Trauma and Insanity
Trauma and Insanity
❝The most merciful thing in the world, I think, is the inability of the human mind to correlate all its contents. [...] Some day the piecing together of dissociated knowledge will open up such terrifying vistas of reality, and of our frightful position therein, that we shall either go mad from the revelation or flee from the deadly light into the peace and safety of a new dark age.❞ - H.P. Lovecraft, The Call of Cthulhu
There are, of course, many kinds of mental illness and psychological disturbances. We'll concern ourselves here solely with insanity as a result of psychological and emotional trauma. Players' interpretations of mental disturbances resulting from factors other than in-game shocks and traumas, or from events in their canons, are entirely left to individual discretion, and trauma may of course be physical as well as mental.
Psychological trauma is, however, a big part of Lovecraft's world, and hence it will be a key factor in Mysterium Tremendum. In fact, it links with the game's name itself and is a tacit part of its premise. Remember (as described on the premise page) that the mysterium tremendum is an experience of visceral and affective dread in the face of divinity's awe-fullness, for our purposes, the awe-fullness of other-worldly entities and gods--the creatures and lore of the Mythos.
Trauma
It should perhaps be no surprise that the experience of "daemonic dread" is an emotionally and mentally traumatizing one, at least potentially, and encounters with the Mythos in any form always carry a risk of psychological trauma. There are myriad other possible shocks and horrors that characters might encounter as well--not all of them will be supernatural, strictly speaking, or related to the Mythos and sometimes the supernatural element will be subtle or ambiguous.
One might see, for example, the body of a trusted colleague strung up by his own entrails--a sight gruesome and horrifying enough to traumatize many a stout heart, but a wholly human horror nonetheless. A particular set of ritual symbols drawn on the facing wall, however, could indicate a power beyond the mortal realm.... If, that is, the character who sees them fully comprehends what is before him or her, and not everyone always does.
The (potentially) traumatic event, in other words, is one thing, but the actual experience of trauma is another.
Trauma might broadly be thought of as a break in the mind's experience of time, a shocking encounter with an event that is unassimilable at the moment of its initial impact, but which will necessarily return later in sometimes veiled ways to haunt the mind which has been marked by its collision.
How the Mythos Causes Insanity
Each individual, of course, has a different degree of resilience and flexibility when it comes to emotional trauma, and some characters in the game will necessarily be more hardened and inured than others. Nonetheless, during the course of the game, characters will all be faced with knowledge and entities of dreadful and awe-inducing implications. Such encounters are what the game is named for and it would defeat the point for any character to simply be immune to such shocks all the time.
The authors of Chaosium's Call of Cthulhu rulebook make this point particularly well:[Lovecraft's fiction] suggested that what we believe to be the immutable laws of time and space are valid only locally, and are only partly true. Beyond our ken are infinities where greater realities hold sway. The real universe, Mythos authors suggest, is one of irrational events, unholy fury, endless struggle, and relentless anarchy. Human insanity opens a window onto this terrible realm. Through such an opening we can glimpse the dark and bloody truth at the heart of everything.
But that truth is, itself, inherently threatening to a human experience of wholeness or any unified experience of self. It caries with it the threat of fracture, of trauma as a rupturing or breaking apart of one's experience of the world, of linear time and space.
Three important points to keep in mind:
• Knowledge of the true universe is not just powerful, it's dangerous. Certainly it's dangerous to use, but more than that, such knowledge is dangerous to comprehend. The mind's defense mechanism is to repress, to erect psychic bulwarks that barricade against understanding. In many cases, not understanding is the thing that saves the mind; comprehension is what wounds most deeply, striking not at the body but at the very core of the self and its relationship to the world.
• Mythos magic effects the physics of the universe. This is what makes it such a threat not only to use but to witness. Encounters with the Mythos in whatever form mean encountering a rupture in the material reality of the world. Using Mythos magic means that one is the cause of that rupture. The spell caster's intent notwithstanding, such uses of magic require one's mind to twist and contort to follow wholly alien pathways, an experience which is necessarily psychically rupturing and wounding, at least to some degree.
• The more "commonplace" supernatural encounters of our world--vampires, ghosts, werewolves, for example--may be shocking and traumatic for some, but they do not imply the same perversion of the physical world as encounters with the Mythos do, and some characters will be far more used to encounters of this kind and thus far less affected by them.
Different Kinds of Insanity
In the context of the game, a character "going insane" doesn't necessarily mean that they're off rocking themselves in a corner, babbling incoherent nonsense, or that they must be committed to the local asylum. Psychological trauma can take all kinds of forms and there are many forms of mental disturbance which don't prevent an individual from taking part in their day-to-day interactions.
Depending on the degree of shock, the impact may be long or short in duration, immediately apparent or not manifest until some time later. Here are some examples for inspiration.
Momentary Insanity
• Fainting or a fit of screaming
• Fleeing in panic
• Hysterical emotional outburst
• Incoherent, rapid speech; logorhea (a torrent of coherent speech)
• Echolalia (repeating the words that other people say)
• Murderous or suicidal mania
Temporary Insanity
• Amnesia
• Severe phobia
• Hallucinations or delusions
• Fetishism (non-sexual attachment to a person or object)
• Uncontrollable tics or tremors
• Psychosomatic blindness, deafness, or paralysis
• Paranoia
• Obsessive rituals
Long-term Mental Disturbances
• On-going amnesia, depression, or obsession
• Dissociative identity disorder or intermittent explosive personality
• Anxiety disorders
• Post-traumatic stress disorder
Keep in mind that these are only a few of the possibilities. It is up to players to choose how and when the results of psychological trauma will present themselves and how obvious and disruptive they will be to the character's life.
It is possible that characters may be institutionalized, either by their own choice or, if they are deemed to be a danger to themselves or others, by order of the local court. It's also possible to overcome many mental disturbances to either a partial or full degree.
Treatment and Therapy (Historical Info)
Keep in mind that in 1928, psychology, psychiatry, and psychoanalysis were all very young disciplines and their status as reputable and professional science was still very much up for debate. Psychiatry and psychology didn’t have their contemporary implications (i.e. psychiatrists weren’t differentiated by their ability to prescribe drugs). There was no specialized training that made one a psychiatrist--any doctor could call himself by the title if he wished, whether or not he had ever received training to do with the brain or the psyche per se.
The primary explanations of mental disorders were somatic--in other words, they were seen as located in the body, not in the mind. This meant that many psychiatrists attempted to treat mental disturbances by doing surgery elsewhere on the body. (Sex organs were a common target, with more than a few doctors claiming excision of the clitoris as a cure for hysteria or hysterical paralysis.) Many "treatments" of the period will sound positively barbaric to contemporary ears.
The prevailing opinion of the time was that the "lower classes" were congenitally predisposed (i.e. "born that way") to lunacy and degeneracy anyway, so attempting to treat them was seen as largely a waste of energy, whereas members of the more affluent classes had simply been corrupted by their environment and could thus be cured by the right kind of medical intervention. (In this pre-WWII moment, the notions of eugenics and social hygiene had yet to take on their sinister cast, and a focus on atavism was still quite common from both doctors and social reformers.)
Keep in mind that there were no antidepressants or mood-stabilizers available in 1928. But neither was there ECT ("electroshock") therapy nor frontal lobotomies. (There were, however, other forms of shock therapy, such as purposefully-induced insulin shock, as well as trepanning, which involved perforating a person’s skull.) Barbiturates were the most common type of sedative, and were commonly prescribed for anxiety and insomnia, often with a high risk of death.
Hypnosis and psychoanalysis (i.e. "the talking cure") were both available, hypnosis having been particularly prevalent since the 1890s. Hydrotherapy was also especially common as were “rest cures” and drug-induced “sleep therapy” during which a patient might be kept asleep for weeks on end. The use of straight jackets, bed straps, and other restraints was totally routine.
Arkham Sanitarium
Arkham does have a local asylum. With fifty beds, it is the largest anywhere between Boston and Newburyport. It is headed by Dr Eric Hardstrom, a diligent and well-intentioned man, but not a great innovator or creative thinker. There are also two other doctors who work out of the facility as well as twelve orderlies and four nurses. Some patients at Arkham Sanitarium are there of their own volition while others have been committed by judge's orders. Many of the latter group are paupers. For those people the sanitarium is likely to be a permanent home--they do not receive any treatment geared towards curing them. That is reserved for paying patients.
There are also a number of psychologists in practice around the town, so patients need not go to the sanitarium for treatment unless they need 24-hour supervision.
If players want to send their characters to the asylum or want them to see an NPC psychiatrist, please get in touch with the mods.
❝The most merciful thing in the world, I think, is the inability of the human mind to correlate all its contents. [...] Some day the piecing together of dissociated knowledge will open up such terrifying vistas of reality, and of our frightful position therein, that we shall either go mad from the revelation or flee from the deadly light into the peace and safety of a new dark age.❞ - H.P. Lovecraft, The Call of Cthulhu
There are, of course, many kinds of mental illness and psychological disturbances. We'll concern ourselves here solely with insanity as a result of psychological and emotional trauma. Players' interpretations of mental disturbances resulting from factors other than in-game shocks and traumas, or from events in their canons, are entirely left to individual discretion, and trauma may of course be physical as well as mental.
Psychological trauma is, however, a big part of Lovecraft's world, and hence it will be a key factor in Mysterium Tremendum. In fact, it links with the game's name itself and is a tacit part of its premise. Remember (as described on the premise page) that the mysterium tremendum is an experience of visceral and affective dread in the face of divinity's awe-fullness, for our purposes, the awe-fullness of other-worldly entities and gods--the creatures and lore of the Mythos.
Trauma
It should perhaps be no surprise that the experience of "daemonic dread" is an emotionally and mentally traumatizing one, at least potentially, and encounters with the Mythos in any form always carry a risk of psychological trauma. There are myriad other possible shocks and horrors that characters might encounter as well--not all of them will be supernatural, strictly speaking, or related to the Mythos and sometimes the supernatural element will be subtle or ambiguous.
One might see, for example, the body of a trusted colleague strung up by his own entrails--a sight gruesome and horrifying enough to traumatize many a stout heart, but a wholly human horror nonetheless. A particular set of ritual symbols drawn on the facing wall, however, could indicate a power beyond the mortal realm.... If, that is, the character who sees them fully comprehends what is before him or her, and not everyone always does.
The (potentially) traumatic event, in other words, is one thing, but the actual experience of trauma is another.
Trauma might broadly be thought of as a break in the mind's experience of time, a shocking encounter with an event that is unassimilable at the moment of its initial impact, but which will necessarily return later in sometimes veiled ways to haunt the mind which has been marked by its collision.
How the Mythos Causes Insanity
Each individual, of course, has a different degree of resilience and flexibility when it comes to emotional trauma, and some characters in the game will necessarily be more hardened and inured than others. Nonetheless, during the course of the game, characters will all be faced with knowledge and entities of dreadful and awe-inducing implications. Such encounters are what the game is named for and it would defeat the point for any character to simply be immune to such shocks all the time.
The authors of Chaosium's Call of Cthulhu rulebook make this point particularly well:[Lovecraft's fiction] suggested that what we believe to be the immutable laws of time and space are valid only locally, and are only partly true. Beyond our ken are infinities where greater realities hold sway. The real universe, Mythos authors suggest, is one of irrational events, unholy fury, endless struggle, and relentless anarchy. Human insanity opens a window onto this terrible realm. Through such an opening we can glimpse the dark and bloody truth at the heart of everything.
But that truth is, itself, inherently threatening to a human experience of wholeness or any unified experience of self. It caries with it the threat of fracture, of trauma as a rupturing or breaking apart of one's experience of the world, of linear time and space.
Three important points to keep in mind:
• Knowledge of the true universe is not just powerful, it's dangerous. Certainly it's dangerous to use, but more than that, such knowledge is dangerous to comprehend. The mind's defense mechanism is to repress, to erect psychic bulwarks that barricade against understanding. In many cases, not understanding is the thing that saves the mind; comprehension is what wounds most deeply, striking not at the body but at the very core of the self and its relationship to the world.
• Mythos magic effects the physics of the universe. This is what makes it such a threat not only to use but to witness. Encounters with the Mythos in whatever form mean encountering a rupture in the material reality of the world. Using Mythos magic means that one is the cause of that rupture. The spell caster's intent notwithstanding, such uses of magic require one's mind to twist and contort to follow wholly alien pathways, an experience which is necessarily psychically rupturing and wounding, at least to some degree.
• The more "commonplace" supernatural encounters of our world--vampires, ghosts, werewolves, for example--may be shocking and traumatic for some, but they do not imply the same perversion of the physical world as encounters with the Mythos do, and some characters will be far more used to encounters of this kind and thus far less affected by them.
Different Kinds of Insanity
In the context of the game, a character "going insane" doesn't necessarily mean that they're off rocking themselves in a corner, babbling incoherent nonsense, or that they must be committed to the local asylum. Psychological trauma can take all kinds of forms and there are many forms of mental disturbance which don't prevent an individual from taking part in their day-to-day interactions.
Depending on the degree of shock, the impact may be long or short in duration, immediately apparent or not manifest until some time later. Here are some examples for inspiration.
Momentary Insanity
• Fainting or a fit of screaming
• Fleeing in panic
• Hysterical emotional outburst
• Incoherent, rapid speech; logorhea (a torrent of coherent speech)
• Echolalia (repeating the words that other people say)
• Murderous or suicidal mania
Temporary Insanity
• Amnesia
• Severe phobia
• Hallucinations or delusions
• Fetishism (non-sexual attachment to a person or object)
• Uncontrollable tics or tremors
• Psychosomatic blindness, deafness, or paralysis
• Paranoia
• Obsessive rituals
Long-term Mental Disturbances
• On-going amnesia, depression, or obsession
• Dissociative identity disorder or intermittent explosive personality
• Anxiety disorders
• Post-traumatic stress disorder
Keep in mind that these are only a few of the possibilities. It is up to players to choose how and when the results of psychological trauma will present themselves and how obvious and disruptive they will be to the character's life.
It is possible that characters may be institutionalized, either by their own choice or, if they are deemed to be a danger to themselves or others, by order of the local court. It's also possible to overcome many mental disturbances to either a partial or full degree.
Treatment and Therapy (Historical Info)
Keep in mind that in 1928, psychology, psychiatry, and psychoanalysis were all very young disciplines and their status as reputable and professional science was still very much up for debate. Psychiatry and psychology didn’t have their contemporary implications (i.e. psychiatrists weren’t differentiated by their ability to prescribe drugs). There was no specialized training that made one a psychiatrist--any doctor could call himself by the title if he wished, whether or not he had ever received training to do with the brain or the psyche per se.
The primary explanations of mental disorders were somatic--in other words, they were seen as located in the body, not in the mind. This meant that many psychiatrists attempted to treat mental disturbances by doing surgery elsewhere on the body. (Sex organs were a common target, with more than a few doctors claiming excision of the clitoris as a cure for hysteria or hysterical paralysis.) Many "treatments" of the period will sound positively barbaric to contemporary ears.
The prevailing opinion of the time was that the "lower classes" were congenitally predisposed (i.e. "born that way") to lunacy and degeneracy anyway, so attempting to treat them was seen as largely a waste of energy, whereas members of the more affluent classes had simply been corrupted by their environment and could thus be cured by the right kind of medical intervention. (In this pre-WWII moment, the notions of eugenics and social hygiene had yet to take on their sinister cast, and a focus on atavism was still quite common from both doctors and social reformers.)
Keep in mind that there were no antidepressants or mood-stabilizers available in 1928. But neither was there ECT ("electroshock") therapy nor frontal lobotomies. (There were, however, other forms of shock therapy, such as purposefully-induced insulin shock, as well as trepanning, which involved perforating a person’s skull.) Barbiturates were the most common type of sedative, and were commonly prescribed for anxiety and insomnia, often with a high risk of death.
Hypnosis and psychoanalysis (i.e. "the talking cure") were both available, hypnosis having been particularly prevalent since the 1890s. Hydrotherapy was also especially common as were “rest cures” and drug-induced “sleep therapy” during which a patient might be kept asleep for weeks on end. The use of straight jackets, bed straps, and other restraints was totally routine.
Arkham Sanitarium
Arkham does have a local asylum. With fifty beds, it is the largest anywhere between Boston and Newburyport. It is headed by Dr Eric Hardstrom, a diligent and well-intentioned man, but not a great innovator or creative thinker. There are also two other doctors who work out of the facility as well as twelve orderlies and four nurses. Some patients at Arkham Sanitarium are there of their own volition while others have been committed by judge's orders. Many of the latter group are paupers. For those people the sanitarium is likely to be a permanent home--they do not receive any treatment geared towards curing them. That is reserved for paying patients.
There are also a number of psychologists in practice around the town, so patients need not go to the sanitarium for treatment unless they need 24-hour supervision.
If players want to send their characters to the asylum or want them to see an NPC psychiatrist, please get in touch with the mods.