Insanity, Horror, and the Outer Beings in Mystara:
by Geoff GanderThis article is intended to add some basic insanity and horror rules to the Mystara setting, as well as provide some additional information about the Outer Beings, and how these rules apply to them.
Who Are the Outer Beings?:
Those who have become aware of the Outer Beings have always been given to pondering their nature. These entities are extremely powerful - mightier even than the Immortals on an individual basis, and their origins are obscure to all but the oldest of Immortals. It is thought that the Outer Beings themselves do not remember their own origins. Despite their vast reserves of strength, the Outer Beings have been constrained for untold millennia by arcane powers, so that they would not be able to interfere in the world's affairs. Sages, wizards, and their like who know of the Outer Beings, know that they are horrible, both in their physical appearance and nature, but also in terms of what they would do if they were ever released into the world once more. Beyond this, and the theorised connection between certain forms of insanity and their influence, little is known about these beings.
The truth about the Outer Beings is something known only to the Old Ones, current and former Hierarch Immortals, and, of course, the DM. Untold aeons ago, the Outer Beings co-existed with the Old Ones; indeed, they were in many ways "cousins" to these enigmatic beings, equal in power. They co-operated in the shaping of many worlds, and both Outer Being and Old One tended their charges in their own ways. Even in the beginning, the Outer Beings' worlds were chaotic and unstable, producing nothing but strife in those regions they controlled. Though they shared many of the powers held by the Old Ones, the Outer Beings lacked the discipline and the sense of order necessary to wield them responsibly. Thus, their creations rarely lasted long, and even when they did, they were fundamentally flawed. Always they coveted the beautiful worlds tended by the Old Ones, above all the planet known as Mystara (and the rest of the Prime Plane for that matter), for it, above all other worlds, lay at the nexus point of powerful energies, imbuing it with its own potent source of magic.
Eventually, the Outer Beings staged an attack against the Old Ones, assaulting them personally, and sending their legions of servitors to all the worlds they could find, so that they could be brought under control. This great battle lasted millennia, and in the process whole galaxies were destroyed by the titanic energies that were released. Eventually, some of the less abhorrent Outer Beings switched sides, and aided the Old Ones in securing a final victory against their former companions. In the aftermath, the Outer Beings were stripped of many of their powers, and the most powerful ones were sealed away into their own pocket dimensions, from which they could not escape. Lesser Outer Beings were also locked away, but they were not separated from each other, as they were deemed to be less dangerous. Many of their servitor races were also locked away, or destroyed outright, for the abominations that they were.
The Old Ones then spent the next several millennia stabilising the multiverse, after which they elected to remove themselves from the planes, so that such mighty powers could not be unleashed freely again. Before doing so, however, they created a new breed of caretakers for the multiverse - the Immortals. Shortly before withdrawing from the multiverse, the Old Ones told the first Hierarch Immortals about the threat posed by the Outer Beings, and bid them keep that sacred knowledge to themselves. Only upon reaching the exalted rank of Hierarch in a Sphere of Immortality, would the knowledge be conveyed, as well as the stricture that it must not be shared with anyone. No records exist of any Immortal breaking this sacred trust; even former Hierarchs, who retain the knowledge even after their fall from grace, do not violate this rule.
Now, the Old Ones simply watch the affairs of the multiverse, their aims unknown. In the meantime, sentient life developed on many worlds, some of which managed to attain Immortality in its own right. The Outer Beings noticed this and, eager to rebuild their armies of servitors, immediately sought means of weakening the barriers imprisoning them, and corrupting the minds of those who would pry too deeply into the sealed regions of the planes.
Today, the Outer Beings still plot to free themselves from their prisons, eager to wreak revenge on those who deprived them of what they see as their destiny. Some inhabitants of Mystara have come into contact with them, and while some have been won over by their dark promises of easy power, most who deal with them are driven mad by their contact with such horrible beings, and their utterly alien thoughts - eventually.
The Outer Beings and Insanity:
Although Mystara is considered by and large to be a world of epic fantasy, a realm of bold warriors and cunning sorcerers, a place of magic and wonder; it also harbours dark secrets. The threat posed by the Outer Beings since their imprisonment so long ago by the Old Ones, while indirect, is very real. Some of their lesser servitor races are known to inhabit certain less-frequented regions of the planet, and small portions of the indigenous races of Mystara have sworn allegiance to these utterly evil entities. Knowledge of the Outer Beings and their foul machinations has always existed among the various peoples of Mystara, in one form or another, though in more recent times that knowledge has begun to spread. Rumoured sightings of strange creatures are also on the rise, though many still dismiss these as products of overactive imaginations, or at worst sightings of humanoids mistakenly identified as something else.
Making matters all the more suspicious is the appearance of the Day of Dread. On that day, the absence of magic is thought by some to temporarily weaken the seals on the Outer Beings' prisons, even though those were not fashioned with mortal magic. On those days, mental illnesses are believed to worsen overall, and the prevalence of nightmares increases.
Treatment and Therapy for the Mentally Insane:
Charitable organisations, temples, and the like have noted increasing numbers of people seeking counsel and aid against "horrible monsters" and "things which should not be". Some of these are surely the products of overactive imaginations, or chance encounters in dark alleys, but others continue to boggle observers and scholars. Although most people coming to these facilities are in a state of mild shock, or otherwise stunned, others have been admitted as raving lunatics, screaming about things they have seen that are just too horrid to behold, creatures that do not even remotely resemble any normal creature they have seen. In more developed nations, where there are means to care for such individuals, some of these victims might be treated, and possibly cured. In less-developed nations, such raving madmen are often abandoned, and left to wander the streets.
Availability of Treatment:
In a medieval world such as Mystara, there are few places where those who are driven insane may find treatment. In most cases, the life of a madman is cruel, and short. Most people tend to shun them, seeing them as cursed, or possessed by evil spirits or in the service of some evil Immortal, but this unfriendly treatment can extend all the way to open hostility towards the insane person, or treating them as some sort of amusement. Nations where treatment is available may not view the insane any more kindly - they may even consider treatment facilities as a means of getting rid of the problem - but the facilities are there for those who can afford them. Exceptions to this include sanctuaries run by religious orders or charities. In the former case, services might be provided in exchange for conversion to the faith providing the treatment, the provision of an annual tithe to the church or temple, or the performance of various tasks benefiting the religious order. Charities are much rarer, being run by wealthy "philanthropists" as a means of reducing their tax burden (in nations where tax deductions are given for charitable acts), or out of an honest desire to help others. In the latter case, such operations often survive through frequent donations, and their stability is tenuous at best, or, in very rare cases, a true humanitarian is providing some of his or her own wealth to run the facility.
In addition to these, some facilities are also run by wizards, though not for the benefit of the patient. Scattered across the more developed nations of the Known World are institutions run by wizards whose sole aim is to perform heinous experiments on their patients, out of a morbid curiosity concerning their insanities and how they might have been caused. In these places, patients are considered little more than test animals, and they are treated as such; the wizards who run them know that few people will care whether a mentally ill person lives or dies, and so they operate with impunity in many nations.
In the Known World of Mystara, the following nations are sufficiently developed to provide psychiatric treatment of the sorts described above, on a wide scale (i.e.: one facility available per 10,000 people):
Alphatia, Darokin, Glantri, Shadowelven Kingdoms, Thyatis, Ylaruam.
The following nations can provide psychiatric treatment of the type described above on a moderate scale (i.e.: one facility available per 20,000 people):
Alfheim, Heldannic Territories, Kastelios, Minrothad Guilds, Rockhome, Wendar, Yavdlom.
The following nations can provide psychiatric treatment of the type described above on a low scale* (i.e.: one facility per 40,000+ people):
Five Shires, Karameikos, Hule, Ierendi, Sind.
*Please note that "low scale" does not imply a lack of social development. The nation might be too poor to make such facilities financially feasible, or the population base is not large enough to support them. Other reasons could include a low incidence of insanity among the populace, different methods of treating insanity that do not require formal care, or a reverence of insanity as an exalted state of being (as might be the case in Hule). This also applies to nations not listed here.
DMs should also note that, just because a given nation has a stated availability of treatment, this does not mean that such treatment is readily available at that level, or even affordable. For example, Darokin is listed as being capable of supporting one facility per 10,000 people, such that, for a city like Selenica (pop.: 40,000), there may be up to four asylums within its walls. It could only have one asylum, though, and even then, that one asylum could be a small one, capable of treating only up to 30 people. The figures given above should be considered as a guideline; just because a person is in a developed nation, it does not mean that treatment will be accessible, or affordable.
Type of Treatment:
The types of treatment available to the insane at these facilities is quite different from that we come to expect in our own world. In a world of magic, there would be very little incentive to develop medicinal or surgical techniques to resolving the problem. In those countries where psychiatric care is more widely available, there are growing fields of research in the areas of the causes of insanity, its effects on the average person, and magical cures to aid victims in recovering from the illnesses. The length of treatment can vary, depending on the nature of the ailment, but as a general rule, it lasts at least 3d6 months, and possibly as long as a year or more.
Magical treatment can consist of regularly-prescribed potions or salves, and can extend to spells cast upon the victim. Non-magical treatment, where it exists, would consist of regular interviews or discussions with the patient, in which the therapist attempts to help the patient deduce what is bothering him or her, and find a way of resolving it - psychoanalysis. In facilities run by religious groups, insanity is sometimes attributed to heresy, and only through conversion or the admission of sins will it be cured. In Sind, where emphasis is placed upon sound minds and bodies, some monasteries have been known to shelter the insane, using yogic exercises and meditation to treat people, sometimes with miraculous results.
As a final note, "quackery" is rife in Mystaran psychiatry, with roving "experts" travelling the byways of the Known World, plying their "magical" cure-alls and imploring upon the Immortals to cure the afflicted, all in exchange for readily available sums of money. Some of them have been known to falsely diagnose people of mental problems they did not know they had (and which do not even exist), in order to boost their own standards of living. Due to the relative novelty of psychiatry on Mystara, no nation has yet enacted a series of laws, or a code of conduct, by which all psychiatrists and therapists must act. As such, quackery is not illegal in itself, but the associated acts (theft, wilful deceit, peddling without a license) most certainly are.
The Typical Asylum:
Most facilities for treating the insane are simple affairs: average-sized buildings containing living quarters for patients, and offices and general purpose rooms for the usage of staff. Living conditions in these asylums vary greatly, ranging from comfortable in well-funded facilities, to abysmal in those that have fewer resources. The better-equipped, and more expensive, facilities often have large walled enclosures surrounding the building itself, where patients can walk outside and relax, or exercise. In most cases, well-funded asylums are kept separate from urban areas, in order to isolate the patients from the rigours of the city, as well as keep them out of sight. Asylums in urban areas, especially those that are squalid, offer little insulation for their patients, and in some cases, cityfolk will visit these places as a means of amusing themselves, by watching the insane go about their activities.
Most asylums tend to be rather small, being capable of treating 11-30 (10 + 1d20) patients at any one time, plus a few rooms for overnight staff (in case patients get violent during the night). Staff is also quite small, being roughly 3-8 people (1d6+2) in most asylums, most of these being caregivers or supervisors. In all asylums there is at least one psychiatrist, or at least a general theoretician in the study of mental illnesses. This person may or may not be a magic user or cleric. In larger facilities, there is also a small group of administrative clerks as well, who balance the books and maintain records of each patient's progress. Where there are not enough resources to hire such people, the caregivers or supervisors themselves will take on these jobs.
Cost of Treatment:
Due to its rarity on Mystara, psychiatric care, even that of poor quality, is very expensive. Even in developed nations, most people would have to travel considerable distances to find an asylum, and even then their capacity to handle patients is very limited. Most average-sized asylums could not greatly exceed their maximum capacity, before the workload would begin to exhaust the staff. Fees are usually assigned on a weekly or monthly basis, covering accommodation, food, staff salaries, and treatment. Most asylums will "encourage" payment in advance, for a specified period of time according to a contract, as well. This of course does not apply to those facilities run by wealthy philanthropists, or religious groups, who will provide services for a nominal fee, or a tithe or conversion in the latter case. If the facility in question is not run by a wealthy religious group or a philanthropist, funding is always a concern. There are always problems in ensuring staff is paid regularly, and enough food is available for the patients. Some facilities, desperate to make ends meet, or morally bankrupt, have been known to sell their "hopeless" patients - those they do not think they will be able to cure - to any who offer a decent price. All too often, these patients are sold to wealthy, misanthropic wizards, some of whom run asylums of their own. As mentioned above, life in these facilities is anything but pleasant, nor is it likely to be very long.
In general, the basic cost of caring for a patient depends on the location of the asylum. In large urban areas, where resources are abundant, the cost will tend to be lower than in isolated locations. The chart below provides some guidelines for determining the monthly costs of treating someone, based on the type of locale and size of facility:
| Type of Locale* | Size of Facility** | Minimum Monthly Cost of Treatment*** |
| Urban | Small | 4 gp |
| Rural | Small | 6 gp |
| Urban | Medium | 7 gp |
| Rural | Medium | 10 gp |
| Urban | Large | 12 gp |
| Rural | Large | 20 gp |
*The type of locale is divided into urban and rural regions. "Urban" is defined as a region in which the population is centred on a settlement that is town-sized or larger (1,000 inhabitants or more). "Rural" is defined as a region in which the local population is less than 1,000.
**The size of the facility is subdivided into "small", "medium", and "large" facilities. Small facilities can house 11-30 (10 +1d20) patients, and have 3-8 (1d6+2) staff members. Medium facilities can care for 21-40 people (20 +1d20), and have 8-16 (8 + 1d8) staff members. Large facilities can accommodate 31-70 (30 + 2d20) patients, and employ 16-25 (15 +1d10) staff members.
***By adventurers' standards, these fees may seem small, but they are very expensive to the average peasant. Large, well-equipped facilities charge more per month than many families make in an entire year. This cost takes into account salaries for staff (with psychiatrists being the most expensive, and large facilities possibly attracting spellcasters willing to spend a few hours per month providing magical aid), food, the cost of accommodation itself, and other factors. Although a larger size does defray some of the costs, having a larger number of patients erodes much of the advantage.
Some asylums have been known to offer their services in exchange for services rendered, especially to those families clearly in need, yet lacking the necessary money. As a rule, this happens rarely, but when it does, relatives of the patient often find themselves performing menial tasks the staff do not wish to do.
Horror Ratings & Horror Checks:
Mystara is a world of magic and wonder, but it still contains its menaces. Though adventurers become accustomed, over the course of their careers, to monsters of many types, there are still some creatures that fundamentally disturb even the staunchest minds. Many of these creatures are the foul progeny of the Outer Beings, while others have their origins in the Dimension of Nightmares. Regardless, all of these creatures have certain attributes which, for whatever reason, have been known to disturb fundamentally the mental balance of many people.
The table below classifies each otherworldly or horrifying creature according to a "Horror Rating", which is measured on 1d20. When such a creature is encountered, the DM makes a secret "Horror Check" by rolling against the creature's Horror Rating. If the number rolled is equal to or less than the creature's Horror Rating score, the person who met the creature may develop an insanity as a result of the encounter. Please note that the descriptions of the creatures listed here are available in the source indicated.
| Creature | Source | Horror Rating |
| Athach | Rules Cyclopaedia | 4 |
| Beholder (& Undead Beholder) | Rules Cyclopaedia | 6 |
| Brain Collector (Neh-Thalggu) | AC 9: Creature Catalogue | 10 |
| Diabolus | Wrath of the Immortals | 2 |
| Hag, Sea | Rules Cyclopaedia | 7 |
| Haunt | Rules Cyclopaedia | 3 |
| Lich | Rules Cyclopaedia | 3 |
| Malfera | Rules Cyclopaedia | 11 |
| Medusa | Rules Cyclopaedia | 4 |
| Minion of Rasthz the Many-Mouthed | The Book* | 4 |
| Mummy | Rules Cyclopaedia | 3 |
| Nekrozon (Catoblepas) | Rules Cyclopaedia | 2 |
| Nuckalavee | Rules Cyclopaedia | 6 |
| Outer Being | The Book* | 20 |
| Phantom | Rules Cyclopaedia | 3 |
| Servitor of Ubbeth | The Book* | 2 |
| Servitor of Yurrgh-Thal, Greater | The Book* | 13 |
| Servitor of Yurrgh-Thal, Lesser | The Book* | 7 |
| Soul Render | The Book* | 7 |
| Spectral Hound | Rules Cyclopaedia | 3 |
| Spirit | Rules Cyclopaedia | 5 |
| Zhochal (Minion of Akh'All) | The Book* | 3 |
*"Geoff's Big Book of Unspeakable Outer Being Lore" - available on several websites.
Other Ways of Triggering Horror Checks:
Encountering frightening creatures is not the only means by which a Horror Check can be triggered; situations can also cause them. The list below contains events that could, at the DM's discretion, force a person to make one. This list should by no means be taken to be exhaustive:
| Event | Horror Rating |
| Seeing a corpse for the first time | 2 |
| Seeing a horribly mutilated corpse or severed body part for the first time | 4 |
| Witnessing the murder of a loved one | 4 |
| Undergoing extreme torture | 3 |
| Being subjected to fleshcrafting (minor alteration) | 4 |
| Being subjected to fleshcrafting (major alteration) | 8 |
| Being subjected to a Shadow Master's harrowing power | 5 |
Determining Insanity:
Having determined whether or not a person has failed their horror check, the DM must then find out what sort of insanity will be inflicted upon the victim. This is determined in part by the creature's Horror Rating, as well as other modifiers, which are described below:
Horror Rating Modifier:
This modifier, positive or negative, reflects how frightening or otherworldly the creature in question appears. Negative modifiers derive from low Horror Ratings, and reflect beings that either do not appear very frightening (or they just appear "odd"), or their forms do not deviate very much from what most people interpret as "normal". Positive modifiers are the result of higher Horror Ratings, which signify that the creature is either very horrible to look at, or their appearance is just so bizarre that people have a great difficulty reconciling its existence in a "rational universe". The simple table below presents the various Horror Ratings, as well as the modifier that is derived from them.
| Horror Rating | Insanity Check Modifier |
| 1-2 | -20% |
| 3-6 | -10% |
| 7-9 | NA |
| 10-14 | +10% |
| 15-18 | +20% |
| 19-20 | +30% |
Wisdom Modifier:
This modifier reflects the bonuses derived from having a high Wisdom. Those with high Wisdom scores are blessed with more common sense, and have a greater ability to see through illusions to the truth the lies underneath. Such people, given their greater mental fortitude, know that there are certain things in the universe that conventional knowledge does not touch; they are better able to rationalise the existence of "darker" creatures. The table below presents the Wisdom modifiers for use in an Insanity Check:
| Wisdom Score | Insanity Check Modifier |
| 3 | +15% |
| 4-6 | +10% |
| 7-8 | +5% |
| 9-12 | NA |
| 13-15 | -5% |
| 16-17 | -10% |
| 18 | -15% |
Other Modifiers:
The table below, by no means exhaustive, presents other modifiers the DM may wish to consider in rolling an Insanity Check. These modifiers are situational, and cumulative:
| Situation | Insanity Check Modifier |
| Victim is already suffering a mental disorder | +10% |
| Victim has lost 50% of hit points or more | +5% |
| Victim has already made a successful Horror Check* | -10% |
| Victim has been blessed | -5% |
| Victim is carrying a holy symbol of some form | -5% |
| Per level of experience | -1% |
| Victim is an Illusionist or Phantasmer | -15% |
*This bonus is applicable only in Horror Checks against that same creature, not against a different one; it is not cumulative. For example, a PC encounters a Zhochal for the second time in one day. In the first encounter with these creatures, a Horror Check was made successfully, and thus the PC gains a bonus of -10% to the Horror Check against this particular Zhochal. If he or she makes this Horror Check and encounters a third Zhochal, the PC does not gain a -20% bonus. If the second creature encountered is different, this bonus does not even apply. If, in subsequent encounters, the Horror Check is failed, this bonus is lost, and must be regained by passing a Horror Check once more.
Once all of the relevant modifiers have been summed, that final number is the modifier that is applied against an Insanity Check. The base chance of suffering some form of mental malady as a result of the encounter is 50%. If the number rolled is less than the modified Insanity Check score, the person in question momentarily loses their sanity, and may suffer some form of ailment afterwards.
Losing Sanity:
When an Insanity Check has been failed, the victim momentarily loses his or her sanity, in which the victim is stunned and gibbering for 1d4 rounds, and could also acquire a permanent mental illness. The chance of developing such a malady is determined by how much the victim fails his or her Insanity Check. If the check is failed by 20% or more, the person develops a permanent insanity, in addition to temporarily "going insane". Permanent insanities vary according to the situation, and the DM should exercise his or her own discretion in assigning a specific insanity. The sample table of insanities below should not be construed as a definitive one; efforts have been made to cover the various mental illnesses on as general a level as possible, so as to be of use to those DMs who wish only the basic details. A more comprehensive, but by no means clinically accurate, overview of mental illnesses should consult the Complete Guide to Sanity for Fantasy Role-Playing Games, a netbook that is readily available on many websites.
| 1d12 Roll | Type of Permanent Insanity Developed |
| 1-2 | Phobia |
| 3-4 | Personality Disorder |
| 5-6 | Nervous Breakdown |
| 7-8 | Multiple Personality |
| 9-10 | Delusion |
| 11-12 | Amnesia |
Phobia: The victim acquires an intense fear of an object, place, being, or other element deriving directly or indirectly from the encounter. For example, a traumatic encounter that took place in a dungeon might make the victim claustrophobic (as they might subconsciously equate enclosed spaces with the encounter), or an insanity developed at sea might make the person hydrophobic. The DM has the final word as to what sort of phobia this might be. Regardless of the phobia type, whenever the person is subjected to the trigger for that fear, he or she must make a save vs. Spells at -4 or be rendered helpless with numbing fright for 1d6 turns. His or her only thought will be to flee from the source of the trauma.
Personality Disorder: This is a catch-all for a host of psychological problems a person may develop, such as obsessive-compulsive behaviour, paranoia, avoidant personality disorder, or passive-aggressive tendencies. The DM is also free to develop other disorders in this vein. All of these disorders are present at all times; there is no event or object to "activate" them. Some of them, such as paranoia, may lead to alienation from society as a whole.
Nervous Breakdown: The insanity-inducing experience is so traumatic that the victim cannot function as an individual. Everything is a potential stimulus for further aggravation of the person's condition, and what he or she really needs is a nice, quiet place to recuperate. Shorter-lived races usually require several months of such treatment, while longer-lived races may require several years. It is the DM's discretion as to how much time is needed.
Multiple Personality: Though technically this could be considered a personality disorder, its effect has such a great impact that it merits its own mention. The traumatic experience was so difficult for the victim that he or she "shuts it out" by means of submerging their personality and creating a new one to deal with the situation. Although the original personality should remain dominant for the most part, stressful situations (such as combat) could lead to the re-emergence of the others. Have the afflicted person make a save vs. Spells at -2, and if the save is failed, another personality comes to the fore for a duration determined by the DM, sometimes only as long as the stressful situation itself. Each new personality should be treated as a different character, possibly with a different alignment and skills. The player and the DM should discuss these alternate personalities privately, so as to make role-playing easier. The DM should decide beforehand whether alternate personalities should be allowed to be of a different class.
Delusion: The insanity-inducing experience changes fundamentally the way the victim sees and interacts with the world. This could take the form of an alignment change, for example, or lead to a proper delusion. Delusions are firmly-held conceptions about oneself, others, or the world in general, which are so forceful as to interfere with a person's everyday life, possibly leading to alienation. A delusional person could believe, for example, that his or her thoughts are being broadcasted to everyone within a certain area, or that everything being said has a reference to themselves. Other delusions include megalomania (the person thinks they are the greatest at everything), or delusions of grandeur, nihilism, persecution, guilt, or others. As already mentioned, the victim's perception of everything in general is highly skewed, such that relating to other people is very difficult.
Amnesia: This disorder arises when a
severe trauma is experienced, and the victim's subconscious blocks
out all memories associated with that experience. This could take
the form of not being able to remember any events during the time
of the trauma, or nothing after the trauma or beforehand. For
example, a person may have lost an arm in a battle against a lesser
spawn of the Outer Beings, but he or she afterwards would only know
that they lost the arm somehow. Such a memory loss could entail the
loss of levels, spells, or skills - as determined by the DM.