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The GM hates you and Paizo is in on the conspiracy to make you suffer.
And thus, all is suffering dedicated to make you despair. And despair you shall, until the bonds of your sanity in real life break and you slowly descend into gibbering madness.
That is the key to the sanity rules. There is no truly understanding them. They are an eldritch abomination in text form, and the more you contemplate them the closer to losing your own sanity you come.
Ia! Ia! Paizo ftaghn!