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Occult Adventures pg. 236
Though they’re mental constructs, mindscapes can sometimes cause physiological effects through mental feedback. A creator with exceptional psychic power might be able to create a mindscape that is harmless for her but harmful for all other inhabitants, but most mindscapes affect everyone in the same way.
Harmful
: Injuries and conditions inflicted upon individuals visiting a harmful mindscape are real. Any psychic attacks harm the body by convincing the brain that the damage is real. Binary mindscapes are always harmful.
Harmless
: Occupants of a harmless mindscape still feel the sensation of the environment or other creatures harming them, but injuries and conditions are not real— they cause no physical harm to the host’s body. A creature that dies in a harmless mindscape wakes up none the worse for wear.