Sanity and Madness


Madness can now be cured by Heal or Greater Restoration. Lost Sanity Points can also be restored in this way. Restoration reduces the current DC of one insanity currently affecting a target by an amount equal to the caster’s level.

Chapter I: Sanity and You

Each PC possesses a number of Sanity points equal to their character level, adjusted by their Wisdom modifier. Each time the PCs witness a mind-shattering horror (as described in certain encounters), they must each make a Will save, ranging from DC 15 to DC 25 dependent upon the circumstance of what may lead to loss of the sanity points. A failed save results in the loss of a variable number of Sanity points.

Once a PC’s Sanity point total is reduced to 2/3 and 1/3, the PC’s develop personality disorders as a result of the loss of sanity points. These are outlined further in the tables below. Once a PC’s Sanity point total reaches 0, that individual is afflicted by one of the forms of insanity found on page 250 of the Pathfinder RPG GameMastery Guide. There are certain extreme events which can also cause these afflictions to occur. Such insanity can only be cured with limited wish, miracle, or wish, or by certain story elements the DM introduces should the PC choose to participate, which also restores a PC’s Sanity points to full.

Chapter II: Personality

I have found little that is good about human beings on the whole. In my experience most of them are trash. –Sigmund Freud.

When a character’s Sanity point total is reduced to 1/3, they develop a Madness-induced personality disorders, which augments the PC’s behavior as well as imparting certain bonuses to some skills while penalizing others. The DM randomly determines these personality disorders types using the following table:

D20 Personality Disorder Skill Adjustment
  • 1-2 Antisocial – +2 Intimidate, +2 Bluff, -2 Profession (all), -2 Craft (all)
  • 3-4 Avoidant – +2 Stealth, +2 Appraise, -2 Perform (all), -2 Diplomacy
  • 5-6 Borderline – +2 Perform (all), +2 Sense Motive, -2 Concentration checks, -2 Diplomacy
  • 7-8 Dependent – +2 Handle Animal, +2 Sense Motive, -2 Intimidate, -2 Profession (all)
  • 9-10 Histrionic – +2 Perform (all), +2 Diplomacy, -2 Intimidate, -2 Bluff
  • 11-12 Narcissistic – +2 Knowledge (any one), +2 CMB, -2 Sense Motive, -2 Diplomacy
  • 13-14 Obsessive Compulsive – +2 Perception, +2 Craft (all), -2 Concentration checks, -2 Diplomacy
  • 15-16 Paranoid – +2 Perception, +2 Bluff, -2 Sense Motive, -2 Diplomacy
  • 17-18 Schizoid – +2 Concentration checks, +2 Knowledge (any),-2 Sense Motive, -2 Perform (all)
  • 19-20 Schizotypal – +2 Perception, +2 Knowledge (any one) , -2 Spellcraft, -2 Sense Motive

At 2/3 of your Sanity Point total, your character has a mild version of the Personality disorder chosen, and the skill bonuses/penalties are +/-2. When it’s been reduced to 1/3 of the total, the disorder becomes the moderate version, and the bonuses/penalties change to +4/-4. If your Sanity is reduced to 0, your character develops the severe version of the disorder and the bonuses/penalties change to +6/-6, and your character develops a Madness as described in the Gamemastery Guide.


The following section provides descriptions of behaviors, viewpoints and concerns of various personality types. Any character could have several of these traits simultaneously.


Antisocial people tend to be contemptuous and cynical and they gain enjoyment from being disruptive, disrespectful and manipulative. The antisocial personality is by far the most dangerous of all types. The most severe of these people are amoral, uncaring, manipulative, remorseless and often – evil. They have no regard for the emotions of others and do not experience guilt. Their view of life is often jaded and cynical. Antisocial people have a low tolerance for frustration and are likely to be confrontational, insulting, and violent.

When dealing with someone they deem useful, antisocial people can be superficially charming, conning, and deceitful. When dealing with people who are of no use to them, antisocial people are mean, cold, and abusive. They tend to be impulsive, irresponsible, egotistical, predatory and often lead parasitic lifestyles. Many of them lie pathologically and exhibit a sense of grandiose self worth by drawing attention to normal things about themselves. Being prone to boredom and lacking morals, they usually pass the time by doing destructive things. They see petty theft, vandalism and other more serious crimes against society as a good way to pass the time.

Mild: Mildly antisocial people are cynical, sarcastic and remarkably cold. They often think along more severe lines but usually don’t act on their impulses. They are highly independent and make better leaders then followers. They frequently meet people that they “just don’t like” and treat these offending people with a stiff dose of cold-shouldered sarcasm and condescending remarks. Many of these mild types find a way to channel their antisocial impulses into socially acceptable avenues. When bored, mildly antisocial people may engage in a little vandalism and bullying.

Moderate: Moderately antisocial people find great difficulty in channeling their innate impulses. They have no permanent place in a normally functioning society and will likely associate with others on the social fringe. They lead tumultuous lives, usually running from the past. Most of their relationships end with hard feelings and conflict. They have few long-term friends since they manipulate or abuse nearly everyone they know. These people fight boredom by striking out maliciously at society. They will resort to violence quickly and are rarely able to control their anger. It is very difficult for these people to hold a job or adhere to a commitment. Bounty hunters, vigilantes, mercenaries, gladiators and criminals are all likely professions for the moderately antisocial.

Severe: Severely antisocial individuals are a danger to themselves and everyone around them. Lives of crime and warfare are the only thing these people know. When manipulating others they can be diabolical, but when dealing with useless people the severely antisocial person will become predatory, heartless and cruel, even taking pleasure from the pain they inflict. These people actively seek personal gain at the expense of others. They consciously spread pain and suffering and take a morbid pleasure in their work.

Role-playing: The interplay of grandiosity and lack of remorse makes antisocial people very vindictive and vengeful. An antisocial person might say “I’ll show them they can’t do that to me!” Many rogues are antisocial since they have no moral inhibitions about crime. Fighters also count a large number of the antisocial among their ranks. Wizards who are antisocial will often be invokers, summoners or necromancers. Antisocial clerics usually worship gods of chaos, war and destruction. The severely antisocial paladin is probably the only personality/class/alignment combination that is not likely to occur, unless it happens as part of that paladin’s conversion to evil or some sort of insanity. All of this is not to say that a severely antisocial person can’t be a librarian. Only that when such a thing happens, the DM should make a few assumptions, such as:

1. The antisocial librarian hasn’t had the job long, and wont keep it for long. 2. He probably got the job so he could steal books or commit some other crime. 3. Unless the characters are clearly of use to him, he will be curt and rude, maybe even blocking them from use of the facilities because he just doesn’t like them (or because they seek books he has already stolen).

Sample Anitsocial Changes

1. Flaunts Norms: The character is excessively proud of the typical things about himself and frequently draws attention to them. He might brag about the one spell he can cast or frequently talk about the single orc he defeated.

2. No Plans: The character fails to plan for the future and has no direction in life.

3. Reckless: The character thinks little about consequences and acts in a rash manner.

4. Irresponsible: The character cannot be depended upon.

5. Remorseless: Characters with this trait feel no guilt for their harmful behavior.

6. Inconstant: The character’s life is in constant disarray and always changing.

7. Aggressive: The character has intimidating mannerisms and often uses violence to solve problems.

8. Conning: Characters with this trait prefer tactics of trickery and deceit to physical attacks. It makes them feel smart.

9. Debt Default: The character’s money always seems to go for things other then bills.

10. Work Inconsistency: The character has an inability to hold a job for more than a few weeks.

AVOIDANT The avoidant person is uncomfortable in social situations. The company of others makes them feel uneasy, nervous and overly self-conscious. As a result, they seek to avoid contact with others. They generally have a low self-esteem and are easily hurt by criticism. Avoidant people tend to be socially inhibited and shy. They also have a great fear of showing anxiety in public, essentially being afraid of being afraid in public. They worry a lot about what others think of them. Unlike the schizoid who disregards socializing, the avoidant person longs for contact and wishes for better social skills. Usually the avoidant person has a close group of friends who do not cause the intense anxiety that strangers cause. It is not uncommon for avoidant people to become dependent (q.v.) on these close friends.

Mild: Those who are only slightly avoidant are a bit shy and a little more sensitive to criticism than other people. They can relate to others and successfully engage in conversation but they do not like it. They will not be the life of the party or a barrel of laughs. The mildly avoidant person may occasionally seem uneasy, nervous, or show a cold sweat. They might mumble a bit and stutter when speaking before a group or when meeting new people. They will also divert their gaze away from other people who try to look them in the eye. In smaller groups these difficulties are not apparent.

Moderate: The moderately avoidant characters have significant difficulty dealing with other people. They rarely socialize with anyone other then their close group of friends and family, whom they feel comfortable with. They will only seek contact with strangers if they have a strong motivation or a lot coaxing from their trusted acquaintances. These people frequently have noticeable difficulty dealing with strangers and large social gatherings.

Severe: A severely avoidant person always has a great deal of difficulty dealing with others. They are constantly fearful and nervous in the presence of all but one or two people in the whole world. Some severely avoidant characters may not have any friends at all and will likely flee from any prospective contact with another person.

Role-playing: A lone hermit in the distant mountains might be avoidant (or schizoid), but most avoidant people live in villages, towns and cities. As a result, they lead lives that minimize contact with others. Night watchmen, sheepherders, and the like are the preferred professions of typical avoidant people.

Encountering other people is always difficult for the avoidant person, causing stress. And it is usually apparent to others that something is wrong, but they rarely know what. This can often lead to misunderstandings and confusion.

1. No Close Friends: The character has acquaintances and accomplices but no one who he truly confides in and trusts.

2. Hypersensitive to Criticism: Criticism strikes directly at the character’s low self-esteem. The character’s feelings are severely hurt by the slightest criticism.

3. Avoids People Out of Fear: Fear of social situations, embarrassment and criticism causes the character to avoid contact with other people.

4. Reticence: The character is disinclined to speak up, tending to be quite and subdued in social situations.

5. Overly Self-conscious: The character is very selfconscious and worries about his appearance and words.

6. Exaggerates Difficulties: The character makes excuses by claiming that certain difficulties are insurmountable.


Borderline people are at the mercy of emotions that rage out of control. They are highly unpredictable and random, suffering from drastic mood swings. This altering mood state can take them quickly from adoring to contemptuous, frolicking to fighting. Sometimes feeling emotionally empty inside, they occasionally suffer from depression. When in this depressed mood state they might become careless and self-destructive. Usually this means deliberately putting themselves in harm’s way or inflicting small wounds on themselves. They often seem fickle, moody, reckless, unpredictable, unreasonable, and volatile. The borderline’s point of view is one of randomness and change. The world looks hopelessly chaotic to them and they react accordingly, leading lives of stormy relationships and physical outbursts.

Mild: Mildly borderline individuals are spontaneous, a bit reckless, creative, and often think in nonlinear patterns. They are moody but functional. They are often quite empathetic; being skilled at feeling other’s emotional pain. When depression strikes the mildly borderline character they become reclusive, gloomy and careless about their personal well being.

Moderate: Moderately borderline characters have few long-term friends (since their behavior makes people want to avoid them), and suffer significant bouts of depression. During these times they may inflict damage upon themselves (usually no more than a few points). They are often alone for a long period of time when they are depressed and will not readily talk about their problems. When in a state of depression they do not practice their trade or class.

Severe: Severely Borderline people are the picture of madness. They never have a stable moment in their lives. They experience a constant shifting of mood that is very dramatic and disturbing to everyone around them. The severely borderline experience is akin to being helplessly adrift on a stormy sea of emotions. A severely borderline character might play the charming host at first and then suddenly fly into a murderous rage, only to be sorrowfully repentant for his deeds moments later.

Role-playing: The primary interpersonal effect these people have is to make others uneasy with their unpredictable mood swings and erratic behavior. Their self mutilation and bouts of gloomy depression are difficult for others to understand. Chaotic people are most likely to be borderline. Lawfully aligned borderline characters often suffer from feeling of guilt and self-loathing for their erratic and unpredictable mood swings. Borderline wizards are perhaps the most dangerous characters. Paladins and monks with this personality are typically guilt ridden and struggle to control their emotions.

1. Impulsive: The character acts without thinking about consequences or options.

2. Mood Liability: The character suffers from rapidly altering emotions.

3. Irascible: The character is prone to angry outbursts.

4. Self-damaging Acts: The character deliberately engages in behavior that is likely to cause physical, emotional, or financial pain to himself.

5. Stormy Relations: The character’s relationships are always fraught with conflict.

6. Identity Disturbance: The character occasionally speaks and behaves like someone else, adopting their mannerisms.

7. Boredom: Occasional listlessness strikes the character, causing him to sit aimlessly and dawdle.

8. Frantic Fear of Lost Relationships: The character has a great fear of loosing his close friendships.


Some people have a psychological need for someone else to make their decisions, support them, and give them direction in life. These people are dependent. They are overly concerned with losing the emotional support of the people around them and feel a strong need for friendships and associations. Most dependent people fear abandonment, which makes them overcompensate with excessive agreeableness. They are typically submissive, timid, and passive when dealing those whom they depend on, since they fear losing these people. This dependency is usually not focused on something tangible like money or safety. Rather it is usually friendship, companionship, and closeness that concern dependent characters. They find it difficult to deny friends favors and put a great emphasis on the bonds between people. Dependent people are very loyal to their friends and quite focused on the quality of the relationship. They usually become extremely upset when the bonds of friendship are compromised or endangered. Dependent people are severely stressed by betrayal from their friends, expecting their companions to adhere to the same principals they do.

Mild: These people are perhaps a little too agreeable for their own good, but it rarely causes serious problems in their lives. They are typically helpful, compromising, and emotionally supportive. They are also somewhat overly attached to their friends, jealous, and slightly manipulative. They prefer help and advice from others but do not need it to get along in life.

Moderate: Moderately dependent people often lead troubled lives. Their strong desire to please others often causes them to compromise their values and principals. Eventually, they find themselves doing things they wish they wouldn’t but they are unable to stop themselves out of fear of losing their friends. These people also have difficulty making decisions and prefer to depend on others to do it for them.

Severe: Severely dependent people cling pathetically to others and are unable to do much without the support of friends. When they are among friends, they are often elated. When they are alone, severely dependent people become greatly depressed. These people are poor leaders but great followers. They have an inability to take care of themselves and require a support network that does nearly everything for them. Without this network of support, the severely dependent person will become depressed and potentially helpless.

Role-playing: Dependent individuals are often the followers and yes-men of other characters. A dependent character will endure great hardships for his friends. The dependent character’s constant need for support and approval from others often causes the character to make decisions he otherwise wouldn’t. A dependent paladin might look the other way when his roguish friend commits theft. Of course, this will cause other problems for the paladin if he hopes to continue his profession. Depending on how strong the severity is, the dependent character may need a support network just to get through the day. Dependent wizards might be very controlling, relying on enchantment spells to build and maintain their support network. Dependent fighters are often wracked with grief as people they become dependent on frequently get killed. Dependent clerics are likely to become attached to their deity and will often be among the most loyal and devoted followers. Dependent rogues are most often concerned with romantic relationships.

1. Submissive: The character fears the consequences of being assertive.

2. Constant Approval Seeking: The character yearns for the approval of others.

3. Fear of Abandonment: The character worries that his social network will die or leave him.

4. Hypersensitivity to Criticism: Slight criticism gravely wounds the character’s ego.

5. Constant Need for Reassurance: The character constantly must have his fears assuaged by friends.

6. Intolerance of Being Alone: The character dislike being without companions.

7. Rejection Sensitivity: The character suffers excessively when rejected by others.

8. Excessive Agreeableness: Rather than upset his friends, the character agrees with whatever they say.

9. Inability to Take Initiative: The character has difficulty leading and making decisions.


Histrionic characters are praise hungry, over-dramatic, self-centered and attention seeking. They behave as though they are constantly on stage; saying and doing what they believe is expected of them so they can gain approval from their audience. They tend to be overly expressive of emotion, crying uncontrollably over a sad story, screaming hysterically at a minor fright, or hugging people they just met. Histrionic people tend to be uncomfortable when they are not the center of attention. They feel as though they must meet everyone else’s expectations and will compromise their own values and integrity to do so. These people often become upset or angry when their friends do not attend to them or praise them. The speech of a histrionic person is often vague and characterized by hyperbole. There is often a smarmy fakery apparent in their interpersonal style. Histrionic people play vastly different roles when they are around different people and are more busy being who others want them to be than being who they are. Although both histrionic and borderline personalities experience powerful emotions, there are several differences between them. The extreme moods of histrionic people are less volatile than those of people with borderline personalities. Although the histrionic’s mood states are strong, they persist over a reasonable amount of time and are set off by somewhat relevant circumstances.

Furthermore, the borderline personalities are not superficial and thespian-like as the histrionic is. Lastly, Histrionics do not inflict damage upon themselves when depressed. Rather, they sulk and cry, seeking emotional support from others. Histrionic and dependent personalities are very similar.

However, dependent people do not exhibit the same extremes of emotion that histrionic people do. Histrionic people are also more focused on themselves than dependent people are.

Mild: The mildest forms of histrionic personalities are simply warm, accommodating, polite, and sociable. They pick up well on social cues but people who know them often see them as fake and spineless. These people tend to lack strong opinions or convictions about major issues, unless doing so appeases a valued friend.

Moderate: The moderately histrionic characters experience strong moods and powerful emotions. They also lack a good ability to deal with their feelings. They are hypersensitive to criticism, often letting it depress their mood state. These people yearn for the approval of others and frequently seek words and signs of acceptance.

Severe: Severely histrionic characters are obsessed with a desire to be the focus of attention and are often overcome with gales of extreme emotions. They are very superficial and concerned with how others perceive them. These people often adopt mannerisms and attitudes of the people around them and rarely behave with consistency. These people’s lives are always in extreme disarray.

Role-playing: The most obvious traits of many histrionic characters are the over dramatic display of emotions and the seemingly smarmy interpersonal style they have. They seem a little too interested in what other people say and they laugh a little too loud at jokes people tell. Bards and rogues are probably the most typical histrionic characters. Histrionic wizards would likely have a repertoire of illusion and enchantment spells and use them frequently to get attention. Histrionic clerics are typically good empathizes and are often well liked by the public. Histrionic fighters might frequently engage in attention-getting displays of weapon prowess and overreact to combat situations.

1. Praise-hungry: The character yearns for the positive comments of others.

2. Seductive: the character seduces others in an attempt to gain the attention he craves.

3. Over-dramatic: The character behaves with exaggerated displays of emotion.

4. Shallow: The character seems superficial and intellectually simple.

5. Self-centered: The character is more concerned with himself than with others.

6. Impressionistic: The character sometimes behaves like someone else would, copying their mannerisms and interpersonal style.

7. Attention-seeking: The character seeks to be the focus of attention, enjoying the spotlight.


The narcissist is self-centered and convinced of his superiority over others in most, if not all, areas. Narcissists believe that they are smarter, stronger, better looking and more charismatic than anyone around them (or at least in possession of very good promise). When they encounter people who are obviously superior to them, they experience unease. They also experience unease when faced with evidence of their own inadequacies or shortcomings. When confronted by such evidence, their psychology takes a number of defense strategies. Areas where they obviously lack superiority will be ignored and rationalized with excuses and followed up with emphasis on the narcissist’s more impressive characteristics. Excuses are the narcissist biggest defense against failure or evidence of inferiority. This mindset causes the narcissist to be overly sensitive to criticism, but unlike the histrionic who is depressed and demoralized by critics, the narcissist is angered and offended by them, often becoming confrontational or aggressively competitive.

The people narcissist like best are those who reaffirm their egocentric beliefs. Yes-men and suck-ups are their favorite people. Second to them, narcissists tend to like weak, stupid, ugly people, since they further accentuate the narcissist’s prowess. The narcissist thinks only of himself, making it difficult for him to understand or relate to others. This also leads to a pattern of behavior that involves berating those who are under him to bolster his self-esteem and provide a psychological bulwark against the things he can’t deny.

Narcissists in positions of authority often play favorites with their subordinates, rewarding those who suck-up the best. They usually take actions in social situations to make people aware of their superiority. Quickly volunteering mundane information in an attempt to showcase their intelligence, bragging about battles and past glory, strutting and spouting brazen speech, all are typical narcissistic behaviors. These people also relish moments of true glory and any sort of compliment or award goes directly to their head.

Mild: The most modest form of this personality has a very healthy sense of self worth. They are somewhat self-centered and have difficulty when trying to understand other’s feelings. Their friends see them as a little arrogant and perhaps vain. They are success oriented and work diligently to improve their skills in a wide range of areas. They also tend to spend a good deal of time tending to their appearance.

Moderate: Those who are moderately narcissistic are very sensitive to criticism and will often strike out at those who are too critical of them. They greatly prefer the company of admirers and are quite disdainful of those who are “lesser” than them. Their inflated egos often cause minor problems in their lives and sometimes cause major problems. These people also have such a strong focus on success that it can lead to depression if their goals are not met.

Severe: The extreme narcissist surrounds himself only with admirers and will not tolerate the company of those who doubt his superiority. He is openly abusive, condescending, and disdainful of those who are “lesser” than he is. He constantly berates others to bolster his self-esteem and pontificates endlessly. This personality feeds on envy. He also secretly harbors a great deal of envy for anyone who is superior. He vigorously seeks to rid his life of these superior people and, if possible, to gain their power base. Furthermore, he will only openly admit to the superiority of other’s under threat of dire consequences. Criticism and humiliation incense severe narcissists to the point of irrational rage.

Role-playing: The narcissist’s self-love can lead to envy, and jealousy of those who are superior. Since narcissists have difficulty understanding the feelings of others, they find it easy to neglect and abuse people, especially for personal gain, or if doing so makes them feel smarter than the other person. Narcissists also set unattainable goals and strive in vain to reach them.

Paladins are the most typical images of narcissistic characters, but any character could easily be overly focused on himself. A narcissistic cleric would believe no one is a more truehearted follower of his deity than he is. Two such clerics might fight about the issue. Narcissistic rogues and bards are also common, being a little too suave for their own good. Narcissistic fighters are often quite skilled, since those who can’t live up to their own boasts often get killed. A narcissistic wizard would likely be quite smug and condescending, often deliberately speaking above the intelligence of those around him.

1. Exploitative: The character uses and exploits others for personal gain.

2. Grandiose: The character tends to behave in flamboyant, bombastic, attention getting ways.

3. Feels Unique: The character is overly proud of his perceived uniqueness.

4. Preoccupied With Success: The character is heavily focused on proving his superiority by succeeding in life.

5. Feels Entitled: The Character believes he is more important than he actually is and behaves accordingly.

6. Seeks Admiration: The character desires and seeks out the admiration of others.

7. Unempathic. The character’s focus on himself makes him unable to understand how others feel.

8. Envious: The character has a resentful desire for the possessions and achievements of others.

9. Hypersensitive to Criticism: The character’s pride is easily damaged by critical words.


Obsessive compulsive type personalities are concerned with methodology and order. They like plans, outlines, schedules, and ridged conformity. These people are not overly spontaneous or creative. They are logical, methodical and believe things must be done “the right way.”

Note that this is not the same thing as the widely known obsessive-compulsive anxiety disorder, which can completely inhibit someone (see Chapter 3). Rather, Obsessive compulsive personality describes the general way the person carries out their daily activities. These people are likely to organize their life in a specific, color-coded, alphabetized manner. They dislike clutter and are often described as “perfectionists.”

Mild: The slightly obsessive compulsive person is seen as stodgy, stuck in his ways, unlikely to adopt new ideas, a stickler for details, or perhaps a perfectionist. Some people might even say such a person is boring. However, these people are also well organized and able to handle tasks that require fine attention to detail.

Moderate: The moderately obsessive-compulsive type is less functional then those who are of only mild severity. These people experience a great deal of stress when encountering disorder and chaos. Confusion, new ideas and changes in routine all cause psychological unease for the moderately obsessive compulsive person. These people often focus excessively on detail and have a difficult time making decisions.

Severe: The most extreme type of obsessive-compulsive person is single minded in his opinions, views and habits. They have no tolerance for sloppiness, slovenliness or disorder. They cannot abide disharmony and insist on having conformity and predictability in their lives. These people strongly dislike surprises and unforeseen consequences. Their focus on detail often causes them to never get projects finished and to never be happy with their work. These people are completely unable to make important decisions for fear of making the wrong choice.

They might spend days or weeks analyzing their options and refining their choice and never actually decide.

Role-playing: The obsessive-compulsive personality lends itself most usefully to arcane spell casters who must take great care and practice to get their magic right. Fighters with this personality will often clean and prep their armor and weapons repeatedly. They are careful to train frequently and tend to fight with textbook tactics. Rouges with this personality are likely to be quite thorough in their work and are very careful about getting caught. Obsessivecompulsive paladins are perhaps the most industrious heroes of all, striving tirelessly for order and stability.

1. Perfectionism: The character is preoccupied with doing everything “right.”

2. Excessive Orderliness: The character has a strict and logical method to his personal habits that he rarely veers from.

3. Stubbornness: The character is resistant to new ideas and the will of others.

4. Over-working: The character’s desire to succeed and “get it right” causes long hours of labor.

5. Indecisiveness: The character worries so much about making the right decision that he often makes no decision at all.

6. Scrupulosity: The character worries excessively about offending others.

7. Reduced display of emotions: The character does not exhibit the same range of emotions in public that others do. They are less happy than others in lighthearted situations and less angry than others in upsetting situations.

8. Parsimony: The character is extremely frugal.

9. Hoarding: The character collects and hides valuables, storing them away for a rainy day.


Paranoid people go through life worrying about all sorts of villainous plots against them. Paranoia skews their perception of the world, causing them to see schemes and danger where none exist. Their fears go well beyond just physical harm. In fact, a great deal of their concern is centered on insidious plans to get their money or usurp their power and influence. They worry about losing relationships, possessions, income, secrets, and opportunities. The bulk of their concern is caused by the certainty that someone, or maybe everyone, is out to get them in every way imaginable. Obtuse conspiracy theories make complete sense to paranoid people. They are always on guard for thieves and con men. A paranoid person might write his name on all his possessions lest they get stolen. If someone should happen to stop talking just as a paranoid person walks by, the paranoid person would automatically assume that they were talking about him. The paranoid person will discount, rationalize and ignore any evidence he encounters that conflicts with his fears. For example, proof that the shopkeeper is not out to get him. On the other hand, if the shopkeeper was found to own a clairaudience scroll, then the paranoid person would be sure the shopkeeper had been listening in on all of his conversations.

Becoming very rich, powerful or important will greatly compound the fears of paranoia, since the character now has much more to lose.

Mild: The mildly paranoid individuals are merely cautious, careful, and pragmatic. They check and worry more than others, but not to a disturbing degree. Their contributions to future plans are always aimed at covering for unlikely eventualities. Advice from these people often takes the form of foreboding warnings. They tend to be suspicious of new acquaintances for no particular reason and sometimes never get past this initial opinion. These people usually don’t believe things that are impossible, only things that are highly unlikely.

Moderate: The moderately paranoid characters worry quite a bit and trust very few people or none at all. They believe that most people are out to get them for a whole litany of reasons. They are likely to believe conspiracy theories about all sorts of things. These people always assume an ulterior motive exists for the behavior of others and are always on guard against rare possibilities. In magical campaign worlds it is also reasonable to believe that horses might actually be spies and the walls might really be listening. This would cause a moderate level of paranoia to be considerably troublesome.

The fears of the moderately paranoid stretch beyond the realistic and mingle with the bizarre. They might believe that everyone in a packed tavern is talking about them as they pass by or that the king and his secret agents are after his family’s beef stew recipe. It is very difficult for a moderately paranoid person to trust anyone. Even their closest friends will receive only a guarded, superficial trust.

Severe: Extreme cases of paranoia experience pervasive, unjustified distrust of everyone. Paranoia bends their perceptions to the point of insanity. These people have no close friends since they can’t trust anyone. They frequently find evidence of others plotting against them and act on this misinformation. Severely paranoid people have a large number of delusional beliefs and take extreme measures to preempt the schemes of others. The plots that they can believe are completely impossible. Such a person might believe that everyone he knows is collectively conspiring against him. Severely paranoid people never trust anyone other than themselves.

Role-playing: Paranoid people will search their surroundings for signs of listening devises and actively seek out magic to protect them from scrying and mind reading. They will also highly value detect scrying, detect evil, alarm and other divinations and abjurations. Of course, the paranoid person will know that these magics are not completely reliable and can be fooled, blocked, or nullified by other magic. Thus the paranoid person can never find solace from his fear. Paranoia is best suited for rogues since their fears help keep them from being apprehended. On the other hand, it also impedes their earnings, since they are too fearful of getting caught to undertake any major heist. Wizards, with their spells, are the most dangerous of paranoid people since their fears motivate them to spy on others. Paranoid fighters might seem cowardly, but they see themselves as merely cautious and wise. Valuables, Power, and Influence: Everyone, even the lowliest of slaves has valuables, power and influence. A slave is valued for his ability to work.

Furthermore, in any community, even the lowliest, there is some kind of barter system of valuables. In the case of the slaves it might be clothing, bed space, and food. Slaves would also put value on the easier work details. Among any group of people there are dynamics of interaction. An attractive loyal servant might have more influence with his master then the other slaves. A headstrong rebellious slave might have power and influence over the other slaves, since they might see him as a leader who could liberate them. On the other hand, they might see him as a troublemaker who worsens their lives by making the master angry. In this case he would still have power and influence among his peers, being able to bring the wrath of the master down on the lot of them with a simple action. If any of these characters were paranoid they would jealously guard any and all of their valuables, power and influence.

1. Fears Others Will Take Advantage: The character worries about what others might do if they get the chance.

2. Mistrustful: The character finds it difficult to believe or rely on the words of others.

3. Suspicious: The character frequently suspects malicious agendas and devious motives.

4. Grudge-holding: The character has difficulty forgetting injustices of the past.

5. Unable to Confide: The character never trusts anyone enough to divulge personal secrets.

6. Touchy: The character makes paranoid associations between the things people say and the things he worries about.

7. Jealous: The character has an unfounded fear of losing the things he has, especially relationships.


The schizoid person likes to be alone. They neither desire nor enjoy contact with others. This differs from the avoidant type in that schizoids do not experience unease when encountering other people. Schizoid people are simply nonsocial. They are detached from social relationships and experience a limited range of emotions. They are perceived as very stoic; never in a rage, but never too happy either. Others see them as aloof, cold and indifferent. They rarely mingle socialize or gossip. Their perception of the world is uncolored by emotion. They make decisions based on fact and disregard the emotional dimension.

These people see socializing as pointless, wasteful, uninteresting, and bothersome.

Mild: The mildest schizoid individual functions fairly well. Although introverted and quiet, these people can successfully handle interpersonal contact when it comes their way. They are highly logical and emotionally stable. They have a bad habit of ignoring the feelings and thoughts of others. Although they enjoy solitude more then others do, they also keep a small group of friends and family that they interact with. These people have a considerable amount of emotional fortitude and very hard hearts.

Moderate: The moderately schizoid person rarely seeks out contact with others and almost never engages in small talk. When they do participate in banter, or even business, they seem rude and cold. These people may even become surly and curt. This is because they lack good interpersonal skills and cannot communicate clearly with others. They often have severe difficulty with one or more areas of interpersonal contact such as listening or speaking clearly and engagingly. They are completely indifferent to the emotions of others. These people have few close relationships. What bonds they do form with others will be dry, mundane and usually centered on some ulterior motive.

Severe: At the extreme end of the spectrum, these people are completely nonsocial. They have no interpersonal skills and no close friends. They will speak with others only about business and in that they will be blunt and direct. They have absolutely no regard for what other people think, say or do. These people spend the vast majority of their time alone, only having contact with others when it is absolutely necessary.

Role-playing: Successful crime bosses and heartless generals are sometimes schizoid. Wizards and priests who devote a lot of time to studying or prayer may also be schizoid. It is easy to imagine sages and hermits with this personality, but what about kings or innkeepers? Schizoid characters often seem detached and aloof, careless of social dynamics. They might also seem annoyed at the presence of other people, as this imposes on their desire to be alone. Furthermore, they have little interest in what others think, so they have few inhibitions about showing their dislike of others.

1. Prefers to be Alone: The character dislikes the company of others.

2. Emotionally Constricted: The character expresses little emotion.

3. No Close Friends: The character has no close relationships

4. Indifference to Romance: The character has no interest in romantic relationships.

5. Aloof: The character seems distant and reserved in social situations.

6. Indifferent to Opinions of Others: The character has little concern for what others think.


These people are frequently judged by others to be odd and eccentric. They usually dress and speak in bizarre ways. They are likely to find symbolic meaning in meaningless events such as eclipses, earthquakes, coincidences, etc. and they are very likely to show a pattern of erroneous interpretations of social cues. These people frequently mistake jokes for insults, sincerity for calculated manipulation, casual conversation for meaningful dialogue or wandering glances for looks of longing love. They sometimes miss sarcasm and implied meanings in conversations and have difficulty “reading between the lines.” Interestingly, schizotypal characters are also likely to be hypochondriacs, believing every little muscle ache and pang of indigestion to be the first stages of a terminal disease. They usually believe that they have the world figured out according to their own personal set of beliefs that are superstitious and unverifiable. They are also likely to be somewhat paranoid and usually have few close friends.

Mild: The mildest form of the schizotypal personality merely seems quirky and offbeat. They sometimes get the wrong idea in conversation or from social cues, but for the most part, they get by without any major incidents. They may be a bit superstitious and/or somewhat of a hypochondriac. There is usually something unique or characteristic about the way they dress and talk.

Moderate: Those who are moderately schizotypal usually misinterpret social cues and often hold strange superstitions. They often dress in a way that is quite different from everyone else. Their speech is frequently peppered with colorful words and composed of obtuse sentences. They might believe that their lives are controlled by fate or that they are a reincarnation of a past life. These people are frequently preoccupied with false ideas about magic and have difficulty determining what is real and what is imaginary when it comes to the arcane and divine arts.

Severe: The most extreme schizotypal person is very superstitious and finds signs and omens everywhere. They might also believe that they posses a limited form of clairvoyance, ESP or telepathy. These people might also speak with such convoluted sentences that no one can understand what they are talking about. They also tend to perceive a reality that only exists in their minds, distorting actual events to fit with their bizarre reasoning. Severely schizotypal characters rarely have friends, since their bizarre behavior and beliefs drives most sane people away from them. They always behave and dress in ways that are strikingly different than other people.

Role-playing: Remember that these characteristics are relevant only to the characters’ culture. If it is part of his religion to believe in reincarnation, then the schizotypal character will take this further, perhaps claiming to be the reincarnation of a famous person or to be able to remember his past life. Fantasy settings by nature are very conducive to the cultivation of schizotypal characters.

Prophets, hedge wizards and oracles are likely to be schizotypal. The best effect these NPCs have on a campaign is the introduction of red herrings. Players more readily believe prophets and seers than anyone else does. If the players should doubt a schizotypal prophet, the DM need only provide a small coincidence to convince the players. Schizotypal wizards and clerics are the most disruptive to a campaign, since their personalities lead to misunderstandings about the workings of magic and the will of the gods. Other classes with this personality type will likely have an interest in magic and will believe they know more about it than they actually do.

1. Ideas of Reference: The character finds meaning in meaningless things. He believes things happen to him for extraordinary personal reasons and often looks for the symbolic personal meaning in these meaningless events.

2. Social Anxiety: The character finds social situations to be stressful, and feels out of place and uncomfortable.

3. Illusions: The character observes behavior in others that is not actually there. He also holds erroneous presumptions about others and their behavior.

4. Magical Thinking: The character believes magical or impossible things are happening.

5. No Close Friends: The character has only associates, acquaintances and accomplices.

6. Odd Speech: The character’s sentences are seasoned with rare and exotic words. This trait mixed with low Intelligence will result in someone who frequently misuses ubiquitous words. Conversely, someone with this trait will sometimes form sentences in obtuse and vague ways, rendering productive communication difficult.

7. Inappropriate Affect: The character displays emotions that are inappropriate to the situation, laughing at a grizzly murder, becoming offended by a friendly joke, being giddy when catastrophe strikes, etc.

8. Eccentric: The character has bizarre personal habits that deviate from the norm.

9. Suspicious: The character is wary and watchful of others, convinced that they are up to no good.

Chapter III: Madness

Madness can be caused by a variety of events. Reducing a character’s Sanity Points to 0 and reducing a character’s Intelligence, Wisdom or Charisma to 0 can cause madness to develop in the character’s mind. Madness can also be inflicted via magic. The spell Insanity inflicts 1 randomly determined insanity per 5 caster levels on its victim rather than causing permanent confusion. Bestow curse can also inflict a single insanity on a foe, although in this case the insanity is also a curse.

It’s possible to suffer from multiple forms of insanity. If you become afflicted with a form of insanity you are already suffering from, the current DC of that insanity increases by +5.

Curing Madness

All madness has a DC that represents the insanity’s strength. The DC for madness indicates the Will save you need to roll in order to resist contracting the insanity when you are initially exposed to it, but also the DC you need to make to recover. Recovering from an insanity naturally is a lengthy process—once per month (due to the dark nature of Ustalav), you make a Will save against the insanity’s current DC. If you succeed on this save, the insanity’s DC is reduced by a number of points equal to your Charisma bonus (minimum of 1). You continue to suffer the full effects of the insanity until its DC is reduced to 0, at which point you are cured and the madness vanishes completely.

Lesser restoration and restoration have no effect on insanity, but greater restoration reduces the current DC of one insanity currently affecting a target by an amount equal to the caster’s level. Limited wish, miracle, or wish immediately cures a target of all madness.

Types of Madness

When a creature goes insane, the DM rolls on the following table to determine what form of madness strikes. Alternatively, the DM can assign the insanity to match the cause.

  • 1–11 Amnesia
  • 12–48 Mania/Phobia
  • 49–68 Multiple Personality Disorder
  • 69–78 Paranoia
  • 79–84 Psychosis
  • 85–100 Schizophrenia


Effect: -4 penalty on Will saving throws and all skill checks; loss of memory

A character suffering from amnesia cannot remember things; his name, his skills, and his past are all equal mysteries. He can build new memories, but any memories that existed before he became an amnesiac are suppressed.

Worse, the amnesiac loses all class abilities, feats, and skill ranks for as long as his amnesia lasts. He retains his base attack bonus, base saving throw bonuses, combat maneuver bonus, combat maneuver defense, total experience points, and hit dice (and hit points), but everything else is gone until the amnesia is cured. If a character gains a class level while suffering from amnesia, he may use any abilities gained by that class level normally. If the class level he gained was of a class he already possess levels in, he gains the abilities of a 1st-level character of that class, even though he is technically of a higher level in that class. If his amnesia is later cured, he regains all the full abilities of this class, including those gained from any levels taken while he was suffering from amnesia.


Effect: target is sickened (if manic) or shaken (if phobic) as long as the source of the mania or phobia is obvious; chance of becoming fascinated or frightened

A mania is an irrational obsession with a (usually inappropriate) particular object or situation, while a phobia is an irrational fear of a (usually commonplace) object or situation. Additionally, if a manic or phobic character is directly confronted by his obsession (requiring a standard action), he must make a Will save against the insanity or become fascinated (if manic) or frightened (if phobic) by the object for 1d6 rounds.

Multiple Personality Disorder

Effect: –6 penalty on Will saving throws and Wisdom based skill checks; multiple personalities

This is a complicated disorder that manifests as 1 or more distinct and different personalities within the same body and mind. The number of additional personalities the victim manifests equals the DC of the insanity divided by 10 (round down, minimum of 1 additional personality). Should the insanity worsen in some way (such as by the save DC increasing), the number of additional personalities increases as well. Likewise, the number of additional personalities decreases as the sufferer recovers and the insanity’s DC decreases. The GM should develop these additional personalities. Every morning, and each time the afflicted character is rendered unconscious, he must make a Will save against his insanity’s DC. Failure indicates that a different personality takes over. A character’s memories and skills remain unchanged, but the various personalities have no knowledge of each other and will deny, often violently, that these other personalities exist.


Effect: –4 penalty on Will saves and Charisma-based skill checks; cannot receive benefit from or attempt the Aid Another action; cannot willingly accept aid (including healing) from another creature unless he makes a Will save against his insanity’s DC

The paranoid character is convinced that the world and all that dwell within it are out to get him. Paranoid characters are typically argumentative or introverted.


Effect: character becomes chaotic evil; gains +10 competence bonus on Bluff checks to hide insanity

This complex insanity fills the victim with hate for the world. He may suppress his psychosis for a period of 1 day by making a Will save against the DC of his insanity, otherwise he cannot help but plot and plan the death and destruction of his friends and enemies alike. For the most part, the impact of psychosis must be roleplayed, although not all players find entertainment in roleplaying a lunatic who’s trying to do in his friends. In such cases, the GM should assume control of the character whenever his psychosis is in control.


Effect: –4 penalty on all Wisdom and Charisma-based skill checks; cannot take 10 or take 20; chance of becoming confused

A schizophrenic character has lost his grip on reality, and can no longer tell the difference between what is real and what is not. These constant hallucinations cause the schizophrenic to appear erratic, chaotic, and unpredictable to others. Each time a schizophrenic character finds himself in a stressful situation (such as combat) he must make a Will save against his insanity’s DC. Failure indicates that the character becomes confused for 1d6 rounds.

Sanity and Madness

A Great and Terrible Whisper Zeram