I am working on a Grimdark version of the old World of Greyhawk setting, and have been doing lots of reading for background and thematic material. I definitely want to include a Horror element, by adding some fun stuff from the Cthulhu Mythos of HP Lovecraft and Robert E Howard.

Horrific Elder Gods, Nameless Cults, unspeakable rituals, foul summonings.

All of these are part and parcel of the Old School Fantasy literature. I’ve been thinking about how to incorporate a mechanic to cover this. I played a Call of Cthulhu game this month at a Con, and the Sanity rules didn’t really grab me. In particular, during the climactic battle at the end of the scenario, my character suffered a rather large loss of Sanity all at once, for viewing a horrific creature. The GM rolled some dice and simply stated that I had lost 11 points of Sanity, and that I was now catatonic and curled up in the fetal position.

This seemed like a little much, as the point loss was just shy of 25% oo my starting Sanity score, and there was no save. I guess it just felt abrupt.

I’ve been doing a lot of research on various OSR rulesets, which often describe the effects of madness or insanity, but don’t really have a way of showing how one gets there.

So here is a first-pass at a rule for Sanity and Madness in the OSR. My #Gamowrimo contribution for 2019.

A Possible Sanity Mechanic

Sanity should be a reflection of maturity, mental and emotional stability, strength of character and force of personality. Therefore I think (WIS +CHA)/2 would be a good starting point for a Sanity Score. As a PC progresses in level there should be a way to increase this score, similar to Hit Points, say +1d4 or 1d6 per level.

Events that affect one’s sanity in a negative way might include:

  • Critical wounds (effect of Shock) -1 Sanity
  • Spell failure -2 Sanity
  • Summoning/Encountering a creature from another dimension -2 Sanity
  • Encounter with a creature that causes Fear or Terror -3 or -4 Sanity
  • Other events or encounters determined by the DM (death of a loved one or other trauma, etc.) -x

A PC can attempt to “pull himself together” from a Sanity-loss event after a short rest and a CHA check at -4. Otherwise Sanity points are regained at the rate of 1 point per long rest.

If, during the course of an adventure, a PC loses Sanity points that take them down to 1/2 of their ORIGINAL Sanity score, there is a 50% chance the loss of 1 point of Sanity will be permanent. A Restoration spell can restore all lost Sanity points, except for any permanently lost.

Effects of Insanity

Sanity loss should have an effect on a PC, beginning with a mild psychological effect, becoming greater with continued Sanity point losses, until eventually the PC succumbs to Catatonia and perhaps, permanent madness. I submit two thresholds for Saving Throw checks, once at 1/3 current maximum and another when the Sanity score reaches 2.

When a PC’s Sanity Score is reduced to 1/3 of its current maximum they will need to make a Save vs Death or become afflicted with a mild effect, as per the AD&D DMG, p. 83. Roll 1d6:

  • 1 – Dipsomania
  • 2 – Kleptomania
  • 3 – Pathological Liar
  • 4 – Monomania
  • 5 – Schizoid
  • 6 – Dementia Praecox

The PC will need to continue to make Save vs Death for each additional Sanity point lost after reaching this threshold, until an effect takes hold, or they reach the final threshold.

At a Sanity score of 2 the PC will need to make a Save vs Death or succumb to Suicidal Mania (AD&D DMG p. 84)

If a PC’s Sanity score reaches 1 or 0 there will be another Save vs Death or be struck with Catatonia. There is an 80% chance that there will be a permanent loss of 2 Sanity points. A successful Save vs Death means the permanent loss of 1 Sanity point.

If a PC manages to be reduced to 0 Sanity points, yet makes all saves to avoid a psychotic event, the PC will automatically experience a full-blown case of Paranoia (AD&D DMG p. 84). This Paranoia will persist until the PC’s Sanity score is restored to its maximum, and ANY loss of Sanity during this recovery process will trigger a Save vs Death or provoke a state of Catatonia until full recovery is made.

Please share your thoughts in the Comments. Criticism, ideas, suggestions are most welcome.

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