With all of the magical cure-alls and condition removal abilities in Starfinder, do you think that various mental maladies, such as PTSD, are largely a thing of the past in the Pact Worlds?
If so, that seems like it would ruin a lot of interesting character concepts, such as my amnesiac assassinroid character who suffers from PTSF and may well later develop dissociative identity disorder.
I don't think so. As someone with experience in mental illness you're looking at the difference between killing a virus or bacteria and rewiring the brain. PTSD in particular is developed from an experience, or a particular trauma.
Now, some mental illnesses like chemical imbalances (Bipolar disorder for example) may be treatable. Particularly hereditary ones might be significantly reduced, as "designer DNA" has actually been one of my arguements for why point buy has everyone on par when I have players arguing for rolled stats.
Now, there is one thing that I would label as a "cure" that exists in universe. The mnemonic editor. Quote: "Memories are not lost entirely; the patient still recalls what it did during its life, whom it met, and how it felt about the moments it experienced, but the impact of those experiences is subtly altered. The device then creates a new set of experiences—clearly artificial but no less effective—..."
That, however, is an expensive hybridized item. And as far as I can tell, the Pact Worlds aren't Canada, there isn't universal health care to cover such expenses. So I imagine it a bit like knowing there's something wrong, but either being financially trapped from taking it, or terrified at the idea of rewriting yourself to "fix" yourself. Both of which I think would make for some interesting character concepts.
It seems like the kind of thing that hits a little too close to home in too many ways for anyone to answer for anyone but their players (if then). Both yes and no come with their own possible implications that people might take the wrong way.
I agree with BNW, it comes down to how you want to handle the issues of mental health conditions in your game which is down to how you and your group will be affected by this. It is plausible that magic can fix any and all issues, it is plausible that some or all mental health issues are too complex for simple spellcasting, it is plausible that for your group ignoring the issue of PTSD and other mental health issues is better for that group. As a result there can be no simile one size fits all solution
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As stated above, it's entirely up to the group. That having been said...
Based on what little we know of PTSD, magic *could* theoretically help reduce its presence. Based on what I recall from research, PTSD either causes (or is caused by, or at least is linked with, in a chicken-egg fashion) a form of very localized neural degeneration in the areas of the brain responsible for memory retrieval and emotional processing. To simplify it almost to an absurd degree, one's brain has basically wired certain memories so destructively that it causes severe harm. In theory, operating under the assumption that this limited knowledge has been expanded upon by a setting that can manipulate the very building blocks of life for commercial gain with limited issue (save for resources and costs), one could imagine that someone has devised, say, a biotech implant that repairs those connections. Thus, when the brain processes that memory, the biotech implant offsets the sudden release of stress hormones, or maybe even repairs the previous damage. Magic might be able to patch it as well, though it would likely require very high level magic (it might require the return of psychic surgery).
In other words, in theory, SF should have the resources to, if not cure, than treat PTSD. The thing is...
Unlike a virus or bacteria, mental illness cannot be eradicated through treatment. And even in an advanced setting like SF< it beggars belief that preventative treatment can be administered to literally every sapient lifeform to someone prevent a mental illness, if that's even possible. Which means new instances of PTSD will always crop up when stressful or traumatic situations occur (and in a dangerous a setting as Starfinder, that'd be often). At which point, one runs into the same issue that the reprint Curse of the Crimson Throne dealt with: just because magic/tech can fix something, doesn't mean resources or availability is sufficient to fix it. Sure, some wealthy or fortunate citizens, perhaps on worlds that have a beefy public health infrastructure, could get excellent and perhaps permanent treatment at little cost. But on Akiton? Absalom Station? Apostae? Forget it. The common person wouldn't be able to afford the sort of high-level tech/magic necessary to treat a complex condition like PTSD. And then there's the fact that we don't know what sorts of cultural stigma each world has on mental illness. I can't see the Veskarium viewing PTSD in any fashion resembling a healthy mindset. I'm sure there are thousands of Vesk soldiers trying to "tough it out" in lieu of getting treatment, for fear of being ridiculed by their colleagues. It's a very real concern in our society, and SF is not universally more advanced as far as culture is concerned. Therefore...PTSD would not be gone, even if a cure were devised. Because said cure would likely be more complex than a single casting of a low-level spell. And thus, to about 80% of the galaxy, it would be out of their reach.
With all of the magical cure-alls and condition removal abilities in Starfinder, do you think that various mental maladies, such as PTSD, are largely a thing of the past in the Pact Worlds?
Mechanically, they don't even exist in SF. I wouldn't have a problem allowing a character with such a problem due to his back story, but it should only come in play outside of combat. Since there are no rules for "getting it", there's also nothing on getting healed - it would be a permanent disadvantage.
Until, or if ever, there's something like the Traits/Drawbacks from the Advanced Player Guide and Ultimate Campaign, it should be only flavor.
As someone who does have PTSD, I can say that the only thing that really helped me at all was years of therapy. Even then, I still suffer the occasional flashback, jump into "flight-or-fight" mode at sudden, loud noises, and am generally jumpy in crowds.
It is a very deeply ingrained thing. Now, maybe the mnemonic editor could help with that. But I don't think that a spell or some basic serum could just be a miracle cure for something like that.
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Keep in mind that the reason my treatment went well is because I wanted treatment in the first place. I've seen career soldiers with it who just don't believe that there's anything wrong. They refuse to believe that anything could be wrong. So even if an adventurer has it, they first have to be willing to be treated. And often, that just isn't the case.
Keep in mind that the reason my treatment went well is because I wanted treatment in the first place. I've seen career soldiers with it who just don't believe that there's anything wrong. They refuse to believe that anything could be wrong. So even if an adventurer has it, they first have to be willing to be treated. And often, that just isn't the case.
That is why one of the players in my campaign is playing a PC with untreated PTSD -- because that character has never sought help, and most NPCs he meets lack the necessary expertise to nudge him in the right direction. In this case, I am trusting the player to have done the research since I told him that I did not want to have to adjudicate this condition in play.
The underlying problem of. . . brain damage?
Given that starfinder magic and or technology can regrow missing limbs and re assemble an adventurer from something that has to be brought home in a bucket the more the problem is physical the easier a time magic should have with it.
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Keeping in mind that there isn't actually a distinction between physical and psychological in reality: all problems are physical, its that we don't have the specific degree of knowledge and detective equipment to tease them apart. I imagine magic would make that possible, however. If anything, given that the soul and the mind are both constructs in SF in ways they aren't IRL would give you even more options.
But then again, IRL we have vaccines against measles and people refuse to take them. We have antibiotics and people don't adhere. People don't report severe illness or go to the doctor's for myriad reasons. So just because it's probably possible doesn't mean people could or would do it.