CTRL+ALT+DEL: Trauma as a Play Mechanic

Curious Expedition

The use of video games in the treatment of PTSD is being covered more and more in recent years. However, what about the use of trauma in games as a play mechanic? How does one interpret the short- and long-term effects — often so hard to analyze in real life — into a usable mechanic to interpret mental distress that characters may encounter?

In games, we are often threatened with fantastic events that would never occur in the physical realm, or situations that would be extraordinary in our real lives. The effects of these situations can be interpreted as a character trait or a penalty to the characteristic numbers needed to interact with the world. Trauma can also be treated as a fact of the world so assured that it wears on an established amount of resistance in the player’s mind, thus, the addition of the ‘sanity’ bar or points present.

In many games, trauma wears down a previously set characteristic or stat. It detracts, makes challenges more difficult, and sometimes makes actions previously taken for granted in the game world daunting or impossible. In games, it is often interpreted into numbers in some way — be they percentage scores to determine the success of rolls and interactions, or negative numbers put against attempted actions.

The numbers game is necessary for game worlds where math in dice-based systems to those defined by physics engines introduces chance into an otherwise completely enclosed, controlled world. Occasionally, games break out of the strictly numerical, such as the cutscenes from the Gamecube release Eternal Darkness: Sanity’s Requiem, and possible long-term effects on character role-playing codified in the hyper organized roll tables of Dungeons & Dragons.

For the purpose of this article, I am defining psychological trauma as damage to the psyche as the result of distressing events, and the symptoms — both short- and long-term — of that damage. Directly as it relates to games, this damage must be measured in a quantifiable mechanic that affects gameplay in some way beyond abstract role-playing.

A word on vocabulary: the term ‘sanity’ is used in many games to denote a specific characteristic that is collected or depleted by interactions with trauma. When used in this article, ‘sanity’ is referring to these mechanics as applicable by game, and not in any way meant to reflect real-world uses of this word. This does not mean, however, that we cannot criticize creators’ choices of vocabulary and their approach to handling trauma as a device within storytelling and/or mechanics of a game.

I reached out to Twitter and game creators for ideas and titles to explore. These are far from the only games exploring mental distress, but I believe this is a good starting point.

Eternal Darkness

Eternal Darkness: Sanity’s Requiem

A mechanic that occurs again and again in games surrounding psychologically traumatic events is the sanity bar or point system. These give characters a numeric value interpreted into an amount of sanity, or resistance to psychologically challenging experiences, which are depleted. These can be depleted at a set rate based on number of interactions with the trauma.

Eternal Darkness was released for the Nintendo Gamecube in 2002, but was one of the first video games people suggested when I embarked on this article. The entirety of the game deals with the unknown and the madness it brings.

It begins with a monologue by the deceased Edward Roivas. In it, he says that, “Your perceptions will not change reality, simply color it.” This seems to be how the sanity effects so many games and how it works. While the character is experiencing the effects of sustained trauma on an ailing mind, the events of the game are still happening — usually in physical terms.

The effects of traumatic interaction with the game is one that breaks the fourth wall. Unfortunately, this is all too rare in horror. For instance, upon a loss of sanity, the game might toss up the Blue Screen of Death as if the system has crashed. The first paragraph explains that “a fatal exception” has occurred, and “[t]he current application will be expunged from memory and replaced with more ‘efficient’ software.”

What follows are bullet points offering the user options for restarting their system, finally telling them to “Press CTRL+ALT+DEL over and over to assert your authority over the Operating System guidelines in a futile attempt to regain control.”

Other pranks on your character’s loss of sanity include the TV appearing to shut off, switch modes, or muting the audio. In an attempt to frustrate the player, chapters in the story (you can interpret these as levels) might end with a cutscene explaining that the storyline will be resolved in an upcoming release, and that the game installment is now over. The game might display an error message that your controller is disconnected before a large battle. In these ways, the game creates stress for the player if their character’s mind is not looked after.

There are also other effects on the character: dark visions of oneself can occur, and typically horrific elements will appear in the environment, such as sourceless blood and flying books. The player’s interaction with their character is affected, too: the sound effects will become louder and the camera angle more skewed the more sanity lost.

While some of the effects are specific to the level being played, many are the result of a depleted Sanity bar. This bar can be depleted by an enemy seeing you, and restored using a spell.

Curious Expedition

Curious Expedition

Curious Expedition’s sanity system involves marking the mental exhaustion of traveling through foreign lands simply by moving. While your party can be injured, poisoned, and develop infections, the most pressing concern is the ever-depleting sanity bar. Points of sanity must be sacrificed to move forward on the map, though combat, tomb raiding, and interacting with locals does not affect it. While resting in certain places and eating or drinking things can bolster you against the pressing mental pressures of survival, resting takes days and eating or drinking provide few comforts against the omnipresent danger to explorers.

The more aggressively you delve into the unknown, the faster your sanity leaves you and your party. The longer one’s stay on a foreign continent, the faster party members will seem to jump from 1 to cannibalism. And yes, you can be cannibalized, too — by those whose minds you’ve neglected too long.

This game makes use of the sanity bar, though the points available are always listed for the player to see. This is because each move costs a certain amount of sanity based on Perks, whether or not the part is encumbered, and some other factors. The amount of sanity something costs is never hidden. Instead, it becomes a calculation on part of the player how much can be sacrificed in order to discover more of the continent and get closer to your goals.

In Curious Expedition, sanity and the trauma of the unknown that wears on it is collective to your party. No matter how many or how few, whether they be animal or human, the party’s collective sanity reflects morale inspired by its leader. The specific causes of sanity loss tend to be implied, rather than cause-effect. It seems to be the unknown and moving through the landscape that most contributes to a lower bar, though party members can get poisoned, have wounds infected, and become ill independently.

Even seeing all the cards of your sanity, the continent’s identity is completely alien to you. This means it is still a gamble to move across it. Will you use the last of your party’s morale to make a run for the temple a villager told you was on a certain square of the map, only to find out there is a mountain range between you and it?

Curious Expedition is still being developed, but is currently available on Steam in an Alpha Access version that can be upgraded to the full game upon release.

Eternal Darkness

The broad scope of experiences identified with trauma make its interpretation into a mechanic almost impossible. Video games require broad definitions to allow access to their narratives by a diverse population of people. Even games one could describe as ‘open world’ must prescribe to sets of rules of interaction defined by series of numbers and code that can only mimic real-world physics and human communication in simplistic ways.

This means that the experience of playing a video game is strictly controlled, and often fails to accurately represent something like trauma. Instead, its mechanics become so generalized that the result of trauma becomes just one element of character building — on par with gaining experience in weaponry or becoming stronger.

This is where thoughtful storytelling is needed: to fill in the weaknesses of mathematically defined mechanics. In the case of Curious Expedition, this storytelling relies largely on sparsely parsed narration that requires the player to fill in the blanks outside of game. The other option is to take the narration as it comes, and treat the sanity meter as another stat in a numbers game to build emotionally affected, but weakly characterized protagonists.

Unlike the programmed worlds of video games, tabletop role-playing games offer a flexibility of portrayal and use of the results of trauma as a collaborative experience between Game Master and players. Rules systems vary from rigid to fluid, but at the table, there are possibilities for more variance in dealing with traumatic experience.

In the next installment, we will be exploring the trauma mechanics of tabletop role-playing games Chill, Call of Cthulhu, and Dungeons & Dragons.


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