The Body Keeps the Score for TTRPGs

Stress impacts on PCs

Mar 09, 2025

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Note: This article includes content that relates to negative psychological and physiological consequences.

I’m interested in the effects of psychological pressure on player characters. My take focuses on the physiological impacts of stress (see The Body Keeps the Score).

This can be bolted onto pretty much any system, but I had some games in mind: Liminal Horror, Mork Borg, Cairn, Into the Odd, Death in Space, Cy_Borg (a lot of these are on sale right now I think).

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Stressful situations

When characters go through something psychologically stressful, they make a check related to psychological resilience afterwards (e.g. ‘Will’). If they are unsuccessful, their character will experience an ‘Impact’: a consequence of stress despite their best efforts.

Which situations prompt this check is up to you and your table. I think any time unexpected violence occurs or there is significant danger, it makes sense to have a roll after the situation is resolved. It makes the psychological risk of violent confrontation and threat more real.

Impacts

Impacts effect how quickly a character can complete tasks or drain their resources (e.g. prevents them sleeping). These come as either short term impacts (which last until a ‘full rest’ is completed e.g. 8 hours to recuperate) and long term impacts (which require action to resolve).

Short term impacts (d8)

When a character experiences a short term impact, roll on this table.

1: Off your food. Can’t eat.

2: Bad dreams. Can’t sleep.

3: Shakes. Fine motor movements take twice as long.

4: Wheeze or cough. Can’t remain silent for more than a few seconds.

5: Weak muscles. Feats of strength take twice as long.

6: Exhausted. Need double sleep to be rested.

7: Fog. Reading, studying, or methodical processes take twice as long.

8: Forget. Leave an object behind when you move on after sleeping.

Long term impacts

When the situation warrants something more long term, the above table is used but it becomes a long term impact. A long-term impact means there is a recurring chance that the character experiences the consequence.

The character begins with a 1-in-6 chance each day to experience the impact e.g. a 1-in-6 chance each day that they don’t manage to sleep.

They don’t gain other types of long-term impact because that means more dice rolls and more tracking. If the character would gain another long-term impact, instead, the daily chance of the first impact rises to 2-in-6 and so on.

If characters recover from a long-term impact, they might gain a different one later.

Recovery

Characters can take significant action to address or learn to manage long term impacts, e.g. retreating to a place of respite where a herbalist can provide them with soothing remedies for a week and they can talk to friends.

If there is a higher chance e.g. 2-in-6, then multiple actions are required to address the impact in stages. Example: by spending time with family for a week, the chance of a character experiencing Bad Dreams daily reduces from 2-in-6 to 1-in-6.

That’s it

A simple approach to how character’s experiences can affect them physiologically. If you’re wanting to run a more grounded game where characters experience stress in a more ‘gritty’ way, give this a try.

If you like this article, please like and share! Commenting helps out MurkMail a lot and I love chatting with you folks. Come chat on the discord. Join our ttrpg bookclub if you want to get involved!

If you are lacking dice to roll on these tables, I’ve used these and this dice tray for years. To note down all this suffering, I’m using Muji notebooks (absolutely, 100% THE BEST notebooks) with a Lamy pen for writing.

Recommendation

~that’s right, recommendations are back~

A free adventure by a new creator, Aaron’s Gaming Stuff, dropped recently: The Ruins of Arbel Monastery. Although the pdf is 12 pages, this dungeon packs a whopping 60+ rooms into 6 of those pages. There’s some fun puzzles in here, a classic feel, and the overall terseness of text and non-linear layout is great.