Insanity Rules

Some of Freeport’s richest qualities are its Lovecraftian undertones. Elements of cosmic horror pervade the setting, from the despicable cults worshipping mad, alien gods to ancient civilizations that once eclipsed all the works of mankind—all set against the looming futility of mortal actions against forces far beyond their control. Though these elements are present in the setting, GMs may embrace them with varying degrees of enthusiasm. Any game that cleaves to cosmic horror ultimately dooms the player characters, which creates a less-than-ideal environment for heroic adventure. For gaming groups who do prefer the darker edge of Freeport, this chapter includes expanded insanity rules that build on and largely replace the standard Sanity and Madness rules (from the Pathfinder Roleplaying Game: GameMastery Guide).

Before you jump in with both feet to use these rules, though, you should be aware of their implications. Most characters have plenty of vulnerabilities without introducing another; under this system, characters are more likely to accumulate insanity points than are the villains, putting them at a notable disadvantage. One way to soften the impact of these rules is to ensure villains are equally saddled with madness (as appropriate). Note: For characters with multiple insanity points, adversaries that have special attacks or spells that target a character’s Will are commensurately more dangerous. They should be treated as having a Challenge Rating of 1 or even 2 higher than normal since insane characters are more vulnerable to such attacks.

*Insanity points

Insanity points, or IP, quantify a character’s derangement, expressing how unhinged he becomes after numerous encounters with the awful. Each time a character studies a forbidden text; endures a profoundly terrible supernatural experience; encounters a shifting abomination hauled up from the underworld to wreak havoc in the mortal plane; or suffers Intelligence, Wisdom, or Charisma drain, that character is at risk of suffering frayed sanity. The more
insanity points a character accumulates, the more insane
the character becomes, until he slips completely into
madness.
eFFects oF insanity points
Insanity points can affect a number of different factors,
but for the most part they affect a character’s Wisdom
score and most of its functions.
For the purpose of skill or ability checks and Will saves,
a character’s effective Wisdom is equal to her Wisdom
score minus her IP.
However, for the purpose of spellcasting or class
abilities (including bonus spells, save DCs, a monk’s
Wisdom bonus to AC and save DCs versus ki abilities,
etc.), the character’s effective Wisdom equals her Wisdom
score plus her IP.
A character cannot gain more insanity points than her
Wisdom score. Should her insanity points reduce her
Wisdom to 0, she immediately stops gaining insanity
points and gains a major madness.
At any time, a character may sacrifice a number of
insanity points to acquire a madness (see below).
getting used to aWFulness
As a character accumulates insanity points, he becomes
progressively more inured to the sorts of things that would
make another person run screaming. Whenever a character
would gain insanity points, reduce the number gained by the
number of insanity points he already has (to a minimum of 0
points). That is, the insanity points one already has effectively
act as damage reduction against further insanity points.
For example, if a character with 2 IP would receive 5 IP
from a traumatizing experience, he reduces that amount
by 2 and thus gains only 3 IP (bringing his current total
to 5). If he is later exposed to an event that would give
him 3 IP, he ignores that effect altogether.
gaining insanity points
There are five basic sources of insanity points:
• mind-affecting attacks
• mental ability drain
• horrific experiences
• horrific creatures
• terrible knowledge
While the rules here assume groups will use all four
methods of acquisition, you should feel free to ignore one
or more sources if you find they unbalance your game.
mind-aFFecting attacks
Any hostile spell or special attack that targets the mind can
cause lasting damage in addition to its immediate effects.
Whenever a character is the target of a harmful mindaffecting spell or ability and fails the saving throw by 5
or more, that character gains a number of insanity points
equal to the spell’s level minus 1. For example, if a character
is targeted by a charm monster spell (DC 18, 4th level) and
rolls a 13 or less on the saving throw, she would gain 3 IP.
A GM wishing to use a version of these rules with
significantly less impact on the PCs (and a much lower
occurrence of insanity) can choose to exclude this method
of gaining insanity points or halve the amount of IP gained.
mental ability drain
Any time a character suffers 2 or more points of ability
drain to his Intelligence, Wisdom, or Charisma (not
merely ability damage, but drain), there is a chance he’ll
gain IP. The character must make a Will save (DC 15 +
ability points drained); on a failed save, he gains a number
of insanity points equal to half the ability points drained.
horriFic experiences
Certain encounters and experiences are so profoundly
awful that they can rend the mind. Seeing the eviscerated
remains of a loved one, enduring torture, facing a powerful
otherworldly entity, being interminably confined or
buried alive, and so on—these things can all take their
toll on a person’s mind. Whether such experiences cause
insanity is best adjudicated by the GM since certain
characters might be more or less deeply affected by some
horrors than others.
The Mind-Rending Events table provides benchmarks
for GMs to gauge the relative severity of awful experiences.
Each intensity has a save DC, representing the Will save
required to not suffer insanity points.
At the GM’s discretion, if a character rolls a natural 1
on his saving throw, he might receive double the number
of insanity points shown on the Mind-Rending Events
table.
horriFic creatures
While many magical creatures are a common reality to
most Freeporters, there are still some beings that one never
expects to see. Truly, the average Freeporter is not likely
to encounter dragons, powerful undead, or demons. An
encounter with these horrors can leave a person forever
changed. As a result, many creatures in the Pathfinder
Roleplaying Game Bestiary and other sources can bestow
insanity points regardless of the creature’s motivations or
alignment.
The default assumption is that the following creature
types can inflict insanity points when encountered if they
are of sufficiently high HD. (A player character is subject
to insanity points only when she encounters a creature of
the following types that has more HD than her character
level.)
• Aberrations
• Dragons
• Outsiders
• Undead
In addition, certain rare and deadly constructs, fey,
magical beasts, monstrous humanoids, oozes, plants, or
vermin, at the GM’s discretion, might also be able to
cause insanity points. Animals and humanoids should
never inflict insanity points, regardless of their HD.
Whenever a character encounters one or more
creatures of any of the above types, she risks gaining
insanity points. In each encounter, only the creature
with the highest HD is considered for this purpose. If
that monster’s HD are greater than the character’s level,
she must succeed on a Will save (DC equals 10 + 1/2
the creature’s HD + the creature’s Charisma modifier).
If the saving throw succeeds, she gains no insanity
points and is not at risk of gaining insanity points from
encountering further creatures of that type for 24 hours.
If she fails the save, she gains insanity points as shown
on the Creatures and Insanity Points table.
mind-rending events
Intensity Will DC IP Examples
Mild 10 1
Tortured; find a severed
body part unexpectedly;
witness untimely demise of
a dear friend
Moderate 15 1d3
Endure excruciating torture
or lengthy confinement;
find the brutalized remains
of a loved one
Severe 20 1d4 Buried alive; maimed or cast
down by a sworn enemy
Extreme 25 1d6
Witness horrific
dismemberment of a dear
friend or loved one while
helpless to stop it
creatures and insanity points
Monster HD* Insanity Points
1-3 1
4-6 1d2
7-9 1d3
10-12 1d4
13-16 1d6
17-20 2d4
21+ 2d6
*PCs are not affected by monsters whose total HD are
less than their character level. NPCs can gain IP from
monsters of any HD.
A GM wishing to use these rules, but with less significant
impact (i.e., a lower occurrence of insanity among PCs),
can choose to exclude this method of gaining insanity
points altogether, or restrict it to unique or particularly
horrific monsters (or perhaps only mythic creatures).
terrible knoWledge
Just as some things were not meant to be seen, some
writings or iconography includes blasphemous or
abominable knowledge that should not be contemplated
by the mortal mind. Exposure to That Which Should
Not Be Known can scar the psyche, particularly for the
weak-willed.
Exposure to anathema, whether willing or not,
requires the character to make a Will save (DC varies)
to avoid insanity points. The GM should decide just
how terrible any particular tract or book should be for
those reading it, but the Terrible Knowledge table can
provide a rough guideline.
terrible knoWledge
Intensity Will DC IP Examples
Mild 10 1
Mad scribbling of a cult
leader; book of torture
techniques
Moderate 15 1d2
Unholy text outlining the
tenets and practices of a
sacrificial cult
Severe 20 1d4
Exhaustive writings by
a mad prophet or high
priest describing the
worship of a primal god
Extreme 25 or
higher 1d8
Ineffable, abominable
passages actually penned
by outsiders serving a
primal power
Insanity points gained in this way cannot be removed
through natural or magical healing and may only be
removed by gaining madness.
removing insanity points
Although insanity points do not go away on their own,
there are a few ways to remove them, some easier than
others.
magic
The easiest way to remove insanity points is with spells. A
lesser restoration spell removes 1d4 IP, while a restoration
removes 2d6 IP. A heal, greater restoration, miracle, or
wish spell removes all insanity points from a character
immediately.
It’s also possible to get some temporary relief from
insanity through magical means. A calm emotions spell or
similar effect suppresses the effects of insanity points for
the duration of the spell.
healing
A character afflicted with insanity points can be helped
via the Heal skill. Another character who spends a week
(at least 4 hours each day) with an afflicted character
and succeeds on a DC 25 Heal check may remove 1
IP from that character. The subject of this treatment
cannot benefit from more than one Heal check in this
way per week.
madness
Madness functions as a release valve for accumulated
insanity points. As a character accumulates insanity
points, he must endure the effects on his Wisdom
score. For some characters, particularly Wisdom-based
spellcasters, these effects can be helpful, but for most,
they are problematic.
Thus, to give characters a chance to eliminate insanity
points without need of a spell or a lengthy healing process,
a character can “spend” insanity points to acquire madness.
going mad
At any time, a character may remove any number of
insanity points, using them to “purchase” either a fear
effect or madness, as shown on the Going Mad table.
Doing so is a free action, and the effects of the fear or
madness are immediate.
going mad
Insanity Points Spent Condition
1+ Fear Effect
2 Temporary Madness
4 Short-Term Madness
8 Indefinite Madness
16 Permanent Madness
Fear eFFect
During the first round of any combat encounter, by
spending 1 IP or more, a character can gain a fear effect,
the intensity of which is determined by a Will save with
a DC of 20 + IP spent. As a free action at the end of each
subsequent round, the character may make a new Will
save, at the same DC, to get a grip on himself and shake
off the fear effect.
A character who is immune to fear cannot spend
insanity points in this way.
Fear eFFects
Will Save Condition
Success Shaken
Failed Frightened
Failed by 5 or more Cowering
Failed by 10 or more Panicked
At the end of an encounter, once all enemies are
defeated or have fled, the fear effect ends if the character
has not managed to remove the effect already.
temporary madness
At the beginning of any encounter, or at the end of any round
during which he or she gains 2 or more insanity points, a
character may spend 2 IP to acquire a temporary madness
lasting 3d4 rounds. Roll 1d20 on the Temporary Madness
table on the facing page to determine the exact effect.
A calm emotions spell suppresses these effects for the
duration of the spell.
short-term madness
At the beginning of any encounter, or at the end of any
round during which he or she gains 4 or more insanity
points, a character may spend 4 IP to acquire a short-term
madness lasting 2d12 hours. Roll a d20 on the ShortTerm Madness table on the facing page to determine the
exact effect.
At the GM’s discretion, a short-term madness has a 50%
chance of occurring immediately; otherwise, the GM rolls
1d3 secretly, and the madness triggers at the beginning of
the next encounter after that many encounters have passed.
A calm emotions spell suppresses these effects for the
duration of the spell.
indeFinite madness
At the beginning of any encounter, or at the end of any
round during which he or she gains 8 or more insanity
points, a character may spend 8 IP to acquire a madness
that begins immediately and lasts indefinitely. Roll a
d20 on the Indefinite Madness table on page 418 to
determine the exact effect.
Where no duration is defined, a character with an
indefinite madness can roll a DC 20 Will save at the end
of every week to end the symptoms.
A calm emotions spell has no effect on this degree of
madness.
permanent madness
At the beginning of any encounter, or at the end of any
round during which he or she gains 16 or more insanity
points, a character may spend 16 IP to acquire a permanent
madness. Roll a d20 on the Indefinite Madness table above
to determine the exact effect. Its effects begin immediately.
A calm emotions spell has no effect on this degree of
madness.
curing madness
Acquiring madness is serious business, even though some
forms of mental illness go away on their own after atime. With indefinite madness and permanent madness,
though, a character is saddled with a nasty vulnerability
that can interfere with a variety of tasks and can be
frustrating if the effects persist overlong.
Curing madness is more involved than removing
insanity points, but the price is often worth it since several
forms of madness can cripple a character beyond repair.
magic
A restoration cannot remove an indefinite or permanent
madness, but can suspend the effects of one for one
week per caster level. A greater restoration or heal spell
can cure any madness; each casting removes just one
form of madness, though it also removes any remaining
insanity points. A miracle or wish spell can remove all of a
character’s madness at once.
healing
A character afflicted with madness can also be cured with
the Heal skill. Such treatment requires 1d6 months of
confinement, during which time the afflicted character
must be attended by a trained healer. At the end of the
treatment period, the healer makes a Heal check (DC
25 for an indefinite madness, or DC 30 for a permanent
madness). A Heal check that succeeds by 10 or more
indicates the character makes a full recovery.
However, madness, once it occurs, is never far away. A
Heal check that succeeds by less than 10 indicates that
the madness is merely suppressed, and the madness could
resurface: Any time a character with a suppressed madness
gains 1 or more insanity points, that character must succeed
on a DC 20 Will save. If the save fails, one previously
suffered form of madness reasserts itself immediately.

short-term madness
d20 Effect
1-4
Obsessive-Compulsive Disorder: You develop obsessive behaviors (constantly washing hands, praying, walking in a
particular rhythm, avoiding cracks in the floor or street, checking to see if your crossbow is loaded) or attachment to
a particular item, fetish, or “lucky charm.” Due to your constant distraction, you suffer a –2 penalty on all attack rolls,
saving throws, and skill and ability checks.
5-7 Impulse Control Disorder: You present symptoms of a psychosocial or antisocial disorder, such as kleptomania, eating
disorder, paraphilia, trichotillomania, attention deficit, etc. You suffer a –6 penalty on all Charisma-based checks.
8-9
Conversion Disorder: You develop psychosomatic muteness, blindness, or deafness (determined randomly; equal
chance for all three). Characters who become mute cannot cast spells with verbal components or activate magic
items requiring spell completion, spell trigger, or command word.
10 Transient Amnesia: You lose all memory of both intimates and associates. For the duration, you are treated as having
0 ranks in all Knowledge skills.
11
Severe Avolition: You lose all volition, suffering a –4 penalty to Will saves, and can take no action unless directed.
Any creature you can see and hear may instruct or command you with a swift action each round. On your turn, you
follow the last command given within the past round; if none was given, you are considered dazed.
12-14
Schizophrenia: You suffer from hallucinations or delusions, possibly exhibiting uncontrollable tremors or agitation.
You take a –4 penalty to all attack rolls, saving throws, and skill and ability checks. You must succeed on a
concentration check (DC 20 + spell level) to cast any spell.
15-16
Phobia: You are gripped with a phobia (GM’s choice, but usually something involved in the triggering encounter) and
refuse to approach either the source of the phobia or anything that reminds you of it unless you succeed on a DC 20
Will save. If you fail the save, you are frightened for 2d6 rounds.
17-18 Reactive Psychosis: You are confused for the duration.
19 Catatonia: You fall into a stupor and are helpless for the duration.
20 Suffer an Indefinite Madness instead.

temporary madness
d20 Effect
1-7
You faint, falling unconscious. You can be awakened
only by vigorous shaking, requiring a full-round
action by an adjacent character; once you awaken,
you are dazzled until the duration expires.
8-12
You babble or scream incoherently, effectively
deafened and staggered for the duration of the
effect.
13-16 You are sickened and cannot willingly move from
your square.
17-19
You become confused. This condition resets at the
end of each of your turns for the duration of the
effect (so if you are attacked, you can respond in
kind only once before you become confused again).
20 Suffer a Short-Term Madness instead.

indeFinite madness
d20 Effect
1-4 Substance Addiction: You become addicted to a particular drug or other potentially harmful substance. (See
the Pathfinder Roleplaying Game: GameMastery Guide for details on addiction.)
5-7 Bipolar Disorder: Every 1d20 hours, roll 1d6 to see if your mood changes. On an odd result, you are manic,
elated and energetic. On an even result, you are depressed and effectively sickened.
8-10
Severe Impulse Control: You suffer a –4 competence penalty on all initiative checks and a –6 penalty on
Charisma-based checks. Any time you are involved in a stressful situation (any time you could not normally take
10 on skill checks), you must succeed on a DC 20 Will save. On a failed save, you are confused for the duration
of the encounter.
11-13
Severe Phobia: As a short-term phobia, but you are shaken and suffer a –4 penalty on initiative checks. The
Will save to approach the source of your phobia has a DC of 20. If you fail the save, you are panicked for 1d10
minutes.
14-15
Psychotic Paraphrenia: Your alignment changes to chaotic neutral and you become severely paranoid. This
alignment change penalty cannot be reversed until your sanity is restored. In any stressful situation, you must
succeed on a DC 20 Will save or enter into an uncontrollable rage; this rage functions exactly like a barbarian’s
rage except you must attack the closest conscious creature (ally or enemy) until you can perceive no other
potential target nearby.
16-17
Dissociative Identity Disorder: Roll 1d4 to determine the number of additional personalities you gain. Each
personality has a separate alignment, determined randomly. (Work with your GM to define these personalities.)
A random personality emerges each time you awaken unless you succeed at a DC 20 Will save. The personalities
may or may not be aware of one another, but feel no particular loyalty to promises or decisions made by other
personalities. Each personality has access to the same class features, feats, skills, and so on, and is generally not
affected mechanically. However, if you have a code of conduct and violate that code while in the control of another
personality, that personality loses access to the class features that rely on adhering to the code.
18
Total Amnesia: Your name, your skills, and your past are all equal mysteries. You can build new memories, but
any memories from before the onset of your amnesia are completely suppressed. You lose all class features
and abilities, feats, and skill ranks for as long as this amnesia lasts. You retain your base attack bonus, CMB,
CMD, base saving throw bonuses, combat maneuver bonus, combat maneuver defense, experience points, and
Hit Dice and hit points, but everything else is inaccessible until the amnesia is cured. If you gain a class level
while suffering from amnesia, you may use any abilities gained by that class level normally; if the class level is
in a class you already possess, you gain the abilities of a 1st-level character of that class, even though you are
technically of a higher level. If your amnesia is later cured, you regain all the abilities of that class, including
those gained from any additional levels gained while you were suffering from amnesia.
19 Multiple Disorders: Roll 1d3+1 times on this table. You suffer all the selected madnesses.
20 Suffer a Permanent Madness instead.

Insanity Rules

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