The Malkavian Problem: Mental Illness in LARP

It's a little late for World Mental Health Day, but I've been thinking about these issues for a while now, and would thus like to talk a little about issues surrounding mental illness in LARP. This post is going to mostly focus on portrayals of mental illness within LARP, though I'm also going to touch on a couple of other things, such as accessibility issues.

More so than any other form of disability, mental illness is subject to a great degree of mystification, prejudice and stigma in contemporary society. Indeed, the argument can be made that mental illness is the last true social taboo; and whilst the twentieth century has seen (for various reasons) a gradual reduction in stigma associated with depressive illnesses and other "neurotic" disorders, there still remains a great deal of stigma directed towards illnesses characterised by psychosis, and towards certain other categories of mental ill-health or non-normative psychology.

(Quick definition time, for the baffled: neurosis and psychosis is one paradigm by which mental illnesses can be classified, currently more in use in psychoanalysis rather than "medical" psychiatry. In this schema, a neurotic state is one in which there is a degree of emotional distress evolving from unconscious conflict; a psychotic state, on the other hand, is one in which there is a distortion or break from the commonly-assumed conception of reality)

For a simple demonstration of the extent of the problem, let's look at the etymology of some common terms.

Mad - from the Old English "gemæd", meaning "enraged"

Insane - from Latin "insanus", meaning "lacking soundness (of body or mind)"

Deranged - from French "déranger", meaning "to disrupt"

Pictured: A typical linguistic relativist

Lunatic - from Latin "lunaticus", meaning "of the moon"

Crazy - from the Middle English "crasen", meaning "to shatter"

Now, etymology is hardly conclusive, as the usage, and thus meaning of words undeniably shifts with time (linguistic prescriptivists be damned), but the etymology of a word does provide a certain framing of context which is important. Language influences modes of thought; thus, the language that we use to discuss mental illness influences, to some extent.

(Let us not have that argument about the Sapier-Whorf hypothesis again)

We thus see that the linguistic picture of mental illness is one of violence and disruption, which meshes closely with the way in which mental illness is stereotyped. This is backed up by numerous negative depictions of people with mental illness in film and literature - the plethora of violent serial killers from Norman Bates to Dexter Morgan; the quirky "craziness" of characters such as Deadpool; characters who are locked in elaborate fantasy worlds; or characters whose illnesses are portrayed as practically a superpower, such as Dr. Daniel Pierce's crime-solving hallucinations and Adrian Monk's magical OCD.

A good overview of these cultural stereotypes is provided by the Time to Change campaign, who break down the stereotypes into Comedy, Faking & Indulgent, Pity, and Violence. Such stereotypes are not only inaccurate, but also harmful to those with mental health conditions.

So, what about portrayals of mental illness in LARP? Well, they're pretty varied. Let's take a look at a few examples, starting with two well known systems in which mental illnesses are dealt with by a central system mechanic.

Derangement: Obsessive/Compulsive

The post-namer is, of course, from the table-top and numerous LARP implementations of Vampire: the Masquerade. There are a bunch of bad examples in the World of Darkness, with the worst by far being Clan Malkavian. They are a group of vampires often described as "mad seers", who are defined by having some intrinsic "derangement", the vast majority of which are taken straight out of the DSM (Diagnostic and Statistical Manual of Mental Illness, AKA The Big Grey Book). A quick flick through some of the Mind's Eye Theater (the "official" LARP implementation of the old World of Darkness) lists such things as "Antisocial Disorder", "Bulimia", "Compulsive Lying", "Hebephrenia", "Manic-Depression",  "Obsessive/Compulsive", "Post-Traumatic Stress Disorder", "Sadism", "Schizophrenia", and "Self-Annihilation Impulse". In news that will surprise exactly nobody who has played a World of Darkness game, they are not exactly handled well or realistically.

Whilst it does away with Clan Malkavian (kind of), the Mind's Eye Theater implementation of the New World of Darkness is no better. Indeed, it is arguably worse, due to one of the central mechanics around character morality. Across the game lines, characters are given a morality rating ("humanity" for vampires, "wisdom" for mages, and so on) which can be lowered if one performs morally questionable acts. Leaving the inherent issues with moral absolutism in LARP for another post, the particular problem here is that characters are at risk of acquiring "derangements" whenever their morality rating decreases - thus leading to the unfortunate association of mental illness and evil.

Another major offender, again a tabletop RPG with multiple LARP implementations, is Call of Cthulhu, and Lovecraftian horror in general. One of the major themes of the genre is the breakdown of sanity due to encounters with horrific and incomprehensible forces from Beyond, often using some kind of scale of "sanity points" to represent a character's grip on reality. The Cthulhu Live ruleset gives a variety of disadvantages that one may begin play with, such as "Phobia", "Obsession" and "Psychosis", which provide additional points to purchase abilities during character generation; characters can lose sanity and rack up various disadvantages across the game due to traumatic events. One of the worst aspects in CoC adaptations is the categorical association of madness with the "bad guys" - indeed, a common fate of a character who loses all their sanity points is that they become a cultist and begin worshiping the Unmentionable Evils.

90% of Mental Illnesses in LARP

A great number of other systems have what might be referred to as "incidental" portrayals of mental illness; these typically fall into the general categories of "player-originated" portrayals, and "system-emergent" portrayals. A player-originated portrayal is one in which a player makes an active choice to portray a character with a mental disorder, whereas a system-emergent portrayal is one which is imposed on a player through some system mechanic. Both categories have the potential to invoke offensive and inaccurate stereotypes, in different ways.

Player-originated portrayals crop up in just about every LARP, in one form or another; the reasons that players give for such portrayals vary tremendously. I won't judge anyone on their reasons (larp-as-therapy or larp-as-personal-exploration are entirely valid playstyles), but will just note that it is often done very badly.

System-emergent portrayals are again massively varied; they often come in the form of simulacra of symptoms of mental illness being imposed on characters as the result of some external agent - potions, magic, science, or what have you. The way in which these mimic psychiatric symptoms is variable - some systems include effects that mimic auditory hallucinations (Project Ragnarok's whispering demonic voices), disassociative states (Falling Down's malevolent auras of power which override one's personality), and any number of others. Again, these have the possibility of being roleplayed in an offensive manner; an equally important problem here is that being subject to effects which compel one to roleplay certain symptoms can be extremely distressing for players who have mental health problems of their own.

So, what can be done to make this better?

Players - if you are considering playing a character who exhibits traits associated with mental illness, consider why. LARP Hacks provides some very good advice around how to roleplay mental illness in LARP - above all, I would recommend that you don't let a character's mental illness being the defining factor of a character.

Designers - there are a lot of factors to be taken into consideration here, both in terms of system and setting. In terms of system, a few good questions to ask yourself would include:

• Do I really need mechanical rules for "sanity" or the like? 
• If so, what purpose should they serve?
• Do any NPCs that are portrayed as having mental illnesses fall into any harmful or offensive stereotype? I'd recommend this, and the ubiquitous TV Tropes as fairly good starting points.
• Are there any mechanics which compel a player to roleplay in a way which could be seen as mimicking the symptoms of mental illness?

Another very useful piece of advice is to consider writing a statement of thematic intents covering what is and is not considered acceptable within a game: a good example of this is the one for Falling Down.

The role of mental illness in any given setting is an extremely complex question, beyond the scope of this post to offer any real advice on; what I will say, however, is that if you wish to include themes around mental illness in a fictitious game-world, it is vitally important to determine how mental illness is conceptualised in that world. There is a school of thought that suggests that all mental illnesses are socio-cultural constructs; thus cultures significantly different our own will likely have vastly different ideas of mental illness, and likely a different set of symptomatic presentations. I will try and cover this at some point in the future - for those who are interested, and can deal with somewhat-dense French structuralism, recommend reading Michel Foucault's Madness and Civilization as an excellent starting point for looking into the power dynamics behind concepts of sanity and madness.