That's a good point. Case in point: Eternal Darkness: Sanity's Requiem Eternal Darkness had some really fucked up sanity effects( like a charactor accidentally shooting himself with an unloaded gun), but never sprung them on you unfairly. You had a Sanity meter that drained whenever you saw something messed up or UNKNOWABLE( because lovecraft says). The thing is, that game had an internal narative. And what I mean by that is that it told it's own story, you could interact and influence it in some small ways, but in the end every time you played through the game you got the same story each time. Now let me tell you how this relates to this topic before I go on a tangent about Cthulhu. The thing about internal narratives as I've described is that they are often moved forward by charactors, personalities within the story. Since they have they're own personalities, they have their own agency and will do what they want according to their own values. Often we are restricted by those values when playing as those charactors (Like not being able to shoot metal gear rex because snake has a thing for grey fox despite furiously mashing the fire button " I can't do it!") or having their atributes and values play a role in the mechanics( Charactors with/without less-then-lethal attacks, people who like to avoid conflict alltogether by sneaking by everything or not having any combat training/experiance, being afraid of the dark and losing their sanity when hiding in it). These charators also tend to have angency in areas the players don't, like cutscenes. But DayZ has no charactors (in the litierary sense), what we have could be more accuratley described as avatars. And because they don't have their own traits(outside their physcal traits) they don't have any real agency. Their agency comes from us, and because of that we are the ones interacting with the world. In DayZ we have what is called "emergent narrative." Emergent narrative is what happens whenever the player does a thing in a game that has a unique outcome, it's actually pretty common in games, it's what makes games games, actually(do I crush the goomba or jump over i- AAAh it killed me!). What makes DayZ unique (to me) is that it's one of the few games that only has emergent narrative. no princess to save, no hero to guide, just you, your virtual body and whatever the engine decided to generate. This is where the problem comes in (my problem anyways). Because the emergant narrative is dependant on the the player's interactions with the game, Introducing psychological elements to the game, in my opinion, would get in the player's way of the player's own psychology, or their narrative for their charactor. When you add hallucinations to the mix, it could get in the way of the player's narrative, With their avatar having a reaction to a situation the player wouldn't. In DayZ, the players don't need their avatars to experiance any psychological issues, because we bring our own baggage to the game. Or just like making weird shit up and acting like weirdos in direct chat.