When invoking horror in tabletop RPGs, you don’t have to use the supernatural or the uncanny. You don’t have bring out the gore.

Just take a look at the history of medical science and you’ll find plenty that’s frightening.

For example, the most terrifying part of The Exorcist isn’t the 12-year-old girl’s demonic possession, it’s the medical procedures the doctors perform on her. Maybe if you’ve seen the movie you might have blanked them out of memory–I know I did until I watched it the other night.

Suddenly there’s Regan MacNeil, tied to a hospital bed and a doctor is sticking a needle in her neck to perform an angiograph, as part of a pneumoencephalography. Basically, they drained part of the fluid from around Regan’s brain and replaced it with air so they could take a better image and pinpoint any potential brain lesions.

And then she’s tied to another hospital bed, with her head clamped still while some machine whirls and buzzes overhead.

And the doctors still couldn’t figure out what’s wrong with Regan.

Science and technology run amok is horrifying because its supposed to be based on rationality and reason. Frankenstein’s monster isn’t undead, it’s a creature of science.

How can this be applied to RPGs?

Many RPGs rely on the supernatural, but what if we reverse that?

  1. The PC discover a body with two puncture wounds to the neck–they’ll immediate think: “Vampire.” But no, the villain is a doctor who tried to perform a rudimentary angiograph.
  2. After a major battle a cleric PC is tending to the wounded and the dying. Suddenly, another person, whom the PC thought was a cleric, starts making drastic incisions and rubbing salt on the wounds. The patients die. (This is actually based on a historical account).
  3. The PCs enter a room full of animal parts, like frog’s legs, attached to electrodes. Again, this is based on history.
  4. Many characters and NPCs in a campaign setting might not have access to spells like detect evil, so they resort to phrenology.

Next: Horror in RPGs–Fear of the Unknown.