Spiders in your Mind
Derangements
I have seen Agnes’s affliction before, though never in adults.
My sister Margaret was a normal child before the headaches.
Her speech slurred, hands grasping as if working a cow’s
udder. Father beat her to stop the twitching gasps. Margaret
loved the outdoors, but now she was not permitted lest
neighbors spy her affliction. Even Mother became frustrated at
how Margaret insisted on sorting herbs into insensible
patterns. Mother was unsurprised when the fever took
Margaret, treating the shudders and rheum with cow bile,
eggs, and nettle tea with milk. When the moon grows heavy, I
shall entreat Agnes to ply the kine with nettle rather than wine,
that blood may salve both body and soul.
— Matthias, childe of de Lille, childe of Agathodaimon,
childe of Rayzeel
From Vampire: the Mascarade Rulebook
Derangements are behaviors that are created when the mind
is forced to confront intolerable or conflicting feelings, such
as overwhelming terror or profound guilt. When the mind is
faced with impressions or emotions that it cannot reconcile,
it attempts to ease the inner conflict by stimulating behavior
such as megalomania, bulimia, or hysteria to provide an
outlet for the tension and stress that the conflict generates.
Vampires or mortals receive derangements under
conditions of intense terror, guilt, or anxiety. If a player
botches a Virtue or Willpower roll (for example, when
confronted with Rötschreck), the Storyteller may decide that
the experience causes a derangement in the character. Other
examples of derangement-inducing events include killing a
loved one while in a frenzy, being buried alive as part of a
Sabbat ritual, or seeing hundreds of years of careful
scheming dashed in an instant of bad luck. Generally, any
experience that causes intense and unpleasant emotion or
thoroughly violates a character’s beliefs or ethics is severe
enough to cause a derangement. The Storyteller determines
which derangement a character receives, working with the
player to choose (or create) one appropriate to the character’s
personality and the circumstances of the event that caused
the disorder.
It must be noted that people who are “crazy” are neither
funny nor arbitrary in their actions. Insanity is frightening to
those who are watching someone rage against unseen
presences or hoard rotten meat to feed to the monsters that
live next door; even something as harmless-sounding as
talking to an invisible rabbit can become disturbing to
observers. The insane, however, are only responding to a
pattern known to them, stimuli that they perceive in their own
minds. To their skewed perceptions, what’s happening to
them is perfectly normal. Your vampire’s derangement is
there for a reason, whether he’s a Malkavian who resided at
Bedlam before his Embrace or a Ventrue pack member who
escaped from five months of torture at the hands of an
Inquisitor. What stimuli is his insanity inflicting on him, and
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how is he reacting to what’s happening?
The player should work with his Storyteller to create a
pattern of provocations for his derangement, and then decide
how his character reacts to such provocation. Derangements
are a challenge to roleplay, without question, but a little time
and care can result in an experience that is dramatic for all
involved.
From Vampire: the Dark Ages Rulebook
Players can use Derangements to show a different side of the
character, or to show how their human side deals with itself
during times of stress. If the character doesn’t succumb to
frenzy, it can be an opportunity to reinforce those human
traits. Besides indicating how a vampire’s mind fractures
under the weight of ages, Storytellers can also use
Derangements to emphasize the different parts of the
vampiric experience: Dyscrasia is a purely material concern
(internally focused), whereas Divine Displeasure is a curse
from outside the character, dealing with the wider spirit
world around the Cainite. Sins of the Soul deal with the
religious nature of the character’s unlife, a major force in the
existence of many around the vampire.
Much of the learned knowledge describing Derangements
in the Dark Ages derives from the work of the ancient
Greeks, who held the result of a mind’s illness to be from
organic causes, namely the deficit or surplus of humors
within the body. Muslim scholars of the era codify and
extrapolate from the Greek texts. Christian clergy, on the
other hand, holds that Derangements stem from moral flaws
in the individual, sins and vices cracking open the soul and
allowing demons to nest within. No few animist cults, or
those descended from ancient religions, hold Derangements
to be supernatural in cause.
From the Guide to the Sabbat
Bear in mind that a derangement is far more than a simple
mechanical penalty to a character - they are the scars left
after a character's struggle with the monster he has become.
Derangements should have a significant impact on the
character's development and behavior, and are excellent
opportunities for intense roleplaying. Storytellers may wish to
penalize players who neglect their derangements except
when the rules absolutely state they must take some action by
withholding experience points. Derangements are rarely "on
and off" affairs; some degree of the character's emotional
erosion should come through in almost every action he takes.
Astute players and Storytellers will note that derangements
tend to set the player up for further frenzies, botches and
ultimately, more derangements. Such is the nature of the
Beast, ad such is the inexorable slide into damnation.
 The level of a clan Discipline is higher than the other two
Roleplaying Derangements clan Disciplines together.
The level of a non-clan Discipline is higher than any clan
Derangements create challenges for the player to solve, but Disciplines.
they’re not intended to provide an impediment to play. The character has multiple powers of the same level of the
Derangements are aspects of a character that frequently Discipline.
impact their unlives negatively, and subsequently require The character has reached her maximum potential in the
adjustments to their interactions to manage or avoid this Discipline without reaching at least level 5 in another.
negative impact. Most Derangements lie somewhat dormant, The character has botched uses of the Disciplines several
with their traits present in small mental and verbal traits or times recently.
tics and only manifesting fully during periods of stress — The character has repeatedly achieved phenomenal
generally, most stimuli that could potentially cause frenzy or results (six or more successes) while using the Discipline
any stress that calls for a Self-Control or Instinct roll will recently.
automatically trigger a Derangement. The player and The character relies heavily on using the Discipline, even
Storyteller should agree on what stimuli triggers the when it is not necessary.
Derangement for the character. Once the stress triggers the The character has learned or advanced in the Discipline
Derangement, it remains in effect for the rest of the night. By as a result of diablerie.
spending a Willpower point, a Cainite may experience a
single turn of lucidity, holding the Derangement at bay by Temporary Discipline derangements fade when the
sheer force of will. Each Derangement stipulates how it conditions that brought them about no longer apply, while
affects vampires; while mortals much the same way vampires permanent Discipline derangements are just that. They may
can, the actual mechanical effects are up to the Storyteller. eventually be overcome just as other derangements, but the
character cannot find a cure by simply refraining from the
use of the Discipline that brought on the derangement; it
Generic System lingers on.
The system effects of derangements vary from case
to case. They usually result from having botched a
Virtue roll or experienced a truly traumatic event.
Use of Merits and Flaws
When appropriate, the Storyteller can ask a Aside from the list below, many Mental, Social or
deranged character’s player to roll Self-Control or Supernatural Merits and Flaws could be used as inspiration
Instinct to resist a derangement overcoming the for "new" derangements. A merit could be reversed, while a 1-
character when presented with a relevant stimulus. pt flaw should be amplified. When doing so, of course, the
The difficulty ranges from 5 to 8 depending on bonus or penalty in freebie points is disregarded.
the power of the stimulus. Most of these "new" derangements would probably fall into
one or more of the derangements described therein, but with
a definite or specific flavor that could make them more
Discipline Derangements unique.
(Source: Player's Guide to High Clans.)
While a Cainite who possesses advanced levels of one or
more Disciplines might have incredible power at her disposal,
such power can (and often does) also begin to affect her
mentally. Just as some mortal lords become corrupt
and degenerate because of the power they wield
over their fellow humans, a Cainite might find her
sanity eroded by the powers of the Gifts of Caine.
When to afflict “Discipline Derangements” is ultima-
tely up to the Storyteller. Below is a list of conditions that
indicate that a Discipline derangement might develop. In
general, only characters who have a Discipline at level 6
or above are in danger of developing Discipline
derangements, but if the player and Storyteller agree,
such a derangement might come at earlier levels. If a
character fulfills three conditions, she is in serious
danger of receiving a temporary derangement.
Fulfilling five or more conditions might inflict a
permanent derangement. The derangements
appropriate to each Discipline are listed in their
own section.

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 List of Derangements
Modern Derangements
Derangement Page Derangement Page Derangement Page
Aboulomania 12 Fantasy 6 Obsessive-Compulsive 9 / 14
Acute Sanguinary Aversion 12 Fits 7 Overcompensation 9
Alien Hand Syndrome 12 Fregoli's Delusion 13 Paranoia 9
Amnesia 5 Fugue 7 Pathohypochondria 13
Antisocial (Sociopathy) 5 Gluttony 7 Perfectionism 10
Avoidant 5 Habbakuk's Achronia 13 Phobia 10
Barklay's Complaint 12 Histrionic 7 Post-Traumatic Stress Disorder 10
Berserk 5 Hysteria 7 Power-Object Fixation 10
Bigorexia 12 Intellectualization 7 Quixotism 13
Bipolar Disorder
5 Jumping Frenchmen Disorder 13 Regression 10
(Manic-Depression)
Blood Sweat 5 Laudau-Kleffner Syndrome 13 Sanguinary Animism 10 / 15
Borderline 5 Leroi's Compulsion 13 Sanguine Personality Disorder 13
Bulimia 6 Lunacy 7 / 14 Self-Annihilation Impulse 11
Capgrass Syndrome 12 Macropsia/Micropsia 13 Schizoid 11
Catatonia 6 Masochism 7 Schizotypal 11
Cotard's Syndrome 12 Megalomania 8 Schizophrenia 11
Dependant 6 Melancholia 8 Stendahl Syndrome 13
Desensitization 6 Memory Lapses 8 Surgical Addiction 13
Dissociative Blood-Spending 6 Multiple Personalities 9 Synthesia 12
Drapetomania 12 Narcissistic 9 Truman's Syndrome 13
Face Blindness 13 Nyphomania/Satyriasis 9 Visions 12 / 15

Discipline Derangements
Derangement Page Derangement Page Derangement Page
Animal Personification 15 Disregard of Human Form 16 Plague's Bride's Contagion 16
Blood Fetishism 15 Empathic Blindness 16 Psychometric Repetition 16
Caise's Unreliability 16 Hyper-Evangelism 16 Telepathic Schizophrenia 16
Compulsive Invibility 15 Illusion Addiction 16 Thaumaturgical Glossolalia 16 / 18
Disdain of Weakness 15 Lack of Survival Instincts 16 Unconscious Influence 16
Dissociative Perceptions Syndrome 15 Novothesia 16 Unconscious Thought Reading 16
Disorientation 15

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Dark Ages Derangements Tremere-Specific Derangements
Derangement Page Derangement Page
Cholerics 14 Hierarchical Sociology Disorder 18
Compulsion 9 / 14 Sanguinary Cryptophagy 18
Melancholics 14 Thaumaturgical Glossolalia 16 / 18
Phlegmatics 14
Ghoul-Specific Derangements
Sacred Disease (Epilepsia) 14
Derangement Page
Saint-Vitus's Dance (Sydenham's Chorea) 14
Animalistic Hysteria 19
Sanguinary Animism 10 / 15
Dependent Personality Disorder 20
Sanguines 14
Self-Defeating Personality Disorder 20
Visions 12 / 15
Severe Dysmenorrheic Psychosis 20
Voices 15
Sexual Dysfunction 20

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Modern Derangements
Amnesia
Amnesiac characters blot out some part of their past, perhaps
a horrific incident (for example their Embrace) or even a
whole period in their lives. The reasons for this memory loss
are almost always stress-related, though physical injury may
cause a similar effect. Amnesia usually affects just memory,
but in some cases, a character may forget some Abilities and
be unable to use them, or be surprised by his ability to do
certain things. (Amnesia can be represented by its Flaw.)
Antisocial (Sociopathy)
This label might be considered a misnomer, as people with
antisocial personality disorder are not necessarily shy or
reclusive, nor do they lack social skills as schizoids or
avoidants do. Often times, the opposite is the case —— a
person is very socially domineering, even aggressive.
Antisocial personality disorder refers to a lack of compassion,
empathy and superego/conscience. The person simply cannot
care about any being other than himself, and almost always
places his own wants and needs above those of others.
People with this disorder casually lie, steal, cheat and exploit
— and a few even rape and kill. Most psychologists and law
enforcers consider this the “serial—killer disorder." Ted
Bundy, John Wayne Gacy and other notorious monsters are
classic examples of offenders who, while legally sane and
capable of making moral distinctions, simply don’t care.
Psychopathy is a severe form of this derangement.
Most Cainites develop this dysfunction to some degree.
Indeed, it can be seen as the flagship disorder of Humanity
loss. Sufferers may transition this condition into the Fugue
derangement (Vampire, p. 224) as the worst of their
dismissal of others is blanked out, even routinely.
Avoidant
Avoidant personality disorder is characterized by extreme
social anxiety. Vampires with this condition often feel
inadequate. avoid social situations, and seek isolation in their
nightly routines. They fear rejection and social humiliation,
often needlessly so. They prefer routine and exaggerate the
potential difficulties of new situations to rationalize avoiding
them. Some display an imaginative bent, creating fantasy
worlds in which they are dominant, loved or triumphant.
Unlike schizoid personality disorder, avoidant people yearn
for social relations yet feel unable to obtain them. They are
frequently depressed and have low self—confidence.
Vampires with this disorder typically have low Social
Attributes and low Willpower. Uncontrolled. they can
succumb to the Manic—Depression or Paranoia
derangements (see Vampire. pp. 223—224).
Berserk
The berserk individual has tremendous difficulty controlling
his feeling of anger and frustration. When confronted with
stressful situations, a berserk individual often loses control,
lashing out against his transgressors (or whomever he
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perceives to be a transgressor) with blind rage.
Berserk individuals are increasingly common among the
Sabbat; the blood lust and violence of the sect seems to breed
this sort of madness. Additionally, a berserk manner often
paves the way to other derangements, as the uncontrollable
vampire finds himself ever more often in the thrall of the
Beast.
Berserk Cainites suffer a +2 difficulty to their rolls to avoid
frenzy.
Bipolar Disorder
(Manic-Depression)
Bipolar individuals suffer from severe mood swings,
sometimes resulting from severe trauma or anxiety. Victims
may be upbeat and confident one moment, then
uncontrollably lethargic and pessimistic the next.
Kindred with this derangement are constantly on a hair
trigger, never knowing when the next mood swing will strike.
Whenever the vampire fails a task, the Storyteller has the
option of secretly making a Willpower roll (difficulty 8) for the
character. If the character fails the roll, she lapses into
depression. Additionally, the vampire will go into depression
whenever one of her rolls is botched, or if her blood pool ever
drops below 2. The Storyteller should roll a die to determine
how many scenes the character remains depressed, keeping
the number a secret.
Vampires in a depressive state have their Willpower ratings
halved (minimum 1). In addition, the vampire may not access
her blood pool to raise Attributes. Upon emerging from the
depressive state, the character is energetic, relentlessly
upbeat and active (obsessively so) for a number of scenes
proportionate to the time spent in depression. When a
vampire is in this manic state, the difficulty of all rolls to
resist frenzy is raised by one.
Blood Sweats
In rare cases, a vampire may become so nervous and agitated
that his state of mind affects his body. Much as a mortal may
exhibit jumpiness and cold sweats, the vampire can become
likewise ill at ease. The "sweat" in the case of vampires,
however, is composed of blood that works its way to the
Cainite's skin. Many other vampires find this particularly
disturbing, as the sweat stains clothes and makes the
vampire in question a horrid sight to look upon. Obviously,
this causes a few uncomfortable situations in which mortals
are involved as well.
A vampire with blood sweats excretes an additional blood
point worth of vitae over the course of every night he rises
from slumber. This blood is almost always very obvious,
though by judiciously wiping his brow and changing clothes,
he may briefly appear "normal" before displaying beads of
collected blood-sweat again. Additionally, the character
should act twichy and unnerved.
Borderline
Vampires with borderline personality suffer from mood
instability and low self—image. Constant, sudden mood
swings and bouts of anger characterize sufferers of this
disability, particularly when frustrated. Borderline victims
sometimes takeout their anger on themselves,
masochistically inflicting injury or even trying to kill
themselves. They think in very blackvandhite terms and often
form intense, conflict ridden relationships.
Borderline Cainites might succumb to the Manic-
Depression or Hysteria derangements (Vampire, p. 7.24).
Bulimia
Individuals with bulimia assuage their guilt and insecurity by
indulging in activities that comfort them — in this case,
consuming food. A bulimic will eat tremendous amounts of
food when subjected to stress, then empty her stomach
through drastic measures so she can eat still more.
In the case of vampires with this derangement, the need to
feed is a means of relieving the fear and anxiety endemic to
the World of Darkness. A bulimic vampire may feed four or
more times a night — gorging herself, burning the blood in
pointless (or not so pointless) activity, then starting the again.
A vampire with bulimia gets hungry much more quickly
than other vampires do. When feeding, a bulimic vampire
must make a Conscience or Conviction roll (difficulty 7). If
she fails the roll, she feeds until her blood pool is full, whether
the vampire needs the extra blood or not. A vampire who is
forcibly kept from feeding risks frenzy (make a frenzy roll,
difficulty 6). The difficulty increases by one for every 15
minutes that she is prevented from drinking.
Catatonia
A character suffering from this derangement may withdraw
from the world entirely at times of stress, remaining largely
immobile and unresponsive. Due to the major limiting factors
on their actions, catatonia is not recommended as a player
derangement.
Dependant
Beings with dependent personality disorder are needy and
helpless. Unlike beings with the Child Nature, they don’t
necessarily retain a sense of wonder or innocence. In fact, the
opposite is often true. People with this condition can't stand
being alone or acting on their own. They cling to others and
fear losing them, often jumping from relationship to
relationship, even abusive ones. They are overly sensitive to
disapproval and may break down, even to the point of suicide
when faced with rejection. They let others make important
decisions for them.
A Dependent Cainite may be particularly vulnerable to the
Bulimia derangement (Vampire, p. 223).
Desensitization
The vampire with this affliction is a virtual emotional
amputee. As a derangement, desensitization inhibits the
vampire's ability to feel any sort of strong emotion whatsover,
whether joy, sadness, anger or love. The afflicted just can't
make the appropriate neural connections (well, for want of a
better term).
The power of Dominate of the blood bond can still hold a
vampire so afflicted in check, but even though such a
supernatural compulsion governs the vampire's actions, it has
less an effect on her psyche. Even when blood bound, the
vampire gos through the motions of love and devotion like a
distracted actor half-heartedly playing a part. She will still
throw herself in from of a car to save her "loved one", but she
will do so without so much as a word, a tear or a smile. When
she frenzies, she does so in a chillingly silent paroxysm of
violence; when struck with the Rötschreck, she scuttles away
like a cockroach instinctively fleeing the light.
Vampires with this derangements find it difficult to truly
believe in their own ideals, and so make all Humanity, Path,
Conscience or Conviction rolls at +2 difficulty. They also
suffer a one-die penalty to any Social dice pools that require
some show of emotion or warmth, and cannot purchase the
Performance Ability at all.
Dissociative Blood-Spending
One of the less obvious derangements, this affliction inhibits
a vampire's conscious control over his own vitae. Vampires
with this derangement have a tendency to unconsciously
spend blood points to raise their Attributes at unusual and
inappropriate times - increasing their strength in the middle
of a round of drinks, upping their reaction speed while trying
to compose a letter, and so on. These vampires have even
been known to spend blood points during the day while they
sleep, waking up even hungrier than usual and never
knowing why.
If a character has this derangement, once per session the
Storyteller can rule that the vampire has just spent a blood
point to raise a given Attribute, or that the vampire wakes up
an extra blood point low. The Storyteller is even within her
rights to tell the player that his character's missing a blood
point, without elaborating exactly when and where he spent
the blood, or what for. After all, the vampire wouldn't know
where it went. Players are also welcome to roleplay this
derangement, of course (and it can be fun to start randomly
spending blood in the middle of a tense scene, just to worry
the other players), but the Storyteller has final control over
making this derangement a drawback rather than a simple
quirk.
Fantasy
Some characters cannot accept the real world, so they
transpose themselves into an illusory world instead. The
scope and degree of this fantasy varies considerably. A
character may hold conversations with characters who aren’t
there, or hear “voices from the gods” commanding him to
carry out a wide range of acts. He may also interact with
people and institutions of the Dark Medieval in an almost
normal manner but with their perception of events skewed by
their fantasy. For example, a Cainite may regard himself as
Lancelot from the Arthurian legends, on a quest to slay a vile
demon or rescue a fair princess. Such fantasies manifest as a
quirky outlook, but they are rarely dangerous (unless the
Cainite believes that he can walk about in the daylight…).
They can, however, adversely affect the character’s reaction to
others, perhaps making them more likely to frenzy (“They are
Mordred’s get, milord!”) or determined to carry out a mad
assault (“The grail lies this way!”)
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 Fits
You suffer t errible fits in stressful situations. The form of the
fit varies with the situation, but it is always inappropriate. You
might break into hysterical laughter at a funeral, wracking
sobs when you are trying to impress some bigshots with your
finesse, or epileptic seizures when it would be better to
remain still. When you find yourself in a stressful situation
you become very nervous, always wondering when your curse
will overtake you and betray you for an uncontrolled fool.
Fugue
Victims suffering from fugue experience “blackouts” and loss
of memory. When subjected to stress, the individual begins a
specific, rigid set of behaviors to remove the stressful
symptoms. This differs from multiple personalities, as the
individual in the grip of a fugue has no separate personality,
but is on a form of “autopilot” similar to sleepwalking.
Kindred suffering from this derangement require a
Willpower roll when subjected to extreme stress or pressure
(difficulty 8). If the roll fails, the player must roleplay her
character’s trancelike state; otherwise, control of the
character passes to the Storyteller for a number of scenes
determined by the roll of a die. During this period, the
Storyteller may have the character act as she sees fit to
remove the source of the stress. At the end of the fugue, the
character “regains consciousness” with no memory of her
actions.
Gluttony
Gluttonous vampires have difficulty taking their sustenance
in moderation. To the mind of the gluttonous Cainite, why
stop when one is merely sated? Why not drink in the heady
vitae until one is full as a bloated tick? This derangement is
particularly common among elder vampires, who have
indulged their vices for so long they lack the ability to control
their hunger.
Vampires suffering from gluttony must spend a point of
Willpower when they wish to stop feeding from a vessel,
unless they have reached their maximum blood pool capacity.
Also, a gluttonous character automatically frenzies when
confronted with the sight, smell or taste of blood when
hungry (at 3 blood pool or less).
Histrionic
Some ghouls sublimate their urge to escape or believe that
their new powers entitle them to a certain amount of
attention. Ghouls who develop histrionics must be center
stage is all situations. They affect extreme but shallow
emotions or behave and dress provocatively. Each scene, a
histronic ghoul must spend a point of Willpower to avoid
seeking the spotlight.
Player beware: this derangement isn't a license to hog
energy scene, then write it off as roleplaying. Histronics are
hypersensitive to the opinions of others, not oblivious to the
glares of the crowd as they enact some slapstick melodrama.
Histronic cases are pathetic, and most people recognize them
as such the first time they flash their shit-eating grins or
refuse to leave the stage. A histronic might latch onto one
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person the entire evening and pester her for every ounce of
attention. He might become sullen or leave in a huff if he
believes that someone has upstage him. If your Storyteller
allows this derangement, roleplay it as the emotional
disorder it is rather than an excuse to be obnoxious.
Hysteria
A person in the grip of hysteria is unable to control her
emotions, suffering severe mood swings and violent fits when
subjected to stress or anxiety. Hysterical Kindred must make
frenzy checks whenever subjected to stress or pressure. The
difficulties of these rolls are normally 6, increasing to 8 if the
stress is sudden or especially severe. Additionally, any action
that results in a botch causes the vampire to frenzy
automatically.
Intellectualization
(Source: The Anarch State.)
You have recoiled from the horror of your situation and
protect yourself by feeling nothing. You insulate yourself in a
world of logic and intellectual vigor where emotions have no
place. By isolating your incompatible needs and thoughts into
separate compartments you avoid losing control. However,
the pressure inevitably mounts and the dam eventually
bursts. If you passion and emotion are thrust upon you during
a stressful situation, you may frenzy. This frenzy may last for
some time depending on how long it's been since you last "let
off steam".
Lunacy
This madness comes and goes, linked to the cycle of the
moon. When the moon is full, the character is manic and
delirious, while at the time of the new moon, he may be
reserved and melancholic. At other times, he may appear
normal and unaffected. His ability to resist frenzy and
Rötschreck varies accordingly, increasing and decreasing by
a point to reflect his mood.
Masochism
A person with this derangement closely associates pain with
pleasure. In vampires, who no longer enjoy sex in its own
right, masochism tends to be linked to the pleasure received
by drinking blood or receiving the Kiss. Masochism is usually
linked to deep feelings of shame, and masochistic vampires
have a tendency to be repulsed by the actual process of
feeding from mortals. They are only fulfilled when they're
suffering, presumably as some sort of penance for the
pleasure they feel when feeding.
Vampires with this derangement begin to have difficulty
operating when they become wounded. Once a masochistic
vampire drops below the Bruised health level, he must make
a Willpower roll, difficulty 6; failure indicates that he takes no
action next turn, instead delighting in the sensation of pain.
Furthermore, the masochist must make a Self-Control roll,
difficulty 8, in order to use blood points to heal himself, no
matter how terrible his injuries.
Megalomania
Individuals with this derangement are obsessed with
accumulating power and wealth, salving their insecurities by
becoming the most potent individuals in their environment.
Such individuals are invariably arrogant and supremely sure
of their abilities, convinced of their own inherent superiority.
The means of achieving their status can take many forms,
from devious conspiracies to outright brutality. Any individual
of equal or higher status than the victim is perceived to be
“competition.”
Kindred with this derangement constantly struggle to rise
to the height of power and influence, by whatever means
necessary. In a megalomaniac’s view, there are only two
classes of people: those who are weaker, and those who do
not deserve the power they have and must be made weaker.
This belief extends to everyone around the vampire,
including members of her own coterie. This derangement
lends an extra die to all of the victim’s Willpower rolls, due to
her towering sense of superiority.
If a megalomaniacal vampire is presented with a realistic
chance to diablerize a more potent Kindred, she will be sorely
tempted. A Willpower roll (difficulty 9) is needed for the
vampire to avoid taking “what is rightfully hers.”
Melancholia
Cainites with this derangement frequently slip into deep
depression, losing interest in their normal activities and
becoming withdrawn. When suffering from melancholia, the
vampire’s Willpower rating is greatly reduced (half the
normal value, round up) and they have difficulty becoming
motivated. These depressive periods often follow failure of a
particular action, though they may also result from hunger (a
blood pool of one-quarter or less) or psychological factors.
Memory Lapses
This derangement isn't like amnesia in the classic sense. It's
not that a portion of the vampire's memories has been
permanently blocked off - it's that the vampire tends to lose
random portions of her memory at inopportune times. The
memories fade in and out, and can return as quickly as within
a few minutes, or they might not come back for decades.
At least once per scene, the vampire suffering from
memory lapses will forget something relevant for a time. This
might be as simple as forgetting where she left her keys
(which can be a real problem when you're locked out of your
haven and the eastern sky's getting brighter), or as
complicated as forgetting an entire Ability - and even the
knowledge that she once had that skill. ("Why are you looking
at me like that? I've never touched a keyboard before in my
life.")
Since this derangement requires particular attention from
the Storyteller, players should double-check that it's okay to
that this for a character. Yes the player can ad lib minor
memory lapses as they come along, but sooner or later the
lapse has to get more serious. It can be hard to determine
just when forgetting how to use a gun will be dramatically
appropriate, and when it'll make the other players organize
an impromptu lynch mob. Storyteller discretion is
particularly advised.
9
 Multiple Personalities
Also called Dissociative Identity Disorder, the trauma that
spawns this derangement fractures the victim’s personality
into one or more additional personas, allowing the victim to
deny her trauma or any actions the trauma causes by placing
the blame on “someone else.” Each personality is created to
respond to certain emotional stimuli — an abused person
might develop a tough-as-nails survivor personality, create a
“protector,” or even become a murderer in order to deny the
abuse she is suffering. In most cases none of the
personalities is aware of the others, and they come and go
through the victim’s mind in response to specific situations or
conditions.
When a vampire suffers this derangement, the Storyteller
and the player must agree upon how many and what kind of
personalities develop, and the situations that trigger their
dominance in the victim. Each personality should be relevant
to the trauma that causes it. Not only is each personality
distinct, but in the case of Kindred, the different personalities
might believe themselves to be from different Clans and sires.
Kindred with multiple personalities can manifest different
Abilities and even Virtues for each of their personalities, but
it is the Storyteller’s responsibility to determine the specific
details.
Narcissistic
Narcissistic personality disorder is characterized by self-
centeredness. As with histrionic disorder, people with this
condition seek attention and praise. They grossly exaggerate
and distort their accomplishments, expecting others to
acknowledge them as superior. They tend to be choosy about
picking friends, since they believe that not just anyone is
worthy of them. They tend to make good fist impressions, yet
have difficulty maintaining long—lasting relationships. They
are generally uninterested in the feelings of others and may
take advantage of them.
A narcissistic vampire is a prime candidate to end up with
the Megalomania derangement (Vampire, p. 223).
Nyphomania/Satyriasis
A notable few vampires have subconsciously denied their
undead state, and find themselves "sexually" attracted to
mortals, other vampires (and, in particularly severe cases,
other paramours). Of course, as vampires lack the ability to
procreate due to their undead status, any couplings they may
achieve are inevitably frustrating and fruitless.
Such limitations do not hinder the efforts of those who
suffer from this derangement, however, and they pursue the
carnal act with every ounce of their being. By spending a
blood point, the vampire may "function" and even bring a
partner to climax, provided they're not dead, too. Vampires
under the influence of this derangement often sink into ever
more depraved activity, hoping to somehow stimulate the
pleasures they have been denied. Indeed, outside of "normal"
hetero- ans homosexual affairs, these vampires may indulge
in bestiality, pedophilia, rape and all manner of other vile
acts.
10
A character afflicted with this derangement is always "on the
prowl" and should attempt to consummates as many
relationships as he can, according to his orientation (which
may well change over the course of the chronicle). This
derangement has no mechanical effect; it is included as a
curious condition rather than a dice-governed system.
Obsessive-Compulsive
The trauma, guilt, or inner conflict that causes this
derangement forces the individual to focus nearly all of her
attention and energy onto a single repetitive behavior or
action. Obsession relates to an individual’s desire to control
her environment — keeping clean, keeping an area quiet and
peaceful, or keeping undesirable individuals from an area, for
example. A compulsion is an action or set of actions that an
individual is driven to perform to soothe her anxieties: for
example, placing objects in an exact order, or feeding from a
mortal in a precise, ritualistic fashion.
Vampires with an obsessive-compulsive derangement must
determine a set of specific actions or behaviors, as described
above, and follow them to the exclusion of all else. The effects
of obsessive-compulsive behavior can be negated for the
course of one scene by spending a temporary Willpower
point. The difficulty of any attempt to coerce or Dominate a
vampire into ceasing her behavior is raised by one. If a
vampire is forcibly prevented from adhering to her
derangement, she automatically frenzies.
Overcompensation
An overcompensating character attempts to make up for a
flaw in her character (real or perceived) by stressing another
aspect of her personality. This limits her actions and skews
her perceptions of the world. She may take a “holier than
thou” attitude toward others, lecturing them about their
shortcomings, constantly attempting to take the moral high
ground. If the character’s own flaws are revealed, the
embarrassment would be acute and her reaction
unpredictable.
Paranoia
The victim of paranoia believes that her misery and insecurity
stem from external persecution and hostility. Paranoid
individuals obsess about their persecution complexes, often
creating vast and intricate conspiracy theories to explain who
is tormenting them and why. Anyone or anything perceived to
be “one of them” is often subjected to violence.
Kindred who suffer from paranoia have difficulty with
social interaction; the difficulties of all dice rolls involving
interaction are increased by one. They are distrustful and
suspicious of everyone, even their own blood-bound progeny.
The slightest hint of suspicious behavior is enough to provoke
a frenzy roll, with the difficulty relative to the degree of the
behavior. This paranoia may even extend to complex and
rigorous feeding practices, to keep “them” from
contaminating the vampire’s food supply.
Perfectionism
Perfectionists seek to control every aspect of their unlives,
often following a rigid set of rules intended to ensure that
everything “runs to plan.” All their efforts are directed to
ensuring that things happen as intended, and if they don’t, the
perfectionists become agitated, possibly even entering frenzy.
Phobia
You have a deep-seated fear of something. Whatever it is, you
dream of it at night, waking to soaked sheets and your own
choked screams of terror. Nothing is more horrible than
being confronted with the object of your fear. You will go to
almost any lengths to avoid this kind of confrontation. You
know it is always possible for you to find yourself in a
nightmare from which you can not escape, because you are
already awake.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) arises in response to
severe trauma such as combat, rape or servitude to a
Tzimisce. A ghoul who has been the subject of his master's
latest experiment with superdermal bone art or witnessed his
hungry master devour his mortal family might develop this
derangement. PTSD can even afflict vampires, perhaps those
who survived a Lupine attack or awoke one night to gfind
their havens on fire.
Symptoms manifest as recurrent, debilitating flashbacks
and extreme avoidance of situations likely to recreate the
initial trauma. The player of a ghoul or Cainite afflicted with
PTSD must spend a point of Willpower for her character to
enter such situations. If compelled by a blood bond or other
forms of control, the sufferer's player cannot spend Willpower
to gain automatic successes on any rolls, and all of the
character's dice pools are halved (rounded down). In any
circumstances, botched Willpower rolls or other stimuli
deemed appropriate by the Storyteller induce flashbacks of
the traumatic episode with the same penalties described
above. Ghouls laboring under this disorder are typically
disposed on by their domitors. Clan Tzimisce requires
servants made of sterner stuff.
Power-Object Fixation
The vampire afflicted with this derangement has invested
much of her self-confidence in an external object, to the point
where she believes she cannot function properly without its
presence. Such a derangement is often linked to some past
trauma in which the object in question played a major role -
although not always in the obvious way. For instance, a victim
might fixate on his dead fiancée's engagement ring if holding
his fiancée's hand was his only source of comfort during hard
years, but another individual might focus on the belt her
father beat her with as he source of strength.
Victims of this fixation lose two dice from all their dice
pools if somehow separated from their object of focus. It is
hard to hide this fixation from careful observers; in time of
stress, the vampire must make a Willpower roll to avoid
cradling the object to her torso, rubbing it obsessively or
otherwise physically comforting herself with its presence.
This derangement sometimes spawns other related
derangements over time. The fixated person may, for
instance, develop multiple personalities related to the object -
the aforementioned abuse victim might develop a bullying
personality much like her abusive father's, and so on.
Regression
Characters suffering from regression also have difficulty
accepting the real world. However, rather than retreating into
a fantasy environment, they retreat into a more simplistic
mentality, often that of a child. Such characters are usually
heavily dependent on others, both for tasks and decision-
making. They are frequently naïve, which may be a boon or a
curse depending on the circumstances. This refuge of youth
may be permanent, or it may kick in as a result of stress.
Some characters retreat even further when placed under
great pressure, their mental faculties completely shutting
down and leaving them to operate on instinct alone. These
episodes result in blackouts and periods of memory loss that
may be roleplayed, with the character acting on instinct
subject to a predetermined set of guidelines, or abstracted,
with the character coming to her senses with no recollection
of the last few minutes/ hours/ days.
Vampires with this derangement are at a permanent +2
difficulty on Self-Control/Instinct rolls; children have very
little sense of discipline for the sake of discipline, and aren't
sufficiently self-aware to master their own Beasts. The
regressive is no different.
(Storyteller beware: This derangement, improperly used,
leads to Malkvavians who are cute rather than creepy; you
know the type. The ones with teddy bears and bunny slippers.
When properly used, a regressive should be terrifying - a
supernaturally powerful creature with no real sense of right
or wrong - so feel free to crack down on players who tend to
play this derangement more for laughts than for horror
value.)
Sanguinary Animism
This derangement is unique to the Kindred, a response to
vampires’ deep-seated guilt regarding the act of feeding on
the blood of mortals. Kindred with this derangement believe
that they do not merely consume victims’ blood, but their
souls as well, which are then made a part of the vampire’s
consciousness. In the hours after feeding, the vampire hears
the voice of her victim inside her head and feels a tirade of
“memories” from the victim’s mind — all created by the
vampire’s subconscious. In extreme cases, this sense of
possession can drive a Kindred to carry out actions on behalf
of her victims. Diablerie would be particularly unwise for an
animist. Whenever a vampire with this derangement feeds on
a mortal, a Willpower roll is needed (difficulty 6, or 9 if she
drains the mortal to the point of death). If the roll succeeds,
she is tormented by the “memories” of the person whose soul
she has partially consumed, but is still able to function
normally. If the roll fails, then the images in her mind are so
strong that it is akin to having a second personality inside her,
an angry and reproachful personality that seeks to cause
harm to the vampire and her associates.
11
 The player must roleplay this state as if the mind of her
victim in control. During the moments just before dawn,
control reverts to the vampire.
Self-Annihilation Impulse
This derangement is more common among older vampires,
although there's nothing stopping a neonate from acquiring
the affliction. The afflicted vampire feels a deep sense of
revulsion for his flesh, and is literally terrified of the thought
of "living" forever, or of continuing to exist inside a cold, dead
shell. This revulsion is entirely unconscious, however; on a
conscious level, the vampire is wholly unaware of his "death
wish," though he may demonstrate a morbid streak.
Whenever the character is confronted with more-or-less
direct evidence of his immortality - such as visiting the
churchyard where is mortal daughter is buried, or watching a
ghoul die - he must make an immediate Willpower roll, or
begin to undertake some sort of potentially deadly behavior.
This behavior might be as direct as storming into Elysium
and giving the Prince a piece of his mind, or it might be more
subtle, such as breaching the Mascarade by talking to a
reporter.
In any event, the pursuit of self-destruction is not a
conscious decision, and it's not open for debate. The
character will doggedly go about his "chosen" task until it's
completed, resisting any attempts to talk him out of it. He
may even consciously believe that the actions he's
undertaking are perfectly safe. The compulsive behavior lasts
only for a scene or so; however, depending on the nature of
the threats he's called down on himself, the consequences
can last quite a bit longer.
Schizoid
Characters with schizoid personality disorder not only have a
difficult time with interaction, they prefer it that way. They
genuinely choose to be alone and do not secretly wish for
popularity. They tend to seek jobs that require little social
12
contact. Their social skills are often weak and they do not
show a need for attention or acceptance. They are perceived
as humorless and distant and often are termed “loners.”
A schizoid Cainite who pulls too far away from reality may
develop Fugue, Schizophrenia or Multiple Personality
derangements (see Vampire. pp. 222-224).
Schizotypal
Schizotypal personality disorder might be a lesser form of
schizophrenia (see Vampire, p. 222). While not as severe as a
derangement, this condition is characterized by odd forms of
thinking and perceiving. Individuals often seek isolation from
others, have difficulty concentrating for long periods of time,
and engage in “conspiracy theory" behavior. Their speech
patterns are convoluted, sometimes nearly nonsensical, with
a free association style of thoughts juxtaposed. Schizotypal
speech is not as incoherent as schizophrenic “word salad,"
but jarring nonetheless.
Schizophrenia
Conflicting, unresolveable sets of feelings and impulses can
cause a victim to develop schizophrenia, which manifests as a
withdrawal from reality, violent changes in behavior, and
hallucinations. Roleplaying this derangement requires careful
thought, because the player must determine a general set of
behaviors relevant to the trauma that caused the
derangement. The hallucinations, bizarre behavior, and
unseen voices stem from a terrible inner conflict that the
individual cannot resolve. The player needs to establish a
firm idea of what that conflict is and then rationalize what
kind of behavior this conflict will cause.
Kindred with this derangement are unpredictable and
dangerous. In situations that trigger a vampire’s inner
conflict, the difficulties of all rolls to resist or direct frenzy
increase by three, and the vampire loses three dice from all
Willpower rolls.
Synesthesia
This derangement has little to do with logic and more with
sensory interpretation. The afflicted vampire's sensory input
is somewhat "scrambled"; although he's still capable of
receiving sensory information, the information each sense
provides is processed in terms of a different sense. In short,
the synesthetic "hears" colors, "smells" textures, "tastes"
sounds and the like, and is hard-pressed to this of such
stimuli in any other fashion.
Although the synesthetic is presumably accustomed to the
unusual sensory input, his real problem lies in
communicating what he senses to others. A character so
afflicted has difficulty expressing concepts as simple as "cut
the red wire" - he's much more likely to say "cut the
sandpapery wire" or something similar - and even has similar
difficulties comprehending speech from others. Since the
associations vary from individual to individual, there's not
even any guarantee that another synesthetic would be able to
understand the vampire.
Apart from the aforementioned difficulties in daily
communication, the synesthetic receives +2 difficulty to any
Expression and Performance rolls that don't involve creating
purely surreal art, poetry or the like. The synesthetic may
spend a Willpower point to correlate her sensory input in a
"normal" fashion for a turn - or rather, at least to be able to
communicate "normally" in terms of colors, textures, smells,
tastes, temperature or sound. The character would still hear a
ringing noise and think of it as a spicy smell, for instance -
he's just able to focus enough to associate that spicy smell he
hears with what other people call "ringing."
Visions
This derangement leads sufferers to believe that they are
granted an insight into the divine through visions, trances
and other ecstatic states. During these spells, they may be
catatonic, in a trance-like state or rave uncontrollably. Their
ability to recall details of the visions is similarly varied,
sometimes recalling precise details while having only the
vaguest recollections of others. Some details may not
resurface until days after the revelation, emerging in
response to some external stimulus.
These visions may be products of an overactive
imagination, or they could, at the Storyteller’s discretion and
very rarely, reflect a real insight into the unknown.
Additional Derangements
(Source: by u/LeRoienJaune, on r/WhiteWolfRPG, except as
noted.)
Aboulomania
Periodic crippling attacks of paralyzing indecision. Not over
major decisions - aboulomania is suddenly being paralyzed
for hours over whether to ask for a side of fries or a side of
onion rings
Acute Sanguinary Aversion
(Source: The Anarch State).
This derangement, unique to the undead, involves a
persistent fear that any source of vitae is dangerous.
Explainations vary - some vampires fear drugged or
contaminated blood, the wrath of God or the presence of a
blood-borne Antediluvian. Regardless, unless the vampire is
frenzied, the player must succeed on a Willpower roll (diff 8)
each time he feeds. Willpower cannot be spent on this roll,
and a botch indicates that the vampire is so revolted by the
prospect of feeding that he vomits up half his blood pool.
Acute sanguinary aversion usually leads to a starve-and-
frenzy pattern, with the vampire avoiding feeding until he
loses control. Instead, the vampire might develop highly
ritualized feeding methods that involve obsession with
repeated, largely arbitrary behaviors that must be observed
before the Kiss is performed on a particular source of vitae.
He might read a passage from the Book of Nod before
feeding or drink blood only from a particular individual.
In any case, if the feeding results in a Conscience or
Conviction roll, increase the difficulty by one.
Alien Hand Syndrome
One of your arms acts with a mind and personality
completely separate from your own.
Barklay’s Complaint
Related to Truman’s Syndrome, Barklay’s Complaint is a
relentless detachment rooted in the persistent belief that
nothing is ‘real’ and therefore of value, permanence or
consequence. Sufferer’s from this delusional complex often
state about how every person they meet is ‘just so many
plastic dolls’ or ‘bundles of twigs’. It is a chronic inability to
recognize the sincerity or authenticity of all that one
encounters.
Bigorexia
In some ways the opposite of anorexia, bigorexia is a disorder
of compulsive exercise and body building. The afflicted
becomes obsessed with gaining muscle mass and becoming
as strong as possible.
Capgrass Syndrome
You continuously believe that other people around you are
imposters, pretending to be the person that they replaced.
You're never really sure if somebody is who they claim to be.
Cotard's Syndrome
You are dead. Quite dead. And you're a ghost, walking around.
This is the afterlife. Nobody can see you. Only other dead
people can see you.
Drapetomania
A sudden overwhelming compulsion to flee your
surroundings and set up a new life and new identity
elsewhere.
13
 Face Blindness
You are utterly incapable of recognizing other people, or their
body language. Everybody looks the same to you - they've all
got two arms, two legs, two eyes. The ugliest Nosferatu and
the most beautiful Toreador are equally indistinct and
unremarkable to your perception. A person with Face
Blindness continuously has to ask people to wear name tags,
because they can't tell anyone apart.
Fregoli’s Delusion
The opposite of Capgrass syndrome: you believe that multiple
people are really just one person, in disguise. A person with
Fregoli’s Delusion often mistakes and reacts to strangers as if
they were people that they already knew.
Habbakuk's Achronia
A supernatural mental disorder, wherein your memory
happens in reverse to the normal time flow. You remember
tomorrow like it was yesterday, but have no knowledge of the
past, because it has yet to occur to you. It's amnesia, but you
model it by maxing out all pre-cognitive/fortune telling merits.
For advanced players only.
Jumping Frenchmen Disorder
Your anxiety and stress expresses itself in sudden burst of
intense physical action. You climb walls and you don't know
why. You take off sprinting for no reason. Sometimes, you
hurtle yourself through a window, just because.
Landau-Kleffner Syndrome
A neurolinguistic disorder affecting syntactic structures.
Think of it as verbal dyslexia, or Yoda's disease. You still
understand individual words, but you continuously confuse
word order and tense without grammar or syntax.
Leroi's Compulsion
You must quantify, and classify, and organize. A taxonomical
expression of Obsessive-Compulsive Disorder, wherein you
14
must make lists, indexes, tables. You develop graphs and
charts for everything. Your haven is cluttered with tables and
non-sensensical case studies, statistical analyses, and
algorithms. Only you have managed to identify the correlation
between Tremere regent feeding cycles and federal reserve
quantitative easing.
Macropsia/Micropsia
Also known as Alice in Wonderland Syndrome, a visual
neurodisorder in which the sufferer continuously
misperceives visual data. Thus, other persons and objects
seem to shrink or grow randomly. One also perceives their
own limbs to grow and shrink.
Pathoheterodoxy
A misguided and delusional expression of Narcissism that
manifests as a continuous under-estimation of the
competence and benignity of others. A patient suffering
pathoheterodoxy believes the world to be populated by
bumbling venal idiots. It’s a compulsive expectation of the
worst behavior of others, and an inability to recognize the
potential of other people.
Psychohypochondria
A continuous anxiety disorder that one is developing new
mental illnesses and psychological disorders. At any given
time, a psychohypochondriac is a bipolar schizophrenic
epileptic with megalomania, or something else like that.
Quixotism
There are no mortals or mundanes. Everybody and
everything is a supernatural creature. Everybody is a part of
some greater conspiracy.
Sanguine Personality Disorder
Blend together Schizoid with Sanguinary Animism. Your
character assumes the personality and identity of whoever
they fed on most recently. Not necessarily what the victim
was actually like, but what you subconsciously believed/
assumed them to be like.
Stendahl Syndrome
Formerly known as Lizstomania, Stendahl Syndrome
involves hysterical reactions to the works of a particular
artists or musician.
Surgical Addiction
The character is addicted to body modification and the
surgical process, possibly doing so without anaesthesia.
Their dysmorphia causes them to continuously pursue new
forms and body shapes.
Truman's Syndrome
You believe that you are the star of a TV show, and everything
around you is a set, and everybody you meet are actors. The
world is controlled by the directors, whom you will never
meet.
Discipline Derangements
Animal Personification
Commonly associated with Animalism, the vampire comes to
treat animals like humans, believing that they can understand
him and expecting them to answer.
Blood Fetishism
Commonly associated with Quietus, the vampire suffers an
unhealthy fascination with blood. They cut themselves just to
see the blood flow, feed slow to savour the taste, and perform
other disturbing acts.
Compulsive Invisibility
Commonly associated with Obfuscate, the vampire has been
so attuned to invisibility that it costs Willpower for him to
turn his powers off.
Disdain of Weakness
Commonly associated with Potence, the vampire will always
use full force when interacting with objects and comment on
the fragility and weakness of their surroundings.
Dissociative Perceptions Syndrome
Since the Week of Nightmares, Chimerstry hasn't behaved
quite the same as it did before. Theories range from the
notion that the Antediluvian's death somehow changed the
Discipline's nature, or that his existence buffered Ravnos
from more extreme effects. Another theory states that the
final curse the Antediluvian laid upon the clan as he was
destroyed distorted Chimerstry's effects. Whatever the
reason, Ravnos who indulge in Chimerstry often slowly lose
the ability to distinguish between what is real and what is not.
At first, the Ravnos suffers as if from the Dementation
power, The Haunting (Vampire: The Masquerade, p. 155).
This happens after a Ravnos has completely depleted his
Willpower reserves (zero temporary Willpower) to create a
Chimerstry illusion. Whenever the player spends all of the
character's Willpower, the character suffers from The
Haunting.
If the Ravnos continues to overuse Chirnerstry, he
experiences full-sensory hallucinations. These hallucinations
can happen at any time, especially moments of great stress.
They can range from seeing a friend as an enemy (or vice
versa) to seeing a busy street as completely empty. The
hallucinations start at relatively low scale and build up over
time until they become potentially threatening to the Ravnos'
continued existence. If the Ravnos realizes he's experiencing
hallucinations, the player can spend one point of Willpower
to negate the hallucinations for a scene.
Disorientation
Commonly associated with Celerity, the vampire finds the
way things move in normal speed disorienting, insisting that
they should move slower.
Disregard of Human Form
Commonly associated with Serpentis, the vampire finds
himself more comfortable in another form than the one
resembling his mortal days. If suggested that they transform
back, they have to check Frenzy.
Empathic Blindness
Commonly associated with Dominate, the vampire cannot
understand why anyone would not heed his commands or
else disagree with him, similar to sociopathy.
Illusion Addiction
Commonly associated with Chimerstry, the vampire becomes
so enamored with his own creations that they completely lose
sight of the real world, instead surrounding themselves with
pleasurable illusions.
Lack of Survival Instincts
Commonly associated with Fortitude, the vampire comes to
believe that he is actually indestructible, willingly facing
mortal danger.
Thaumaturgical Glossolalia
(See also under the Tremere-Specific Derangements.)
Commonly associated with Thaumaturgy (although in
theory, any school of Blood Magic could be the catalyst), the
vampire falls into speaking and thinking only in terms of
magical correspondences and symbology. Similar to magical
aphasia, the vampire cannot communicate this state of mind
to others and eventually fails to recognize anything other than
these correspondences.
Unconscious Influence
Commonly associated with Presence, the vampire activates
his persuading powers without acknowledging that he use
them. If someone would point the use out to them, they
vehemently deny it.
15
 Unconscious Thought Reading
Commonly associated with Auspex, the vampire begins to
casually invade the mind of others, reacting to thoughts
before they are spoken. Too many people cause a static
background noise that can drive the vampire into Frenzy.
Additional Discipline
Derangements
(Source: by u/LeRoienJaune, on r/WhiteWolfRPG)
Caise's Unreliability
Your Obfuscate powers are tied to your derangement, and
triggers random invisibility or at the Storyteller's discretion.
When you're obfuscated, you've ceased to exist. Essentially,
you occasionally flicker in and out of existence.
Hyper-Evangelism
You have the compulsive need to imprint (through dominate
perhaps) certain beliefs and opinions onto others. Not
necessarily because it would be useful to you. You just go
around converting random people to Hinduism. Or radical
Marxism. Or being unwavering fans of Bobby Darin.
Novothesia
Frequently expressed in characters who over-use Heightened
Senses (Auspex 1), Novothesia is the delusional perception of
the non-existent stimuli. A novothesia sees more colors than
there a words for colors, hears sounds that exist beyond
human language. They are continuously making judgements
based on imperceptible stimuli: "I don't like that guy- he's
emitting way too much infra-red, and he smells like he
smoked marijuana when he was in his twenties."
Plague Bride's Contagion
Also called "Folie des Autres". Pick a particular mental
disorder. You know have a compulsion to inflict that
particular disorder onto random people, using your Dominate
or Dementation abilities. Perhaps you believe it's
enlightenment. Perhaps your anxiety, or your ego, or your
enthusiasm, just has a way of rubbing off on people.
Whatever the case, you leave a trail of madmen in your wake,
where-ever you go.
Psychometric Repetition
You feel the irresistible compulsion to re-enact what you
perceive with The Spirit's Touch/Psychometry (Auspex 3).
Your perception is so lucid as to overwhelm you, and the
power fires at random. At least once in any given night, you
are re-enacting somebody else's past.
Telepathic Schizophrenia
You are constantly subconsciously using your telepathic
power (Auspex or otherwise) to skim the emotions and
surface thoughts of others, and then interpreting the received
thoughts to be your own.
16
Dark Ages Derangements
The derangements below include some of those above but
grouped into three sub-groups, reflecting the "medical"
knowledge that mortals and Cainite of the Dark Ages had.
Aside from this classification, these derangements are used
as any others. Furthermore, other "modern-day"
derangements can afflict characters of the Dark Ages equally;
they would just be identified and classified differently.
Divine Displeasure
A curse upon the mind. Sacred curses are, hearth wisdom
holds, the result of incurring the displeasure of pagan gods
and spirits.
Compulsion: The disorder of nature causes a physical
discomfort in the character, resulting in an obsessive
desire to order the world around them. Nervous and
meticulous, they have some form of ritual taboo that they
obsessively practice during periods of stress — frequent
bathing, counting coins, or sorting books and possessions
by size or type. If they can’t practice this ritual, they suffer
from extreme agitation (-3 dice to all frenzy rolls; the
Storyteller should call for a frenzy roll more often than
normal when this Derangement is triggered).
Lunacy: First codified by the Romans but well-known for
centuries, this Derangement is caused by a curse of Luna,
the moon’s goddess. The character experiences mania and
depression according to the lunar cycle. While the moon
waxes, the character slowly grows more irritable until
they’re manic and full of energy during the full moon (-1
difficulty to all extended rolls, +1 to all difficulties to
frenzy). Waning moons cause a deepening lethargy
resembling melancholia, and the new moon requires more
effort to from their blood to rouse them (vampire’s
Willpower rating is reduced by half the normal value,
rounding up; the vampires requires an additional blood
point to rise on the night of the new moon).
Sacred Disease: Even great Caesar himself suffered from
the same curse the character does. No matter how
implacable or stalwart the character is, they’re a victim to
a trembling disorder that renders them insensate. On a
Derangement trigger, the player rolls Stamina (difficulty
8). On a failure, the character feels the disease
overpowering them, collapsing into a seizure within three
turns. They writhe and slam their limbs about, frothing
blood at the mouth as their veins bulge and distend.
Unlike other Derangements, the sacred disease only lasts
for the rest of the scene, though the character is worn out
for rest of the night (-1 die penalty to all Physical tests).
(Known as Epilepsy in the modern days.)
Saint Vitus’s Dance: Related to the Sacred Disease, the
dance causes involuntary movements of the face and
limbs, with a sweating fever and bloody rheum streaming
from the eyes. While the individual’s mental faculties
aren’t impaired, the difficulty for all her Social rolls
increases by two. Saint Vitus’s Dance can spread
throughout a group, leading to mass outbreaks of the
“madness.” (Known as the Sydenham's Chorea in the
modern days.)
Dyscrasia
A disease of the body. The four humors of the human (and
Cainite) body lie in a delicate balance, though individuals are
predisposed towards different temperaments depending on
how much of one humor they’ve got in their body. However,
factors both internal and external can lead to one humor’s
ascendency over the others, causing a physical and mental
reaction.
Players of characters with a humor imbalance should
choose one that’s fairly close to the character’s personality.
Humor imbalances are personality traits magnified to
extremes.
Melancholics are introverted, introspective, and irritable.
They can be startlingly dispirited (even when the situation
calls for or demands a more spirited response). They tend
to stare off listlessly, lost in sadness deep and dark as
black bile. They lose track of themselves, and can’t touch
their emotions easily. Melancholia causes a -1 penalty to
all dice pools, but a -1 difficulty for all manner of frenzy.
Phlegmatics are calm, thoughtful, and patient. The
temperament is common amongst academics, and they
tend to be extremely orderly about their area of expertise.
However, due to their inward focus, they have trouble
adapting quickly or adroitly to changes in their
environment (-1 die to Wits and Dexterity rolls).
Sanguines are lively, sociable, optimistic, and passionate,
sometimes overly so. When the blood sings in their veins,
every emotion is heightened and verges on the
inappropriate. They have deep difficulties in focusing on
the moment. The Storyteller chooses three Abilities at
random; the difficulty for rolls using these Abilities
increases by one, due to the character’s lack of focus.
Increase the difficulty of all rolls featuring Mental
Attributes by one as well.
Cholerics are restless, aggressive, and impulsive. They
tend to be ambitious, but may become angered or even
violent when their ambitions are thwarted. When gripped
by an imbalance of black bile, increase the character’s
difficulty to resist frenzy by two, but reduce the difficulty to
perform any acts of painful physical violence by one.
Sins of the Soul
A damning pall over the soul. The Church and its adherents
hold that the moral failures of the impious are what cause
these Derangements, but they can affect even the holiest
individuals.
Sanguinary Animism: This uniquely Cainite
Derangement leads sufferers to believe they drink the
souls of their victims with the blood. Feeding causes
intense guilt in sufferers of sanguinary animism; their
victims communicate with them as voices in their heads
and memories seeping into their consciousness. The
suffering vampire often blames his actions on these
voices, claiming that they are an effort to pacify his
tormentors. The vampire is compelled to reply to the
voices, and must utter these replies aloud (even if it’s just a
low muttering). This may result in variable difficulties to
Social rolls.
Visions: You’ve transgressed against your culture, causing
potentially irreparable harm to your soul. You’ve struggled
to put your guilt behind you. But someone, or something,
forgives you — and they let you know. During times of
stress, the character sees holy figures encouraging her to
act according to her better nature, ready to punish her if
she fails again. She is especially wary of the holy figures’
watchfulness (-2 dice to all degeneration rolls).
Voices: The demons know your sins, and they’re hunting
you for it. Victims of demon voices become paragons of
self-persecution, fearing divine retribution and seeing it in
every angle. Their paranoia exhibits during times of
stress; they’re wary of social interactions (+1 difficulty to
Social rolls) and fearful that anyone could be a demon in
disguise. A botch on a Social roll (from either party) will
invariably result in panicked flight from the perceived
demon (an automatic fear frenzy).
17

Tremere-Specific
Derangements
Of all the clans, the Tremere are the most universally steeped
in mystic understanding. While Malkavians have a built-in
perception of a broken universe, and Tzimisce have their own
forms of sorcery, the Tremere’s very seat of power predicates
upon symbolism, mystical links, symmetry and patterns of
will. As Tremere students of the occult must pit their minds
against unnatural forces and permutations of their own
vampiric Curse, it’s no surprise that some levels of mental
imbalance and affliction crop up among an unfortunate few,
as well as those who repeatedly delve into mysteries best left
unexplored.
Conservative Cainite scholars argue that the Curse
encompasses only certain needs, and thus that some types of
power fly in the face of what is “normal” for vampirism.
Thaumaturgy is foremost on the lists of such reactionaries.
While most Tremere scoff at this and merely assert that their
formidable training and methods allow them to access
powers that other Cainites simply haven’t the skill to use,
some indications have arisen that thaumaturgical study can
be rather unbalancing. Indeed, the very nature of
Thaumaturgy — pitting one’s will against the curse of undeath
to channel the power of blood into new forms — speaks of
unwholesome investigation into the terrible malison that
afflicts the Kindred. Some Tremere find the truths unearthed
therein too terrible to confront rationally.
Hierarchical Sociology Disorder
Enforcement of the Tremere’s pyramid structure sometimes
has negative effects. Strong-willed individuals are the ones
most commonly Embraced by the Tremere, but the
occasional exception does slip through. Furthermore,
centuries of practice in conditioning young neonates to their
policies means that sometimes Tremere organizational
practices are a little too effective.
Most Tremere have at least a marginal loyalty to the clan as
an abstract whole, enforced both through the blood of the
Seven and through the psychological conditioning of the oath
administered during the turmoil just after the Embrace.
Vampires who adjust comparatively well go on to normalize
their personal drives with the problems of the undead
condition. Those who can’t handle the stress, though,
sometimes turn to the pyramid as a surrogate for
responsibility.
A recent inductee who’s unable to cope with the stress of
hunting for blood and dealing with the Beast may transfer
such responsibility to the Tremere pyramid. In such cases the
individual becomes almost dronelike; such victims cannot
handle their own moral responsibility, so they delineate their
world by the bounds of the Tremere code. What their
superiors order, they obey; what the code prohibits, they
fanatically shun. By making the Tremere clan the repository
of their consciences, these poor souls are “only following
orders.” The degradation of Humanity and the toll of frenzy,
hunger and fear still drive the Kindred into a downward
spiral, but it’s one that he can almost sociopathically ignore.
After all, it’s neither his fault nor his problem.
18
Confronted with a choice, a victim of this disorder looks to
the Tremere hierarchy for answers. Every action must be
supported by the pyramid. Pressed for a personal opinion, the
hapless vampire gives a pat answer or an uncomfortable “I
don’t know.” Unsurprisingly, Tremere superiors are quick to
weed out neophytes who succumb to this disorder — a drone
without personal initiative or imagination is even more
volatile than a revolutionary. Such individuals find themselves
assigned to dangerous tasks where they’ll succeed with the
clan’s interests in mind, die horribly or snap into a more
rational state of mind.
Sanguinary Cryptophagy
Subsistence upon blood to the exclusion of normal foods is
one of the first practical adjustments that vampires must
make. Tremere have a particularly curious adjustment, fed as
they are blood that transubstantiates into the vitae of the
council, then trained in powers to examine the tastes of blood
for its peculiar qualities. A few Tremere become enamored of
the flavors in exotic blood. While it’s true that any vampire
can develop a taste for certain pedigrees, so to speak, the
common Tremere sensitivity to unusual currents — both
through superlative sensation and thaumaturgical study —
leads some Tremere to hunt down the most extraordinary
bouquets that they can.
Naturally, some vampires move to rather exclusive tastes
and learn the savory thrill of other Cainite blood. Tremere,
often able to detect the subtleties of bloodlines or unique
manifestations of the vampiric condition, may take this to
extremes. A cryptophage becomes obsessed with the pursuit
of more and different flavors of blood. Such individuals
sometimes have a penchant for diablerie, becoming fixated
on the tastes of various other clans. Stranger Tremere take to
hunting the globe for “rare vintages” like Lupine or faerie
blood. Unchecked, such an obsession throws the Tremere into
dangerous situations as she hunts other supernatural
creatures. Worse still, such Tremere often become bored with
“lesser vintages.” Although still able to subsist upon human
or animal blood (physically if not psychologically),
cryptophages develop a distaste for such common fare. A
cryptophage may even be incapable of swallowing such
common blood without an effort of will.
Again, note that cryptophagy is a psychological condition
and not a physical dependency; a cryptophage still can (and
will) drink any form of blood during a frenzy. In extreme
cases this may be the only sustenance that the vampire gets;
she becomes nervous and twitchy from hunger while she
hunts supernatural creatures for their scarlet nectar. A
cryptophage may even go to the lengths of exerting herself to
expend blood or draining her own veins in order to cause a
greater appreciation for the rush and taste of unusual vitae.
Thaumaturgical Glossolalia
Language is a means to build common symbols for the
description of concepts. Thaumaturgy recognizes this power;
the voice alone is a potent tool, but so too are symbols.
Indeed, skilled thamaturges learn to think in symbolic
languages, much as a mathematician may construct complex
explanations out of numbers. Some sorcerers theorize that
thaumaturgical numerology functions because of its mystical
tie to universal concepts. Just as mathematics describes the
physical universe, Thaumaturgy describes the metaphysical.
Because these symbols function on such an abstract level,
though, they do not fit easily within the human or undead
mind.
Highly proficient thaumaturges sometimes suffer a bizarre
form of regression. A mind trained to examine the world in
supernatural terms cannot always cope with stress in a
rational manner. Under tension, such thaumaturges revert to
speaking in tongues, but in this case, in thaumaturgical
symbology. The affliction of glossolalia (speaking in tongues)
comes hysterically upon these unfortunates and makes them
incomprehensible.
While normal glossolalia involves speaking in dead
tongues, a thaumaturge reverts to arcane constructs. Other
thaumaturges may recognize scattered words, but often the
mind of the individual seems to shift into a different state of
thought almost like magical aphasia. Oftentimes the subject
reverts to words that he would not formally know or study.
The thaumaturge in question rarely has any idea that he
sdoing anything unusual. His own mind still equates these
concepts to the strange words, while conversely he becomes
unable to translate more mundane language. Given enough
time or concentration, the thaumaturge usually reverts to
normal speech, with no real understanding of what he
mystically said before.
Most Tremere would be mildly unnerved to see this
derangement in action; thaumaturges have displayed
knowledge of concepts normally far beyond their skill while
so possessed. Of course, a frenzied thaumaturge shouting out
guttural invectives in some dead magical language would be
enough to terrify almost anyone.
This is a difficult derangement to portray well, and
Storytellers should not only be wary of assigning it too
cavalierly, they may wish to offer additional experience points
for players who handle it with grace. Evinced correctly,
Thaumaturgical Glossolalia is not idiotic gibberish or
childish babble it is the transition of symbols to words by
which a fractured mind communicates the horrors that have
driven it to madness.
Ghoul-Specific
Derangements
Derangement in this category are more often observed
amongst the ghouls living in servitude to an abusing domitor,
though some could also apply to mortals and Cainites in
similar situations.
Animalistic Hysteria
Animalistic Hysteria — the vaunted “frenzy” so often spoken
of in Kindred circles — poses a constant threat to many
ghouls, even those who seem to retain control of their half—
vampiric natures. This behavioral disorder can strike a ghoul
at any time — often, embarrassingly enough, when he is in
the company of mortals. it is thankfully only a temporary
condition in most ghouls, but it becomes much more difficult
for the haIf-mortal ghoul to interact with humans when he is
in the throes of hysterical rage. The ghoul, often not realizing
that his “Beast” (vampiric nature) is taking over, feels
tremendous shame and guilt when he succumbs to Hysteria
in front of humans. After such an episode occurs, he often
grows fearful of punishment by his domitor, who may
instinctively know that the attack occurred even if she is not
present (see Case Study 15-4, involving myself and Dr.
Netchurch).
Animalistic Hysteria is triggered by sensory, environmental,
physical or emotional stimuli that the ghoul construes as
negative: feelings of inferiority to his domitor; abandonment
by his domitor; his domitor becoming injured; overdose or
lack of vampire blood; unrequited romantic feelings for his
domitor; grave physical endangerment; or being forced to
commit acts in violation of his moral, cultural, or ethical
codes. Really, any stressful situation may cause the ghoul to
enter frenzy; the triggers vary according to the individual
ghoul’s perceptions and past experiences.
Electroconvulsive therapy — ECT, more commonly known
as “shock treatment” — has been utilized more effectively in
the treatment of severe frenzy attacks than have various drug
treatments. Because 80% of ghoul study subjects’ hysteria
symptoms cease within five hours of the initial attack, the
best treatment may be none at all. ln cases where ghouls
experience frenzy for more than 48 consecutive hours.
however, they may prove unresponsive t0 anything short of
lobotomy or hypnosis. Drug treatment is often to be avoided
because many of the psychopharmaceuticals presently
available have adverse effects when introduced into a vitae-
permeated bloodstream. These drugs can, in fact, increase
the intensity of the symptoms evident during hysterical
episodes.
As a Derangement: All ghouls run the risk of frenzy, but a
ghoul who gains Animalistic Hysteria as a specific
Derangement must check against difficulties equal to those of
vampires. Bratovitch revenants automatically suffer from
similar afflictions and thus may not gain Animalistic Hysteria.
19
 Dependent Personality Disorder
As the name of this disorder implies, a ghoul possessing it
displays tremendous dependence on others, namely the
domitor or any remaining human contacts he may have after
the transformation into ghoulhood takes place. A ghoul
affected by this personality disorder is usually extremely
indecisive — if it were up to him, his domitor would tell him
what to wear, what to eat, whom to associate with, when to
go to sleep and what to enjoy. Most of this behavior is brought
on by excessive fear of abandonment. Fearing disownment,
the ghoul instead tolerates constant abuse. The more the
ghoul tolerates others’ control over him, the more he feels
helpless and stupid, and so he is further discouraged from
taking any actions that would ease his situation. Thus, this
disorder often goes untreated as long as the dependent
ghoul’s clingy behavior is reinforced by his domitor.
As a Derangement: The victim must make a Willpower
roll (usually difficulty 6) to refuse an order or suggestion from
his domitor. The ghoul‘s Nature often changes to that of
Sycophant.
Self-Defeating Personality
Disorder
More commonly known as masochism, Self—defeating
Personality Disorder appears routinely in ghouls, particularly
those ghouls in vassalage to Cainite “elders.” The servitors in
question seem compulsively drawn into situations or
relationships that they know will cause them intense pain
(often to the detriment of their mortal liaisons). They make
numerous sacrifices, often needless ones. in the names of
their domitors. These disturbed ghouls often have difficulty
relating to other ghouls, mortals or vampires who treat them
with respect.
Contrary to common opinion, many ghouls who display
signs of Self-defeating Personality Disorder do not
necessarily enjoy pain and suffering; most sufferers of this
disorder simply fear to assert themselves to their domitors.
Others were abused or sexually molested as mortals, and do
not know how to be treated any differently. Still others deny
that they are being abused, as they feel sacrifices must be
made in exchange for the eternal life provided by their
domitors. Finally, a few ghouls rationalize that they are being
rightfully punished for “sinning” against the God in which
they believed during mortal years.
20
Self—defeating Personality Disorder usually goes untreated,
as many domitors prefer their ghouls to be somewhat
submissive. Often this disorder is accompanied by
promiscuity in the ghoul, who may receive sexual gratification
from pain, feeling that this is the only form of attention she
gets from her domitor.
As a Derangement: The ghoul's nature changes to that of
Masochist or Martyr. Fulfilling the conditions of the Nature is
the only way this ghoul can regain Will- power (i.e., he does
not regain an automatic point per story, etc.).
Severe Dysmenorrheic Psychosis
This disorder manifests itself in approximately 30-40% of
“healthy” female ghouls who continue to have regular
menstrual cycles after the transformation into ghoulhood.
Aside from painful menstrual cramps, the victim suffers from
bouts of severe depression and paranoid delusions during her
period. These episodes usually Iast from five to seven days,
depending on the average length of the ghoul’s menstrual
cycle and the amount of blood lost during the cycle. If a ghoul
has not yet ingested her required monthly dose of vampire
vitae by the time her menstrual cycle begins, the blood loss
that occurs during her menstrual period has traumatic
psychological effects. The ghoul feels that she is about to die,
and i she becomes extraordinarily paranoid about not being
tended to by her domitor. During the onset of SDP, the ghoul
bursts into hysterics at every perceived slight, literally deathly
afraid that her domitor will fail to replenish the dwindling
supply of vampire vitae in her bloodstream. There is no
known cure for Severe Dysmenorrheic Psychosis, although
Dr. Netchurch has formulated a serum that alleviates some of
the disorder's symptoms. This drug has not been approved by
the Food and Drug Administration and is currently available
only on the black market or through the express permission
of Dr. Netchurch.
As a Derangement: Whenever the appropriate conditions
exist, the ghoul loses two points of temporary Willpower;
these points return at the end of the menstrual cycle.
Sexual Dysfunction
A ghoul who spends any time in the thrall of a Tzimisce
domitor is likely encumbered with a variety of sexual
dysfunctions. Female ghouls typically develop vaginismus,
involuntary contracting of the vulval and rectal muscles
preventing penetration, or dyspareunia, severe pain during
intercourse. Males, if not rendered completely impotent,
sometimes fixate sexually on acts favored by their domitors.
All such conditions are likely to instill an extreme aversion to
sex, further separating ghouls from the lifestyles they lead
prior to their servitorship.
Before allowing this derangement, Storytellers should
consider whether its inclusion will make any player
uncomfortable. Many people prefer not to explore such
personal issues in detail, especially during a game. Although
the setting is a suitable venue for such unpleasantness, you
can challenge your players without resorting to poor taste.
These caveats in mind, this derangement can be played
without mentioning graphic details - Storytellers can
extrapolate the likely effects such a condition might have on a
ghoul's relationship with his or her partners.
 Image Sources
The marks
of your
struggles
Derangements are behaviors that are created
White Wolf Game Studio References
when the mind is forced to confront intolerable
or conflicting feelings, such as overwhelming
terror or profound guilt. When the mind is faced
with impressions or emotions that it cannot
reconcile, the derangement is its attempt to ease
the inner conflict.
Other examples of derangement-incuding events
include killing a loved one while in a frenzy,
being buried alive, or seeing hundreds of years of
Revision Log (r1)
careful scheming dashed in an instant of bad
luck. Generally, any experience that causes
intense and unpleasant emotion or thoroughly
violates a character’s beliefs or ethics is severe
enough to cause a derangement.
Derangements are a challenge to roleplay,
without question, but a little time and care can
result in an experience that is dramatic for all
involved.
WWW.GMBINDER.COM
Cover : Neuroimaging techniques
Page 3: Paranoia is paralysing
Page 5: Mutilate, by Eric Peterson (for Magic:
the Gathering)
Page 9: Split: The One Man Show
Page 12: Schizophrenia
Page 14: Fregoli's Delusion, by Rafal
Hrynkiewicz (for Call of Cthulhu LCG)
Page 15: Clanbook: Malkavian cover
Page 17: Asylum Visitor, by Bastien Lecouffe
Dehame (for Magic: the Gathering)
Page 19: Arcanum Sanguinis Physical
Page 20: Dementation
Vampire: the Mascarade Rulebook, 20th
Anniversary Edition
Player's Guide Second Edition
Vampire: the Dark Ages, 20th Anniversary
Edition
Dark Ages: Vampires
Player's Guide to High Clans
Player's Guide to Low Clans
Clanbook: Malkavian (Revised)
Clanbook: Ravnos (Revised)
Clanbook: Tremere (Revised)
Clanbook: Tzimisce (Revised)
Chaining the Beast
Ghouls: Fatal Addiction
Guide to the Sabbat
Demon: the Fallen
Table of Content
More images and revised image locations