So you have all of your players around the table and are well away into a tale of woe and dread. Everyone's managing to truly get their head in the game but the immersion keeps faltering here and there as the very rules you're using to enhance the horror and realism also seem to keep getting in the way of the game itself. You don't want to ditch the rules, but you are finding a few things annoying.
The characters have been at it for so many hours they're fatigued and you warn them that they're now suffering a fatigue penalty. You pause to explain the rules and then everyone, including you, promptly forgets about that when later rolls are made.
Someone cracks open a book that drives them mad! You want to add an element of randomness so you have them roll a d10 on a pre-prepared table of likely disorders and then inform them (and all the other players) of their character's affliction. You may also need to explain just what Trichotillomania actually is.
Another character goes mad and their roll means they're now hallucinating and they already had paranoia. Oops! Now the players are all aware of these hallucinations which drops some of the fear factor when so-and-so starts ranting and raving about the shadows.
A third character becomes struck by a mind compulsion to start plotting against the other players which means you either take them aside and slow down the game or you clue in the other players.
And a fourth character gets nauseated. But what does that mean again? What are the rules for that? Time to break the flow to explain it all to them (and perhaps later again to remind them).
To bypass all of this, I got several pages of card and cut them into 5cm long by 3cm high cards. I then wrote on the back of them Madness; Hallucination; Status, etc. I wrote on the other side either details of the hallucination; the name of the madness (plus a first person description such as "Pulling out my hair calms me down"); or the rules of the status ailment.
When they got fatigued, I'd give them that card and they could refer to the rules at their leisure. When they went mad or had a hallucination, I could either pick out the right card or simply shuffle the deck, pull seven cards, and let them randomly select a card. No one else needed to know. Heck, depending on how I positioned the cards, they might not even know what type of deck it was.
I could also write down little notes to pass along on black versions of those cards, such as "You hear a scuttling sound" or "Blake's reactions seem manic; has he gone mad?" or "You should attack them soon", depending on my needs. And let's face it, tabletop players get paranoid when you start passing notes as it's unusual. Normally, what is described to one player gets known to the others. You can also give them blank cards so they can pass notes back to you, such as "Stealth check to steal Blake's gun" or "Subterfuge on not stealing the compass".
When used well, it can actually be pretty seamless.
Oh yeah, also, I created Adrenaline cards to encourage players to buy into fear and panic. Basically, if something became frightening enough to their character, the players could elect that their characters become flooded with adrenaline. This gave them a temporary +1 bonus to Initiative, Feats of Strength, and Perception checks, and the downside was only that they had to roleplay being jumpy and hopped up on adrenaline. Well, half an hour later they'd also feel it by becoming strained and taking a -1 to Speed and Composure through sheer weariness.
I think at some point I might trial Panic cards. Better bonuses but your character must behave in abject terror, such as fleeing through tunnels and general mindless escapism.
It's not too far from the truth of the situation but it does encourage people to have their characters buy into the fear. Sure, good roleplayers will have fearful characters but only great ones will be able to bypass the emotional distance and player pragmatism to truly react in a troublesome way for realism's sake.
See the rest of the articles in this series over here!