#3: Playing with Madness, Part One

[RPGnet Columns]

http://www.rpg.net/columns/medical/medical3.phtml

Summary:

Realistic schizophrenia and OCD in RPGs.

Go to the column (http://www.rpg.net/columns/medical/medical3.phtml) for more information.

[Asklepios]

Yay it's up! This is actually the first column in the series that I don't wince on re-reading. Every time I look at the first two articles the writing style makes me cringe and the disjointed sentences make me cry, but I think I'm starting to get the hang of it. :)

I would still appreciate feedbacks from all you writer-types out there, of course.

Shannon: Column 6 is on the way to you soon, I promise. I didn't get much writing done in my week off work, but they should start turning up more frequently again now I'm back.

[Hobbes VII]

I really enjoy this column. It gives me a lot of good information, both on the player and the GM sides. It helps me look at the medical side of games in a new way and my in-game descriptions have benefited. Keep up the good work!

[Asklepios]

Thanks for your kind words, and thanks for reading!

Helping GMs and Players to rp in new and different ways is my only goal, and I'm glad you've managed to use some of this stuff...

[algi]

Hi!

This is my first post here at rpg.net. I like this column very much and it was a very long wait for me till the second article appeared in Medical Musings.

About the part that the schysophrenia is only as much a gift as cancer: I think that those rpgs that handle such mental illnesses as gifts DO handle cancer as a gift. I'm thinking right now specifically about Kult, that is the most horroristic game I ever read in every aspect. (Or if you don't agrre, let's say: what I understand under Kult is the most horroristic game I could imagine.) And when an rpg "advertises" a mental illness or cancer for that matter, I think it is meant as a negative advertisement.

[Shimeran]

I agree that mental illness isn't much of a "gift". However, it does occur to me that psychically sensitive characters could easily be diagnosed with schizophrenia, particularly in a setting where the supernatural is well hidden. In fact, if the supernatural is present but not widely believed in, anyone who can sense it would probably be considered hallucinating and delusional. That might be part of where the cross-over comes from.

[Hobbes VII]

So, you're saying that insight is mistaken as madness instead of coming through madness? I would also say that having insight and never being believed could cause madness. How long could you hear people say you are crazy without starting to believe it? How long could you try to tell people a truth they do not want to hear before the strain starts to cause cracks?

[Asklepios]

I think that people with mystical insight being mistaken as mentally ill, or people being driven mad by their mystical insights is ok. What I dislike is the perception of mental illness as blessing in itself, which exists in just a couple of games.

Ultimately though even this is ok if handled maturely and responsibly. What <i>really</i> irks me is when mental illness is played for laughs.

[Karro]

Yay it's up! This is actually the first column in the series that I don't wince on re-reading. Every time I look at the first two articles the writing style makes me cringe and the disjointed sentences make me cry, but I think I'm starting to get the hang of it. :)

I would still appreciate feedbacks from all you writer-types out there, of course.


This is the first one that didn't make me wince the first time reading through--but not necessarily due to bad writing (I didn't read them for the quality of writing). Actually, I couldn't even finish the other two primarily because of a very high squick factor that I just can't explain adequately. I guess it's because, lacking a point of reference, I started imagining all those lacerations, cuts, and injuries on my own body, and it just made me feel ill... (Easier just not to read it, and continue using terminology and descriptions in games that dissassociates myself from bodily injuries, real or imagined ;))

OTOH, I feel your pain with regards to how mental illness is portrayed in games. I GMed a situation, once, in a world where killing a certain type of monster can inflict a temporary madness. Not having a whole lot of knowledge or experience, I didn't provide my players with much more information than that. I knew how I thought it should look but not how to describe it to the players. Nevertheless, I was still surprised when the players who had been thus afflicted began to behave in an erratic and random fashion. Not that I had forgotten that they were being mentally afflicted, but as there was no "method to the madness", I was totally confused as to what they were portraying or why they were acting the way they were.

What I gain from this article is the insight that such psychoses really produce very structured and predictable behavior--e.i. that it's not random at all--but that this behavior is out of synch with what would generally be considered normal, so that the lay-person perceives erratic, random, and irrational behavior, where in fact the behavior is indee irrational but not truly erratic. It looks like such a mental disorder needs a focus to be portrayed properly: whether it is a specific delusion that fuels hallucinations or anxieties, or a specific and distinct set of obssessive behaviors. Random and erratic behavior makes for light fare, but is silly for a serious take on mental illnesses.

At least I know now how better to discuss these issues with future players.

[Asklepios]

That's a good point. I'd never really thought of it in that way, but now you mention it most of what I've labelled as "bad depictions" of mental illness have actually been players just acting completely randomly. I'd never thought of mental illness as "structured" but I guess it really is.

Of course even with common threads of behaviour and thought between several patients with the same diagnosis, everybody is an individual and shaped by individual experiences. While a modern day soldier getting auditory hallucinations might think he can hear George Bush talking to him through the radio receivers in his teeth, a fantasy knight might think that it is Lord Arioch muttering in his head. Of course, he might be right. :)

Glad this has been useful to you.

[Karro]

That's a good point. I'd never really thought of it in that way, but now you mention it most of what I've labelled as "bad depictions" of mental illness have actually been players just acting completely randomly. I'd never thought of mental illness as "structured" but I guess it really is.

Of course even with common threads of behaviour and thought between several patients with the same diagnosis, everybody is an individual and shaped by individual experiences. While a modern day soldier getting auditory hallucinations might think he can hear George Bush talking to him through the radio receivers in his teeth, a fantasy knight might think that it is Lord Arioch muttering in his head. Of course, he might be right. :)

Glad this has been useful to you.

Well, looking at it a certain way, the basis of being able to make a diagnosis of a mental disorder is that there are consistent and recognizable symptoms. If something acts in a consistent and recognizable pattern, that's pretty structured. I just hadn't thought of it this way in game-terms until reading this column, where certain patterns of abnormal behavior were laid out. Thanks!

[dogstar]

The schizophrenic is ordered in many ways, they just don't makes sense to us, what they are experiencing is very real. However its worth remembering that the schizophrenic will occassionally make statements that make a lot of sense, maybe more so, because their thought process and approch is very different than our own.

Theres quite a lot of work been done into how the patient expresses themselves and patterns of logic exist (even in herbphenic). In many ways there is a tendency to lose sight of that beneath the symptoms is normal human being and just see the medical condition. In many ways its better to look at schizophrenia being an illness that occurs in perception, rather than the whole being. Their very experience is altered but what is being experienced isn't.

Also schizophrenia is a collection of at least two of the four main symptoms. And there are four different forms of schizophrenia, of which the detail version is the most common (the others being catatonic, paranoid and herbephrenic) - with two types of paranoid schizophrenia existing - one is false persoanlity, and the other i s full on paranoid schizophrenia - which lacks hallucination syptoms).

Antipsycotic Medications (major Tranquilisers) can have some rather severe side effects, and like all mental health medication have a various levels of success dependent on the patient, rather than the medication. Particually in the early stages

For an interesting take on Schizophrenia R D Lang and the Anti-Psychaitry movement (Existential-Humanist Psychology) approch not the illness but rather individual patients experience. Also there is a long history of a connection between artistic talents and schizophrenia.

There is also an rare varient of schizophrenia known as Benign Schizophrenia in which the experience is positive rather than negative. Occurances among the population are staggeringly rare (largely of course because the experience, being positive, lends itself not to being diagnosis

[LUGTrekGM]

Pretty good descriptions, here.

Though cutting is also a way to feel pain, to prove the world is real, not a waking dream.

It's more complex than that, of course.