“Your shoelace is untied.” By the end of this article, you’ll understand the significance and meaning of that phrase.

Mentioning Call Of Cthulhu in Monday’s article reminded me of a discussion that I once had with Dennis Ashelford, still probably the best CoC GM that I’ve ever seen in operation, about how best to convey the effect of Insanity on an affected character.

Some background (from memory – be warned, I’m not sure how much of the rules I’m about to offer are canon, or even correct): CoC is based on the Lovecraftian mythos amongst other sources. Exposure to books, fell magics, and creatures from the nether domains (or wherever) costs the character sanity points, and can eventually drive the character around the twist. Lose a certain percentage of your remaining sanity points in one encounter (or adventure?) and you picked up some minor quirk that restricted but did not excessively hamper your character’s ability to function as one of the Good Guys fighting to stop the invasion/conquest of our world by these other-dimensional horrors. Lose them all, and you earned yourself a mental problem that could be crippling at best, and require permanent residence in a sanitarium at worst, ending your ability to adventure. Once you had a problem, further loss of sanity points only made it worse.

Both Dennis and I agreed that the worst possible way of handling this game-mechanics development was to simply tell the character “Your character has picked up an insanity. You are now (die roll, die roll) suffering from…” and name whatever it was.

Between us, we worked out a system for handling insanities and other mental breakdowns that I still use, to this day.

Inside this envelope…

The first rule of thumb was to roll for insanities in advance and place the results in an envelope. When a character acquired one, that character’s name would be written on the envelope, the GM would check the contents, and NOT inform the player or update the character. That only happened when the breakdown was successfully diagnosed.


The second rule was never to describe the problem, only to describe the symptoms – and only to do that in a roleplayed context. The goal was to describe to the player how the world now looked to the character, and let the player decide how to handle it. As much as possible, symptoms were to be backed up by reference and research – something that was a lot trickier in the days before the internet, though we now face the problem that much of what’s available is severely technical, requiring a fair amount of knowledge to decode and decipher. For that reason, Wikipedia is not be my first resource when applying these techniques in the modern world; I start with a Google search and add the word “layman” to the search terms. Then I repeat the search (if necessary) with “symptoms” and “plain language” – the latter in inverted commas to make it an exact quote instead of simply adding plain and language to the list of search terms.


The third rule was to come up with a list of triggering situations, the length and ubiquitousness of which were determined by the degree of insanity. These triggering conditions were also kept from the player.

The effect

This meant that the PC was free to do whatever the player thought appropriate, at all times, but that the character was often laboring under a false view of the world – a view that the other player characters did not share. When times were quiet, and there was leisure to ask “did you see that?” the flaw in the world-view was relatively quickly apparent; but in the middle of an attack by cultists, or with Cthulhu (or something else Man Was Not Meant To Know) oozing through an open portal from another world, or whatever, this is not something that you have the time for. Nor is it the sort of thing that one can do readily in the middle of a civic reception, or when giving a speech, when all eyes are upon the character. A deliberate effort was made, in fact, to place the character in such situations for a while – not only did it keep the game active, but it gave the peculiarity an opportunity to manifest.

Other Games

Insanity also occurs in other games. There are spells to induce it in D&D. There have been several characters with what could most charitably be called “distorted senses of reality” in both my superhero campaign and in the pulp campaign that I co-GM. So this technique isn’t just for CoC GMs.

Six Examples

I have a set of six examples to offer. I want to emphasize that these are actual examples from back then, or the fruits of our discussions at the time; I have not done any research on the symptoms in question for this article. As a result, they may be ignorant, incomplete, or shortsighted; at best, they are likely to be cartoonish caricatures of the real symptomology. I am not a professional psychologist or psychiatrist.

Whispers in the crowd

A crowd gathers after some sort of incident – a house fire or whatever. The character happens to see two people in the crowd point at him or at another PC and whisper to each other. No other PC is looking in the right direction at the right time. Are they cultists? Are they the people responsible for whatever has just happened? Is it a red herring? Or is it all in his head, the beginnings of paranoia?

This is the sort of thing that a character in CoC can’t afford to ignore. Depending on the circumstances, he might not make a big fuss about it; he might simply drop back to keep an eye on them, or might tell another of the PCs. It’s worth remembering that the players know about the insanity rules; if you mishandle the situation, or they have already been told that the character is now suffering from mild paranoia, the incident will be immediately discounted by the other PCs. But if they don’t know, the reactions of the other PCs will be realistic.

Your shoelace is untied

This is one that Dennis actually used at one point, subsequent to our conversation. Every now and then, he would tell the character that “You notice that your shoelace is untied.” The character would stop to retie the laces; after all, action could break out at any moment, and he didn’t want the GM to be able to say that he tripped over them.

The other players initially ignored it, the first time or two. Then they joked about it, suggesting that he buy a new pair of laces, or wash the ones that he had already to take off whatever was making them so slippery, or call in an exorcist. The next time it happened, Dennis let the PC notice an important clue while he was adjusting his shoelaces. Every twenty-to-thirty minutes of real time, the character would be told, “Your shoelace is untied”, or loose, or something along those lines. After about four hours of play, and about ten such incidents, the player noticed on the character sheet that the character habitually wore boots (it was a convention game, with pregenerated characters), and promptly announced his discovery to the world. Dennis simply grinned, and told him, “I know. Your shoelace is untied…”

Was the character obsessive-compulsive? Was the character paranoid about his shoelaces coming undone at a vital moment? Was he delusional? What else might he get wrong? If it weren’t for that time he spotted the important clue, the other players might have been inclined to distrust everything the character said. What should they do about the situation? Just as it would in real life, the debate lasted for a good half-hour or more, in-game…

The envelope is ticking

“You receive your mail through the slot in your front door. There are three bills, and what appears to be a letter in an envelope. The Envelope is ticking…”

You might think that the character was suffering from Paranoia. He wasn’t; he was suffering from auditory hallucinations, in which he kept hearing a clock, ticking, a reflection of his sense of urgency. Mental illnesses are not always easy to diagnose – and that’s in the real world, never mind in a world where there really are monsters and fell creatures and cultists out to sacrifice humanity to creatures from the Ninth Dimension…

There’s something behind you

This is one that I used, in a Champions solo mini-adventure. The PC was dealing with an enemy that could do all sorts of things with shadows – animate them, teleport between them, make them solid – but he didn’t know that at first. I simply kept telling him, “there’s something behind you.” Never mind what this did to the character’s mental landscape, it seriously ‘creeped out’ the player (to use his own parlance for what was happening).

He tried using his powers (energy-based attacks) to dispel the shadows, but that only shifted them. He lashed out at a pair of garbage cans, convinced that his enemy was hiding in the shadows behind them, and slowly started to unravel… eventually the character pulled himself together and got on top of the situation, but for a while afterwards, he would overreact to the phrase, “there’s something behind you…” – exactly as the character should, after an encounter like that!

NB: This doesn’t work so well in a crowd!

It looks like rain

This is one from my Champions campaign that didn’t work out as well as it should have. A satanic cult were raising money to continue their attempts to summon something from hell by running a drug ring, disguising their wares as sugar-based candy treats in the shape of pentagrams, which they would sell to school-kids. This was calculated to get one of the characters extremely hot under the collar (“hates drug pushers” and “protective of children” being two of the character’s psych lims). One of the PCs scouted the drugs lab, which wasn’t very well constructed, and was exposed to fumes that cause temporary psychosis. He saw all sorts of weird stuff in the basement, where the summoning rituals were being carried out, and became convinced that they had actually succeeded in summoning a demonic power, which had possessed the body of the cult leader.

The tip-off was supposed to come from the way I kept telling the PC in question that it looked like rain. There was always a conveniently located umbrella or pair of galoshes in the scenery (the trigger). The other PCs were supposed to eventually figure out that the character suffering was not himself, but they all got caught up in their plans to capture the cult and drive the demon back to Hell, to the point where I felt it would be a total let-down for everyone if I went ahead with the plot as written. Instead, I had to jump horses in midstream, make the summoning/possession “real”, and carry on from there. The result didn’t really satisfy anyone very much, I’m afraid. Looking back on it now, I might well have been better off sticking to my guns and letting the chips fall where they may, even though it would have complicated the campaign tremendously at a time when I was trying to simplify it to enable the players to focus their attention a little more.

The mistake I made was in not having a solid enough tipoff to the other players that this was a delusion of some sort. I had tried to use a number of “sunshine” and “blue skies” references, but they simply assumed that this meant that the rainclouds were on the horizon, and that I was threatening to have their evidence wash away.

Handled slightly differently, and in a slightly different context, and/or with a different group of players, it might have worked. This time around, it didn’t. There’s a lesson or two in that – nothing works 100% of the time, and sometimes you simply have to bite the bullet and get it over with even if it makes the adventure unsatisfactory to everyone involved.

Salted Peanuts

My final example is another of Dennis’ ideas, one that I don’t think he ever implemented. The idea was to require the player of the character to be affected to snack on salted peanuts by providing such snacks for everyone – but telling that player (by note) that he was not allowed to drink anything until his character’s circumstances changed. This was back in the 80s, when peanut allergies were either not as widespread, or not as widely recognized. The player was to be told that this was to help him roleplay his character who was in a difficult situation but didn’t know it. The idea was to try to simulate the mild break with reality; every time the player would comment on how dry his mouth was, Dennis would make it clear that this was something the character was also saying. Eventually, the character would get the opportunity to attempt to drink his fill, and at that point, Dennis would provide the player with plenty of bottled water – then only just coming in, and quite expensive.

Insanity and Social Sensitivity

These days, people are a lot more aware of mental disorders and the devastating effects they can have – and that most sufferers are capable of living quite ordinary and fulfilling lives if they receive the correct treatment. Those treatments have also improved vastly over the last X years, especially in terms of the unwanted side-effects of the medications, which often used to be almost as devastating as the illness itself, and which often led to sufferers refusing to take the medication.

I have used the term “X years” because… well, I started with 20 years, and then changed it to 30 years, and then to 50 years, and then 100 – and I came to realize that you could plug just about any number into that statement and it would still be true.

Accompanying those advances in medicine have been changes in social attitudes – perhaps incompletely, and not as uniformly as they should be, but improvements nevertheless. Most forms of mental illness these days are considered medical phenomena with psychological impacts and symptoms, often resulting from chemical imbalances, acute stresses, physical trauma, or long-term abusive situations.

The world has changed – and in this respect, it’s for the better – and I’m not sure what impact that should have on the way we represent mental illness in the games that we play.

On the one hand, in a game set in an era that is not so aware, you could argue that these techniques are still an appropriate way of depicting the problems faced. You could argue that by simulating, however shallowly, the perspective of a sufferer, you are actually raising awareness of the issue. On the other hand, it could be considered insensitive and disrespectful of the struggle that sufferers face on a daily basis. Finally, you could argue that this is just a game we’re talking about, and that it doesn’t need to reflect our personal opinions on any subject.

These are issues that I think every GM has to work out in his own mind and his own campaign. I don’t think there are any “right answers”. But I don’t want any readers of Campaign Mastery to think that I am being insensitive to the issue, or deliberately offensive. I’m sure we all know someone who faces the challenges of a mental disorder, whether we know about it or not, and those sufferers have nothing but my full heartfelt support and sympathy in dealing with those challenges.

I can’t think of a better way to end this article than this:

If you need help, or you know someone else who needs help, please seek professional advice, and the support of people who care about you. Don’t let yourself become just another statistic.

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