Fear Horror and Madness

Heroes may find themselves facing slavering monsters that can slay with a touch, haunted by the memory of horrendous cruelties, or exposed to alien forces that can wrench their minds apart. The heroes can prevail – but only if they can face their fears.
Fear, Horror and Madness saves represent the power of terror – a roleplaying tool to help players visualize the hysteria that often clouds the minds of characters in classic tales of horror. If a player portrays the stark terror of their hero without prompting, no die roll is necessary. Note: Creatures without Intelligence scores are immune to Fear, Horror and Madness effects.

Saving Throws

Fear, Horror and Madness saves are considered Will saves in all respects. Anything that modifies a Will save likewise modifies Fear, Horror and Madness saves; anything that modifies saves against fear effects modifies Fear saves.
Fear, Horror and Madness saves all use the same basic mechanic: a Will save against a specified DC. Specified DCs depend on the situation and type of check being made. Luck effect and resistance effects (such as those generated by a luckstone or a cloak of resistance) do not affect Fear, Horror and Madness saves; they are outside the purview of luck and are not active effects that would be resisted. Divine effects do aid Fear, Horror and Madness saves, however.
If a character succeeds at the Will save, then there is no effect, and they are immune to that specific source of Fear, Horror or Madness for 24 hours.
If a character fails the Will save, then the margin of failure determines the result. Subtract the final check result from the DC; this result determines whether the character suffers a minor, moderate, or major effect.

Failure Margin Effect
1-5 points Minor
6-10 points Moderate
11-15 points Major
16+ points Major, plus additional effect

When determining the effects of failed Horror and Madness saves, the player also needs to roll 1d4 to select a specific effect.

Fear Saves

A character should make a Fear save when facing overwhelming odds or immediate, dire physical danger. Fear saves can also be used to test the morale of the heroes’ foes. Common fear triggers include the following.

  • The group is badly outnumbered or out classed by opponents (EL is 4+ higher than the party level).
  • The most powerful character in the group or half of the group’s members are killed.
  • A menacing creature is immune to the group’s attacks.
  • A menacing creature is at least two size categories larger than the biggest member of the group.
  • A menacing creature has the frightful presence special attack.
  • The character is helpless and threatened by immediate death (trapped underwater, for example).

Appearances are everything; if a character doesn’t know they’re in dire peril, they have no reason to make a Fear save. Likewise, if a player thinks their hero is doomed, a Fear save may be warranted. Illusions can often trigger these false Fear saves.

Failure Results

Minor Effect: Shaken. The character suffers a -2 morale penalty on attack rolls, skill and ability checks and saves.
Moderate Effect: Frightened. The character is shaken and flees as well as they can. They can fight to defend themselves if unable to flee. A frightened character can use special abilities, including spells, to flee; indeed, they must use such means if that is the only way to escape.
Major Effect: Panicked. The character suffers a -2 morale penalty on skill and ability saving throws and must flee. They drop what they’re holding, chooses their path randomly (as long as they escape from immediate danger), and flees any other dangers that confront them. If cornered, they cower. A panicked character may use a special ability or spell to escape. If the character fails the Fear save by 16+ points, they are panicked and must make an immediate horror save (DC = failed Fear save DC -5).
Additional Failures: Fear effects stack. A shaken character who fails another Fear save becomes frightened. A frightened character who fails another Fear save becomes panicked.

Recovering from Fear

Fear effects last 5d6 rounds. Certain spell effects (such as modify memory or remove fear) can remove all Fear effects.

Horror Saves

Horror is a broader emotion than fear, and yet, more intimate. Horror often permanently colors a characters view of the world, be it through the shock of realizing that merciless events are possible or the paralyzing dismay of discovering some monstrous trait within oneself. Horror is the murderer of innocence.
Possible examples of scenes that might require a Horror save.

  • Signs of violence (a drying pool of blood, a splintered door and so on).
  • A decaying body.
  • A scene of pain or suffering (a beggar ravaged by disease; a doctor sewing wounds shut).
  • A freshly slain corpse.
  • A scene of terrible agony (torture, involuntary transformation).
  • A scene of evil, cruelty and madness (finding dismembered bodies that have been turned into marionettes).
  • Malign paradigm shift.

A “malign paradigm shift” is a situation in which a character discovers that an important element of the surroundings is not only drastically wrong, it has been all along, unbeknownst to the character. Characters typically do not need to make Horror saves when witnessing the aftereffects of their own deliberate actions.

Failure Results

A character who fails a Horror save is subject to a minor, moderate or major Horror effect, depending on the margin of failure. The player rolls 1d4 and the DM compares it to the minor, moderate or major effect category. If a character fails a Horror save by 16+ points, they suffer a major Horror effect and must make an immediate Madness save (DC = Horror save DC -5). Below is a Horror effect chart.

1d4 Minor Moderate Major
1 Aversion Nightmares Fascination
2 Fearstruck Obsession Haunted
3 Frozen Enraged Mental Shock
4 Nausea Revulsion System Shock

Minor Horror Effects

Aversion: The character is frightened. Although the Fear effect has a duration of only 5d6 rounds, for as long as the character suffers from this horror effect they are automatically shaken whenever they come within 50 feet of the location where they failed the Horror save or any identical places.
Fearstruck: The character is panicked. This Fear effect lasts 5d6 rounds, but the character suffers no further effects.
Frozen: The character is momentarily overwhelmed by the scene before them and can take no action for 3 rounds. They are considered flat-footed for the duration.
Nauseated: The sight causes the character to become physically ill. They cannot attack, cast spells, concentrate on spells, or do anything requiring attention. The only action allowed the character is a single move per turn, plus free actions (except for quickened spells). This effect lasts 1d4+1 rounds.

Moderate Horror Effects

Nightmares: For the moment, the character is merely shaken. This Fear effect lasts 5d6 rounds. However, the next time the character tries to go to sleep, the horrific events of this scene play themselves out again in the character’s mind, causing the character to wake with a scream after only 5d6 minutes. The nightmares return every time the character tries to sleep, preventing rest. For as long as this Horror effect lasts, the character cannot regain arcane spells, and each full day without rest incurs a cumulative -1 morale penalty on all attack rolls, saves and skill and ability checks, to a -4 maximum penalty. Lack of sleep also erodes the character’s health. Without rest, they cannot regain hit points through natural healing. The sleep spell grants dreamless rest, allowing the character to regain spells and negate accumulated penalties. If the character does not receive a sleep spell every night, however, the nightmares begin again. Elves nether truly sleep nor dream and thus are immune to this effect; players of elven characters should reroll the d4 or choose another moderate effect instead.
Obsession: The character is unable to shake this horrific memory. They continually replay the events in their mind, mumbles about the events under their breath and tries to bring all conversations back to this terrible topic. Their obsessed mind becomes clouded, and they seldom sleep. With each day of restless obsession, they suffer a cumulative -1 morale penalty on initiative and Listen, Search and Spot checks, to a maximum penalty of -4. The character ignores their health while obsessed. They cannot regain hit points through natural healing, and each full week without rest inflicts 1 point of Constitution damage. Once the character recovers from obsession, lost Constitution points return at the rate of 1 per day.
Enraged: The character’s mind is overwhelmed by a primitive, mindless fury directed toward to source of horror. They must drop anything in their hands that is not a weapon, the rush forward to attack the object of their hatred in melee. This blind fury acts as a barbarian’s rage ability, with the following exceptions: unlike a barbarian, the character is not in control of their actions. They cannot retreat from battle and will not stop attacking the subject of their rage even if it is destroyed. They must also move toward the subject using the most direct route, even if it means passing through threatened areas. If anyone – even an ally – tries to block their path and the character cannot move around, they fight their way through the obstacle. The character is enraged a number of rounds equal to 3 + the character’s (heightened) Constitution modifier. The character regains control of their actions afterward, but they are fatigued in the same manner as a barbarian once his rage ends.
Revulsion: Works as aversion, except that the character is shaken if exposed to anything that merely reminds them of the horror scene. A character horrified by a vampire attack may suffer repulsion upon seeing a large swarm of bats or hearing the conversational mention of a vampire, for example.

Major Horror Effects

Fascination: The character develops a morbid fascination with the scene. This obsession becomes so overpowering that it warps the character’s personality. In the fascinated creature’s mind, the source of the horror effect becomes increasingly powerful. The fascinated character may eventually believe that the source omnipotent; they may even revere it. As an example, a character who becomes fascinated after witnessing a vampire draining the blood from a victim may seek out that vampire and offer their servitude. As the fascinated character warps them self into a willing slave of their own horror, they suffer a cumulative loss of 1 point of Wisdom and Charisma damage each week. If either score drops below 3, the character becomes a lost one. Once the character recovers from fascination, the lost Wisdom and Charisma points return at the rate of 1 each per day.
Haunted: Witnessing the horrific scene shatters the characters ability to see any good in the world. They suffer the obsession effect and suffers 1d6+1 points of Charisma damage as their spirit becomes hardened and withdrawn. Once the character recovers from the haunted effect, lost Constitution and Charisma points return at the rate of 1 each per day.
Mental Shock: The character’s mind simply shuts down, unable to comprehend what it is witnessing. While suffering from mental shock, the character can take no actions and is considered flat footed. They walk as if dragged along but cannot run. Mental shock lasts 3 rounds. At the end of that duration, the character must make another Horror save at the same DC to escape the effects. If they fail, the effects persist, but they can retry the saving throw once every 3 rounds until they succeed. If the horrific scene is no longer present, the character gains a cumulative +1 morale bonus to each retry until they succeed.
System Shock: The shock provides to be too much for the character’s heart; they must make an immediate Fortitude save against the same DC or suffer 3d6 points of Constitution damage.

Recovering from Horror

Minor Horror effects last one week. Moderate effects last two weeks. Major effects last thirty days. At the end of this duration, the character rolls a recovery check (a Horror save). Use the DC of the Horror save with a -2 morale bonus, since time and distance heal all wounds. If the character succeeds at this check, the Horror effect persists for another duration period. A character can retry failed Horror recovery checks each time they reach the end of the duration period. The -2 DC modifier is cumulative with each attempt.

Madness Saves

Failed Madness saves can cripple a character; fortunately, they’re also the least common type of effect. Make a Madness save in the following three situations:

  • The character makes mental contact (using spells, special abilities and so on) with any darklord, aberration, elemental, ooze, outsider, plant, or insane mind (any creature suffering from a Madness effect). Druids and clerics with the Plant domain are exempt from making Madness saves when contacting plants.
  • The character is the victim of “gaslighting:” a purposeful attempt by another party to drive her insane.
  • The character suffers a total catastrophe. This can include witnessing the brutal destruction of the rest of the party, leaving the character to face the threat alone; a paladin being stripped of their powers; suffering an involuntary alignment change; or being subjected to a horrific physical transformation (such as being turned into a broken one).

Determining the Madness Save DC

A Madness save’s DC is determined on a case-by-case basis.

Mental Contact: If a Madness save is prompted by contact with an alien or insane mind, the DC is 10+1/2 the contacted creature’s HD + contacted creature’s Wisdom modifier.
Gaslighting: Gaslighting comes in two varieties. If an opponent tries to drive a character mad with a spell or other magical effect (such as bestow curse or wish), then default to the saving throw indicated by the spell (typically a Will save). That saving throw stands in for the Madness save.
One character can also gaslight another through nonmagical means. To do this, the perpetrator must gain the victim’s trust and remain in close proximity for thirty days, using that time to slowly convince the victim that their sanity is slipping away. At the end of the thirty days, the perpetrator must make an opposed Bluff check against the victim’s Sense Motive check. If the victim fails this check, they have been driven mad; as with other Madness saves, the degree of failure determines the result. The perpetrator can select a specific madness effect from the selected category if they wish. If the victim’s Sense Motive check defeats the perpetrator’s Bluff check, they are unaffected. If they succeed by 10 or more points, they immediately become aware of the perpetrator’s failed gaslightling attempt. If the perpetrator is not detected, they can try again (with each attempt taking another thirty days).
Total Catastrophe: Madness saves prompted by personal catastrophes can be considered a particularly shattering form of Horror save. The DM should use the recommended DCs and modifiers listed under Horror saves, though this often requires the DM to make a judgment call.

Failure Results

Failed Madness saves can quickly hinder or cripple a character. As with Horror saves, the player should roll 1d4 and compare it to the failure category to select an effect. In addition to the listed Madness effects below, all failed Madness checks cause effective ability decreases to Intelligence, Wisdom and Charisma. (Roll separately for each ability score.)
A character with minor Madness effects takes 1d6 points of damage per ability score. The character regains 1 point in each ability score per hour.
A character with a moderate Madness effect also takes 1d6 points per ability, but these points cannot be regained without effort.
A character with a major Madness effect takes 1d10 points of damage per ability score. As with moderate effects, these points cannot be regained without effort.
If a character fails a Madness save by 16+ points, their mind is shattered. Unable to function, they immediately drop to -1 hit points and starts to die. If they survive this shock to the system, they suffer a major Madness effect and takes 1d12 points per ability score. All Madness effects described below are in addition to the ability point loses detailed above. As a note, minor madness effects tend to be forgiving and pass within a few hours. Moderate effects can be troubling, but PCs can usually continue to function. Characters suffering from major Madness effects often pose a danger to themselves and others and require close supervision.

1d4 Minor Moderate Major
1 Blackout Delusions Amnesia
2 Denial Depression Multiple Personalities
3 Horrified Hallucination Schizophrenia
4 Unhinged Paranoia Suicidal Thoughts

Minor Madness Effects

Blackout: The character is shaken at first. However, they do not recall anything in the time between (and including) the scene that prompted the Madness save and when they regain the last of their decreased ability scores.
If the character is alone, the DM may simply cut to when they “come to,” wandering and alone, with no memory of how they came to be in their current location. Some spells, such as modify memory, can restore lost memories.
Denial: The character’s mind refuses to accept the existence of the threat that prompted the Madness save. Until they regain all lost ability score points, they act as if this threat simply does not exist. Denial provides the character with an effective +4 insight bonus on any Will save against that threat’s attacks but otherwise offers no protection. When all ability scores are regained, the character once again acknowledges the existence of the threat (but loses the insight bonus).
Horrified: The character suffers a moderate Horror effect (determined randomly). This Horror effect’s duration lasts only until the character regains all lost ability score points, rather than the usual two weeks.
Unhinged: The portion of the character’s mind that should have gone mad simply shuts down instead. This leaves the character able to function but affects their personality. They receive an effective +2 morale bonus on all Fear and Horror saves, but their alignment temporarily changes (roll 1d8 to randomly select a new alignment, omitting the character’s original alignment from the options). A DC 20 Sense Motive check can reveal that the Unhinged character is not quite their self, assuming it isn’t obvious. The character regains their normal alignment (but loses the morale bonus) when all lost ability score points are restored. An alignment change from this Madness effect does not cause an additional Madness check.

Moderate Madness Effects

Delusions: The character believes something about their self that is simply not true. The nature of this delusion is usually tied into the event that provoked the Madness save. Examples might include a character who believes they have endless wealth (paying for services with pebbles they insist are rubies), believes they transform into a wolf under the light of the full moon, or believes they are a specific NPC. The character can perform actions only if they can rationalize them within the context of their delusion. For example, a character who believes they are actually a vampire would not be willing to expose themselves to sunlight.
If a character ever performs an action that should be impossible within the context of their delusion (in other words, if the player cannot immediately provide a rationalization for the action), the character must make an immediate DC 15 Horror check.
Depression: The character is overcome by a deep melancholy, sapping away their will to live and their interest in the world around them. Such a character just wants to be left alone; they do not suggest ideas, give commands or otherwise direct other characters. In fact, in any given situation, the character must make a Will save at the same DC as the failed Madness to take any action whatsoever. If the character fails this Will save, they do nothing at all, even in dangerous situations. In a combat situation, they cannot take any actions and are considered flat-footed.
Even if the character is motivated to act, they do so listlessly and reluctantly. They can follow the instructions of allies, but they suffer an effective -4 morale penalty on all attack rolls, loses any Dexterity bonus to AC and on Reflex saves and cannot take attacks of opportunity. On the other hand, the character’s utter lack of interest in their surroundings provides them wit an effective +4 insight bonus on all subsequent Fear, Horror, and Madness saves.
Hallucinations: The character perceives something in the world that simply does not exist. In a sense, hallucinations can be considered the external companion to the internal delusions effect. As with delusions, the nature of the hallucination is usually related to the event that prompted the failed Madness check.
Examples: A character might believe that they can see ghosts, that biting insects have infested their armor or that mind flayers visit them at night. They might even occasionally encounter an NPC who exists only in their mind.
In a sense, a hallucination can be thought of as a phantasm spell on the level of a major image, but one where the insane character is both caster and subject. As with illusions, the DM should present hallucinatory episodes as real events, when they first manifest. Menacing hallucinations may provoke Fear or Horror saves (DC depends on the specific scene; see the respective sections on determining DC). Hallucinations can even attack the character, though they deal only nonlethal damage, as the character merely believes they are being harmed.
Characters have little mental defense against their own inner demons. Thus, a hallucinating character suffers a -2 morale penalty on all Fear and Horror saves provoked by their own visions.
If a character somehow becomes aware that their hallucinations are just that, they must still concentrate to convince themselves that the visions are not real. This works just like disbelieving illusions; to dispel a hallucination, the character must make a Will save at DC (13 + character’s Wisdom modifier). Unlike with illusions, however, the reassurances of allies cannot grant a hallucinating character any bonus on their Will save. An attempt to disbelieve a hallucination is a standard action and can be retried each round.
If a character successfully disbelieves a hallucination, the episode continues for another 1d4 rounds. That hallucination can no longer provoke Fear or Horror saves, however, nor can it deal nonlethal damage.
Paranoia: The character believes that they exist at the center of a conspiracy dedicated to their destruction. No amount of rational argument can convince them otherwise. Although the character’s madness does not extend to actual hallucinations, the DM should present all NPCs and conversations with other characters in a menacing light. The DM might drop subtle visual clues that other characters are inhuman, or thread vague, easily misinterpreted threats into NPC dialogue.
As with hallucinations, the DM may want to give the other players secret signals that the scene is not being presented quite as it actually exists, or the DM may want to focus on the paranoid character’s interaction with NPCs only when separated from other PCs. This avoids the extra work of explaining what’s really happening to the other players.
The paranoid character must succeed at a Will save with a DC equal to that of the failed Madness save to place any trust in other characters. If the character fails the Will save, she must refuse all offers of help as being obvious traps. If a paranoid character ever does come upon actual evidence that they have been betrayed or that others are conspiring against them, they must make an immediate Horror save (at DC 12 + character’s Wisdom modifier).

Major Madness Effects

Amnesia: A much more disabling form of the blackout effect, amnesia is the result of an affected mind’s desperate attempt to shield itself from the memory that provoked the failed Madness save. The amnesiac character immediately blocks out all memory of the maddening event – along with many of the months or years that came before it. If a failed Madness save results in an amnesia effect, the DM should roll d%. Multiply this percentage times the character’s total levels (rounding down). The character then receives that many negative levels.
Although an amnesiac character still has access to all their skills, they lose all memory of events since gaining those levels. A character who acquires a number of negative levels equal to their character level regresses to childhood.
Restoration spells cannot remove those negative levels; they are caused by memory loss, not negative energy.
Multiple Personalities: The character’s psyche makes a desperate attempt to contain the mental trauma it has suffered by splintering into separate identities. The character retains a core personality, 10d10 fragments, and 2d10 alter egos.
The core personality is the character’s original persona. It has access to all the character’s memories, skills and abilities.
Fragments are partial personas, easily described in a single phrase, such as “coin collector,” “sleepy child,” or “talented dancer.” The player can assign a single skill or ability to each fragment. Fragments can use their one talent if called upon, but they always ignore anything that is not related to their subject.
Alter egos are fully formed personalities. Each alter ego considers itself a distinct individual but often believes that its race, class or even gender differs from the core personality. As with delusional characters, these alter egos cannot be convinced that they are not as real as the core personality. The player should flesh out the persona of each alter ego:

  • Roll 1d6 to determine each alter ego’s approximate age. 1:Child. 2:Adolescent. 3:Adult. 4:Middle aged. 5:Old. 6:Venerable.
  • Roll 1d6 to determine each alter ego’s supposed sex and race. 1:Same sex, same race. 2:Male, same race. 3:Female, same race. 4:Male, different race. 5:Female, different race. 6:Same sex, different race. Most alter egos who believe themselves a different race still consider themselves humanoids, but some alter egos believe they are giants, fey or even magical beasts.
  • Roll d% on Table 4-24 in the D&D Dungeon Master’s Guide to select a trait as the base of the alter ego’s personality.

Alter egos have access to all the core personality’s skills and abilities, but they do not use them if doing so is out of character for the alter ego. For example, a wizard’s alter ego that believes itself to be an ogre distrustful of magic would not cast spells. The player should keep a numbered list of their hero’s fragments and alter egos for ease of reference.

Whenever a character suffering from multiple personalities has to make a Will save, they must also make an immediate additional Will save equal to the failed Madness save’s DC or randomly switch personalities (as a free action). The character should also make a Will save (DC 15 + character’s Wisdom modifier) each time they rest. If the character succeeds at the Will save, they wake up as the core personality. If they fail they switch to a random persona. The core personality has no conscious memory of time spent in other personalities, but the character does not acquire negative levels as with amnesia. Alter egos typically are aware of each other and can leave messages for each other if they wish. It is not uncommon for alter egos to dislike each other or the core personality.
Schizophrenia: The character’s personality suffers a serious collapse. As the character’s sense of self erodes, they cacn experience drastic and unpredictable personality shifts. Once every week, and whenever the character makes a will save of any kind, they must succeed at a Will save (DC 15 + character’s Wisdom modifier) or have their alignment immediately and randomly change. They player should roll 2d4 of different colors: one die represents ethical alignment (1:Lawful 2:Neutral 3:Chaotic 4:Original Alignment); the other represents moral alignment (1:Good 2:Neutral 3:Evil 4:Original Alignment). A character might be a saint one moment, a monster the next. An alignment change due to this Madness effect does not cause an additional Madness check.
Suicidal Thoughts: This is a more serious for of the depression effect. In addition to all the effects detailed under depression, the character’s will to live hangs by a thread. If the character fails any subsequent Fear, Horror or Madness saves, they must soon (within an hour) attempt to take their own life. The character makes the suicide attempt via the most efficient means at their disposal: leaping off a high balcony, drinking poisonous chemicals, hurling themselves into a river and so on. A character can also use a piercing or slashing melee weapon to deal a coup de grace against themselves. This is also possible with some ranged weapons, such as crossbows and firearms.

Wisdom and Madness Saving Throws

Usually, a character with a high wisdom has an advantage to any saving throws affected by their wisdom score. When saving against Madness, characters add their Wisdom bonus to the saving throw’s DC.

Additional Failures

If a character fails another Madness save while already suffering a Madness effect, do not roll 1d4 to determine a new effect. The character’s mind, already insane, merely sinks deeper into its existing dementia. Ability score losses are cumulative with multiple failed Madness saves, however. If a character’s ability score drops to 3 or lower they become what is commonly known as a lost one – a walking catatonic whose mind was shattered by memories too horrible to bear.

Recovering from Madness

The road from madness to sanity is often long and difficult. Madness effects are removed when all ability points lost to the failed Madness save are regained. In the case of minor Madness effects, this period is mercifully short: never longer than six hours. Moderate and major effects require much more effort to shake off. Several methods are available to characters in need of recovery.

Peace and Quiet: If the character rests for thirty days without failing any subsequent Will saves, they can make a recovery check (a Madness save) against the same DC. If this check succeeds, they regain 1 point in one of their decreased ability scores. While the player can choose which ability score to place the point in, the fastest road lies in restoring Wisdom to normal first.
The character can attempt a new recovery check once per restful month against the original DC until Intelligence, Wisdom and Charisma return to normal. However, particularly if the character’s Wisdom score was drastically lowered by the Madness save, the DC may be so high that the character cannot succeed. In these cases, the character needs to turn to outside help.
Magic: If available, magic is the quickest and most efficient method of recovery. Restoration can restore decreased ability scores but requires threes castings to remove a Madness effect (one casting to restore each ability score), while the spells greater restoration and heal can each cure madness at a stroke. Note that of these spells, only heal can restore memories lost to a blackout or amnesia. Modify memory can also restore lost memories, but it may require multiple castings to recover all lost memories.
Hypnosis: If the character does not have access to magic, access to a character with the Hypnosis skill is the next best option. The hypnotism spell can be used in the same way; use this system, but the spell’s increased efficiency grants the subject a +2 bonus on their recovery check.
Hypnosis is a new technique, first developed by (and still largely limited to) doctors working in the handful of asylums and sanitariums. Were magic more plentiful, this skill would be even less known – it is primarily a nonmagical substitute for the hypnotism spell.
When a character is curing madness, the DC of a Hypnosis check is equal to the DC of the subject’s failed Madness save. The hypnotist may benefit from a +2 synergy bonus on the skill check if they have at least 5 ranks in Heal. The hypnotist can retry Hypnosis checks one per week (per subject) until the subject recovers. This means that the aid of a successful hypnotist can give the insane character four chances to make a recovery check each month, rather than just one. A character cannot use hypnosis on themselves. A successful Hypnosis check garners two results. First, the subject can attempt an immediate recovery check to regain a single ability point. Second, each successful use of Hypnosis reduces the recovery check by 1 point.
Sanitarium: A few sanitariums are scattered across the land. While their purpose is to lift the affliction of derangement, more often they simply serve as prisons for the insane. Recovery in a sanitarium works just like hypnosis, but the sad truth is that a patient in a sanitarium is unlikely to receive the careful attention they require. Each sanitarium offers a flat 1d8-5 morale modifier to all recovery checks made in its care. As the modifier indicates, many patients in sanitariums would be better off locked in their nephews’ attics.
Patients in a sanitarium can make one recovery check per month, using the modifier above Each success restores 1 point in one decreased ability score and reduces the DC of future recovery checks by 1 point.

Fear Horror and Madness

Vile Shadows Seiba