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Psychological Horror

Source Horror Adventures pg. 196
As a counterpoint to body horror, the psychological horror subgenre plays upon the fears and uncertainties rooted deep within the mind. The possibility of becoming detached from reality, plots to drive people mad, and the menace of taboo urges all fill the surreal world of psychological horror. While these stories might involve supernatural elements, it’s often difficult for characters to be sure whether such menaces are real or entirely within their heads.

Storytelling: Among the most challenging subgenres of horror to re-create in a Pathfinder adventure, psychological horror stories often deal with themes of conspiracy, doubt, and paranoia. In film and fiction, these stories might focus on a single individual being pushed beyond her limit as the lines of reality blur around her. In a Pathfinder adventure, it’s difficult to make one PC the victim of such horror—but it is possible. While the rules for sanity simulate a variety of psychological effects, these are most effective when a player chooses to roleplay their effects, forcing the group to acknowledge that the character’s grip on reality has slipped. Beyond those rules, the techniques described in the Warp Reality section and in the Secrets and Suspicion section can help sow uncertainty among the players, leaving them wondering what’s real and who they can trust.

Easier to create are adventures where another individual has lost his grip on reality, leading him to commit monstrous acts and possibly transform his home into a manifestation of his delusions. Conspiracy plots might unite a cadre of foes seeking to hide some shocking truth, perhaps making the PCs question whether lifelong beliefs have been lies all along. In more extreme cases, the PCs might become victims of gaslighting (perhaps by a gaslighter mesmerist), either in subtle ways or in elaborate experiments—like a dungeon of shifting passages or a deadly puzzle room— meant to drive them insane.

Monsters and Threats: Cunning shapechangers (like araneas, doppelgangers, and rakshasas) and creatures with manipulative mind powers (like aboleths, grays, and lotus trees) make fantastic foes in psychological horror adventures. Psychic magic is an obvious threat in these tales, warping memories and outright controlling the weak willed, but so are illusions, which can manipulate what a victim perceives or thinks he knows. More insidious than monsters in psychological horror stories are the everyday people who manufacture plots to undermine someone’s sanity or the individuals whose stresses and delusions become uncontrollable enough to set them on deadly courses—like a deranged individual who makes his home a trap-filled murder pit or a zealot who believes his sins can only be purified with innocent blood.

Basic Plots: A divine emissary in animal form comes to a PC and encourages her to slay a secret enemy of the faith— but it only speaks when the PC is alone. The PCs need to cure a scholar who has gone insane by entering his hag-haunted nightmares. The PCs come to a town where a teenage girl can turn herself invisible, and everyone lives in fear of what she does, doesn’t, or could know.

Advanced Plots: The PCs become aware they are the only true humanoids in a society that consists entirely of doppelgangers. Derros kidnap the inhabitants of an entire village without their knowledge, relocating them to a near-perfect re-creation of their community deep underground. A pakalchi sahkil convinces the queen that her court mages have turned against her, leading her to start a bloody witch hunt throughout the entire nation.