC 15. For each day beyond the first the character attempts to resist the addiction (or is unable to find a source to feed the addiction) the Will save DC is modified by +1. Thus the first day would be a DC 15, the second day would be a DC 16, the third day DC 17 etc. This check can not exceed a maximum DC of 25. If the character makes this save 28 days in a row then they are clear of the addiction and no longer need to make the will save unless they suffer any sanity loss.

Addiction Table

1 - Alcohol; Alcohol is a fairly easy addiction to feed and thus only requires that the character spend money to insure they have a ready source of alcohol. For effects of intoxication see the core rule book.

2 - Illicit drugs; The character becomes addicted to some kind of illicit drugs. In order to locate a source of their drug of choice the character needs to succeed on a knowledge (local) check of DC 15. A failure indicates an inability to find the drug and withdrawal symptoms begin.

3 - Sex; The character becomes addicted to sex. The character may either find and pay a prostitute (Knowledge local DC 15) or find a cooperative partner which requires a  diplomacy check of DC 20. If the character is unable to find a sexual partner they will begin to suffer the effects of withdrawal.

4 - Violence; The character becomes addicted to the exhilaration of violence. In order to satisfy this addiction the character must engage in some form of violent activity every day. This does not have to be killing another individual but does have to involve some form of damage against another creature. If a character can not engage in violent behavior they begin to suffer from the effects of withdrawal.


A character suffering from paranoia does not trust anyone, believes some unknown person or group is out to get them, thinks their food is poisoned etc. A paranoid character will question everyone they know about their intentions. The character will take extreme steps to make sure they are protected such as block off all doors and windows into their domicile, disguise themselves as someone different and other such behaviors.

Because a paranoid character is suspicious of everyone they find it incredibly difficult to be around other people. If a paranoid character wishes to be in the presence of other people they must succeed a will save of DC 15. If the save is made they may spend up to twenty four hours in the presence of people before needing to make the will save again. If the paranoid character fails this will save and is unable to flee they must make an immediate insanity check of DC 20. A fail indicates the paranoia becomes overwhelming and the paranoid character will become incredibly hostile (see becoming enraged under long term sanity effects) and will remain so until they are either incapacitated or are able to flee.


A character stricken with amnesia can not remember anything about themselves or their history. While the character retains all class abilities they do not remember how they got them. While under the effects of amnesia the character is still able to relearn new spells and gain granted abilities. If a character with amnesia attempts a knowledge check they must first succeed on a will save of DC 15. If the save is successful the character rolls the check like normal. If the character fails they are not allowed to make the knowledge check at all.

Facade of Innocence

The horrors the character has experienced have such a profound effect on their psyche that their mind retreats into a false belief in their innocence. A character afflicted with a facade of innocence is unable to see the ugliness of the world and refuses to consider any action that might harm another individual. While on the surface the character may seem to be harmless a roiling mess of emotions lies just underneath the surface. If the character is ever confronted with violence or fails a sanity check they will be required to make a DC 15 will save. If the save is successful the character will continue on acting innocent. If the save fails the facade of innocent crumbles and the character is now a homicidal lunatic.

If an character suffering from false innocent becomes a homicidal lunatic they feel compelled to murder someone in the next twenty four hours. This murder must be a cold blooded murder of a humanoid (or goblinoid if the character is a goblinoid). Because the character suffers from unconscious guilt the character must make a will save of DC 20 or they will leave some kind of clue as to their identity. After the murder is committed the character will again resume the facade of innocence forgetting about the murder they committed. They will find such an act atrocious and may involve themselves in the investigation to find the perpetrator of such a heinous crime. If this character is confronted with evidence that they are the murderer they must make a sanity check of DC 20 with a failure carrying the normal results.

Recovering From Sanity Loss

Because of the stiff penalties incurred from sanity loss it would be unbalanced to not give PCs some method of recovering from sanity loss. While in the real world dealing with mental illness is still a puzzle we do not fully understand, putting that restriction on a fantasy role playing game is counter productive. While any fantasy world is unlikely to have a better understanding of mental illness than we do in our world, there are tools in a fantasy world that we do not have access to in the real world. These tools include things like healing magic, arcane magic, skill checks, saving throws and more. With these tools available it stands to reason that we should incorporate them in dealing with sanity loss.

Recovering from temporary insanity.

While all of the temporary insanity effects are fairly short lived, there are times when a character suffering from such an effect could be incredibly detrimental to the party. When a character is suffering from a temporary insanity effect a cure light wounds (or equivalent spell or ability such as lay on hands) can shorten the duration by one round for every hp cured.

Recovering from long term insanity

A character suffering from long term insanity is allowed a daily saving throw. However, if the character receives a cure moderate wounds spell they are allowed to make an additional  saving throw with a +1 bonus granted for every 2 points of healing they receive. If the character succeeds in the saving throw they are no longer afflicted by the long term insanity effect. If the character fails they may attempt the daily saving throw as normal or receive another cure moderate wounds spell.

Recovering from permanent insanity

Because of the nature of permanent insanity effects, the only way these can be cured by magical means is through a wish or miracle spell. If such a spell is not available then the character must have a full week of rest at which point they may make a will save of DC 20 to regain their sanity. At this point the character is not cured but is no longer under the effects of the insanity. If the character fails a sanity check in the future they will once again fall under the effects of their permanent insanity.

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