Delusional Misidentification Syndrome
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Basic Information

There are several different psychological disorders that can cause the sufferer to believe that the people in their lives are not what they appear, and even a few that can lead the sufferer to have such doubts about themself. Many of these are known collectively as Delusional Misidentification Syndromes. We're oversimplifying a little to put all these on the same list, but it's close enough for gaming. Here they are alphabetically, each with a single-sentence description of the false conclusion, false belief, or false perception the condition causes.

See Also:

Other issues that fit a similar theme include:

  • Alien Hand Syndrome - one of your limbs has a mind of its own
  • Apophenia - noticing patterns or connections where they don't actually exist
  • Confirmation Bias - the tendency to only acknowledge evidence that supports your prior beliefs and ignore evidence that disagrees
  • Deja Vu - the feeling that you have lived through this moment or event before when you haven't
  • Gambler's Fallacy - believing that luck (or random numbers) come in predictable streaks and your turn is due
  • Pareidolia - seeing patterns in random stimuli, like faces in the color variations of your floor tiles
  • Paranoia - everybody is out to get you
  • Prosopagnosia - facial blindness, the inability to recognize faces


Game and Story Use

  • The delusions, disorders and syndromes listed above could make for interesting characterization.
  • Or they could be the consequence of sanity damage.
    • Trail of Cthulhu and some other Gumshoe RPGs have interesting madness rules where the GM and other players conspire to make something about the shared consensus reality be different, possibly changing the history of the game. So you might decide, for example, that the PC who failed a mental save now has Fregoli Delusions. You pick two NPCs and make them retroactively same person, with some very good reason for them to go by two names. Every other player is "in on the joke" but you're subtle about it at first so the player of the afflicted character has to figure it out over time.
  • Or, since this is gaming and fiction we're talking about here, they might not be delusions at all. In that context, they might be actual dopplegangers, shapeshifters, mimics, ghosts, tulpa, changeling, secret agents, masters of disguise, confidence artists, or a case of enchantment, mindcontrol, possession, poppet magic, illusion, espionage, necromancy, etc.
  • As always, where mental health is involved, some sensitivity is in order. Know your players, and especially get to know whether or not such topics in game are likely to push people's buttons or ruin the fun.
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