Dungeons & Dragons Online

Phantasmal Force – a psych major’s perspective

I was looking up the spell text for phantasmal force and got sidetracked reading threads debating how to adjudicate the effects of the spell, so I thought I'd weigh in on one aspect that seems to confuse many people – the target rationalizing the inconsistencies they detect.

You see, this is something that a lot of people with brain injuries or mental illnesses do IRL with the symptoms of their condition.

For example, left spatial neglect and cortical blindness both affect conscious visual processing, while leaving more subconscious visual abilities intact. In the case of left spatial neglect, it's anything the person perceives as being to the "left side" of their current frame of reference, whereas in cortical blindness, it affects patches of their visual field, or possibly the entire visual field in severe cases. (It's always the left side, too, no cases of right spatial neglect have been reported.)

But with both conditions, the person is still able to see, subconsciously, and their visual abilities affect their choices. A classic test for left spatial neglect involves showing the person a picture of two houses that look identical on the right side, but on the left side, one house is on fire. If you ask them if there's any differences between the houses, a person with left spatial neglect will say no. But if you ask them which one they'd rather live in, they'll pick the one that's not on fire, consistently. And then if you ask them why they picked that house, they'll make up some imaginary difference on the right side of the house, like "the gables look cleaner".

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For cortical blindness, the person might walk across a room without stumbling over any obstacles that a blind person would normally be expected to stumble across. But if you ask them why they swerved to avoid the open cupboard drawer that was aimed at their forehead, they'll make up something. "Oh, the floor feels nicer here."

For another example, sometimes people who are severely depressed to the point of psychotic symptoms will develop the fixed belief that they're dead. And no evidence will convince them otherwise. If you point out that they're talking, well, they're a ghost. If you prick them and they bleed, well, whaddya know, I guess dead people can bleed! Any bit of evidence is rationalized in a way that makes it compatible with their fixed belief that they're dead.

Or for another example, many people with left spatial neglect also have left-sided paralysis, since the brain regions associated with both symptoms are near each other and fed by the same arteries. Frequently, these patients will insist that they're not paralyzed at all, both of their arms work fine. If asked to raise both arms, they think they have, even though only the right one was raised. If the doctor points out that they haven't raised their left arm, they tend to give some excuse as to why, or just abruptly change the subject. Some patients even use their right arm to lift their left, and then insist that they moved it on its own power.

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Some of these paralyzed left neglect patients even deny that the paralyzed arm is a part of their body. For example, they might claim it belongs to a nearby person instead, or it's a fake limb. Pointing out that it's attached to their own body will also be met with bizarre rationalizations.

I recommend that you play someone who is affected by phantasmal force as if they had a brain injury or delusional disorder, not as a rational person reacting to perceptions that aren't real. It doesn't really matter if their rationalizations don't make sense to anyone else – in their spell-affected mind, they make perfect sense, just as it makes perfect sense to someone with left spatial neglect and paralysis to claim that the doctors decided to randomly graft a doll arm onto the side of their body right beside their totally real, totally not paralyzed left arm.

And in general, consider looking at neuropsychology case studies for inspiration on how to roleplay NPCs affected by enchantment or illusion spells.


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