Madness and Trauma: 3 things D&D could learn from Blades in the Dark

I’ve never had a good experience with madness in D&D. Maybe I’m just precious about my characters, but I don’t want a randomized table to determine how they might respond to the horrors of adventuring life. I build upon a character over time, factoring their experiences into their personality and growth to discover who they are. However, when a DM hands me one of D&D’s pre-baked madness symptoms, I commit to the bit for all of five minutes before forgetting it entirely.

The player gets no input; you roll a d100 to determine a symptom, and then you’re handed a one-line prompt. These prompts can be anything from needing a stiff drink, to lashing out at everyone around you, to thinking you’re the most beautiful person in the world. They’re not tailored to the traumatic event, and they’re often too specific to interpret in interesting ways. Moreover, the player isn’t rewarded for acting these symptoms out, they’re just told to do so in the interest of ‘fun’. But if an indefinite madness doesn’t suit a character or their experiences at all, I don’t think there’s any fun to be had.

Now, I’m aware I’m conflating madness with trauma here, but D&D talks about how this optional rule is meant to represent the stresses of adventuring, rather than a brush against an alien god. For that purpose, I think it can do much, much better – and for improvements, I’d look towards Blades in the Dark.

Blades in the Dark is a game about being a criminal in an uncaring gothic hellscape; the world is drowned, the sea is pitch-black, the sun never shines, and ghosts infest the world like rats. Naturally, stress and trauma are a factor: quite literally. Stress is a resource you can manage and spend on various abilities, but it also builds whenever you want to defend yourself from a consequence. If you max out your stress, your character’s taken out of the equation for that session and returns to their criminal life holding a Trauma.

Aside from being a less problematic name (I have issues with calling a trauma response indefinite madness) these traumas are far more realistic and considered in presentation. They have names like “Cold” or “Reckless” or “Vicious”, rather than “I’ve discovered that I really like killing people.” The best part? Not only do you get to choose which trauma your character inherits, but you also aren’t obligated to act them out, either.

You might want to, though, because Blades in the Dark puts a carrot in front of you: XP. The system rewards you constantly for throwing your various spanners into the works, giving you XP for desperate rolls or acting out a playbook’s (problem-causing) traits, such as the “Cutter” being encouraged to resolve problems with violence. These XP rewards also occur whenever you let your traumas impact a situation. Blades in the Dark gives you a choice of how your character has been traumatised, then rewards you for committing to it.

So, how can you add these traumas to your D&D game? First off, allow your players to choose which indefinite madness they inherit. Randomly receiving a trait is annoying, but it’s also a little insensitive. When people experience trauma in the real world, their response to that trauma is tailored to the trauma itself; often in the form of a protective or self-preserving instinct gone haywire. This doesn’t hold true if your character’s response is random, playing into the idea that mental illness is nonsensical and dangerous.

Secondly, keep the afflictions vague enough for exploration. Blades in the Dark’s traumas work well because they don’t bind the player to a specific course of action. There are a lot of ways that recklessness, paranoia, or obsessions could manifest. For example, one of D&D’s indefinite madness conditions decrees its victim must laugh at everything, whereas a Blades in the Dark player can choose to become Unstable, then represent that instability as laughing, crying or raging at the drop of a hat.

Finally, reward players for leaning in. This is harder, as D&D doesn’t reward you for roleplaying often. XP is obtained by defeating (or avoiding conflict with) monsters, and little else. However, I don’t think XP is a good reward for leaning into madness in D&D: while a level disparity between party members in D&D can unbalance combat, Blades in the Dark typically gives you more special abilities when you level up instead of raw statistical power. I’d recommend using the Inspiration system, with a limit of once per session to avoid party dysfunction.

Ultimately, D&D’s madness systems are pretty lacking. They’re an optional rule, but they come across as insensitive, half-baked, and too controlling. A character’s response to trauma should be a personalized one, rather than an assigned, specific quirk. Giving players a choice in the matter, leaving room for interpretation, and rewarding them for doing so are three sure-fire ways to make ‘madness’ an interesting choice, rather than a roleplayer’s burden.