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You’re right.
If I kept the disorders secret and prompted players to roll dice and then forced them to act, I would agree 100% that it’s no different than a save-or-die.
I give my players some hints about the mechanics of their disorders, for this very reason. “If you see alcohol, you might be forced to drink.” “If you are under a moment of great emotional stress, you might retreat into yourself.” “If you are forced into a small, enclosed and dark space, you might go crazy.”
Most people, over time, come to cope with their conditions, and at the least learn what kind of stimuli can bring about symptoms, so it’s not totally unrealistic for players to have this kind of information. It also means that PC’s are very rarely completely surprised into a situation they could not have prepared or accounted for.
You also still have room for the scripted moments that you like, since the PC who’s deathly afraid of horses could be tasked with fetching the duke’s horse, or the claustrophobic PC could need to descend into a small cave to save a comrade from some giant spiders, etc.