Describe the mechanism without turning it into destiny.

11

Aberrant Salience

An experience in which ordinary stimuli acquire unusually intense significance, urgency, or emotional weight.

Operational context

A neutral sound, color, timing coincidence, or gesture may feel charged with personal meaning and become part of an explanatory system.

Interpretive caution

The experience is not a supernatural perception and does not make the person violent, deceptive, or unintelligent.

17

Altered Salience

Neutral or ordinary stimuli acquire unusual urgency, personal meaning, or threat significance.

Operational context

In play, a hum, color, timestamp, or glance may become central before the character has a settled explanation.

Interpretive caution

Salience describes experience; it does not establish why the stimulus feels important or whether any underlying anomaly is real.

06

Cognitive Dissonance

Psychological tension caused by holding incompatible beliefs, identities, or accounts of one's behavior.

Operational context

Operatives may preserve both patriotic self-concepts and conduct that contradicts them by isolating explanations.

Interpretive caution

Dissonance is a normal human process, not proof of deception.

34

Collateral History

Information from people, records, and prior observations used to establish baseline and change.

Operational context

Multiple sources can reveal onset and function while also introducing bias or copied language.

Interpretive caution

Collateral sources are not automatically neutral or independent.

01

Compartmentalization

Separating conflicting roles, memories, or emotions so a person can function without processing them together.

Operational context

Adaptive in short bursts; rigid long-term use can produce emotional estrangement and identity strain.

Interpretive caution

A defense mechanism is not automatically a disorder.

25

Confabulation

Unintentional filling of memory gaps with information that feels coherent and true to the speaker.

Operational context

A character may preserve real fragments while connecting them through an inaccurate chronology.

Interpretive caution

Confabulation is not lying and should not be punished as deception.

35

Cultural Formulation

The meaning of beliefs and experiences is assessed within cultural, religious, political, and community context.

Operational context

Prevents the game from treating unfamiliar belief as pathology by default.

Interpretive caution

Cultural context does not prevent investigation of distress, coercion, or factual threat.

24

Delirium

An acute disturbance of attention and awareness that fluctuates and usually reflects a medical cause.

Operational context

In gameplay, timing, orientation, medication records, infection, and level of consciousness become critical evidence.

Interpretive caution

Delirium is a medical emergency context, not a mystery-device for extracting secrets.

18

Delusional Mood

A pervasive sense that the familiar world has changed and an important event is about to reveal itself.

Operational context

Useful for portraying a pre-explanatory phase in which tension and meaning accumulate before a fixed theory forms.

Interpretive caution

Do not turn this into supernatural intuition or a guaranteed warning of plot truth.

29

Dimensional Insight

Awareness of illness, uncertainty, consequences, or alternative explanations varies by domain and over time.

Operational context

A character can doubt one conclusion while remaining certain of another.

Interpretive caution

Insight is not an obedience score.

13

Double Bookkeeping

The capacity to inhabit a private altered reality while simultaneously navigating many rules of shared everyday reality.

Operational context

A person may act competently, protect relationships, and follow routines while also holding convictions that others do not share.

Interpretive caution

Coexisting realities are not proof of malingering, manipulation, or total loss of judgment.

15

Emotion-Focused Validation

Acknowledging fear, confusion, grief, or distress without affirming an unverified belief or perceived threat as fact.

Operational context

A response can state what the responder does and does not perceive while remaining present, respectful, and collaborative.

Interpretive caution

Validation is not agreement with a delusion; blunt confrontation and deceptive collusion can both increase distress.

33

Exposure Timeline

A chronology of substances, medications, withdrawal, sleep, and symptom change used to evaluate causation.

Operational context

It powers toxicology, staffing, pharmacy, and communications casework.

Interpretive caution

A positive or negative toxicology result has limits and is not a moral verdict.

21

Fixed Delusion

A belief held with high certainty despite strong counterevidence and not adequately explained by shared cultural context.

Operational context

The game models the observation, inference, and social consequences separately.

Interpretive caution

A clinician’s label does not determine whether every component of a surveillance claim is false.

26

Fluctuating Attention

Attention and clarity vary substantially over minutes or hours.

Operational context

Player timing and repeated assessment can change what is observable.

Interpretive caution

Do not exploit a lucid interval as blanket consent for unrelated disclosure.

16

Formal Thought Disorder

Observable disruption in the organization or expression of thought, including derailment, tangentiality, unusual associations, or reduced coherence.

Operational context

Dialogue systems can represent changes in connection, abstraction, and conversational repair without turning speech into random word salad.

Interpretive caution

Disorganized expression varies by person and state; it does not erase intelligence, history, humor, or communicative intent.

02

Hypervigilance

Persistent scanning for threat, anomaly, or surveillance even when immediate danger is uncertain.

Operational context

Can be a trained survival response and later become exhausting, sleep-disrupting, and difficult to deactivate.

Interpretive caution

Accurate threat detection and anxiety can coexist.

19

Idea of Reference

An ambiguous event is experienced as unusually related to oneself without necessarily reaching fixed delusional certainty.

Operational context

A broadcast, gesture, or sequence may feel personally directed and can become a clue, symptom, coincidence, or deliberate signal.

Interpretive caution

Personal relevance must be tested; it is not automatically psychosis or evidence.

04

Identity Strain

Conflict between authentic, professional, cover, and socially expected selves.

Operational context

Deep cover and long-term deception can make re-entry into ordinary relationships feel unsafe or unreal.

Interpretive caution

Identity strain is broader than dissociative identity disorder and should not be conflated with it.

05

Institutional Betrayal

Harm compounded when a trusted organization fails to prevent, acknowledge, or repair injury.

Operational context

Secrecy, clearance fears, and dual-role clinicians can make help-seeking feel like another security risk.

Interpretive caution

Institutional failure can be real even when individual staff intend to help.

12

Ipseity Disturbance

A disturbance in the basic pre-reflective sense that thoughts, perceptions, and bodily experiences belong naturally to oneself.

Operational context

Can appear as hyper-awareness of normally automatic mental processes, diminished self-presence, depersonalization, or uncertainty about mental ownership.

Interpretive caution

This is a phenomenological model, not a complete explanation of every psychotic experience and not a label to apply without clinical context.

08

Learned Helplessness

Reduced attempts to escape or change conditions after repeated experiences of uncontrollable harm.

Operational context

Coercive systems may cultivate passivity and then misread it as consent or stability.

Interpretive caution

Apparent compliance does not establish voluntary agreement.

32

Medical Causality Triad

Atypicality, temporality, and explicability are used together to test whether symptoms are linked to a medical condition.

Operational context

The player asks whether presentation is unusual, time-linked to illness or exposure, and medically plausible.

Interpretive caution

No single test establishes causation by itself.

22

Mood-Congruent Psychosis

Psychotic content that matches the emotional themes of a mood episode, such as special power in mania or deserved punishment in depression.

Operational context

Useful for tracking how espionage themes change with energy, sleep, guilt, and grandiosity.

Interpretive caution

Mood congruence is evidence for formulation, not proof of motive or truth.

03

Moral Injury

Distress following participation in, failure to prevent, or betrayal around acts that violate deeply held moral commitments.

Operational context

Common themes include guilt, shame, anger, alienation, and loss of trust in authority.

Interpretive caution

Moral injury is not itself a formal diagnosis and should not be reduced to one symptom.

28

Negative Symptoms

Reductions in motivation, expression, speech, pleasure, or social engagement that may occur in psychotic disorders.

Operational context

They affect pacing, goals, and participation without eliminating inner experience.

Interpretive caution

Do not frame reduced expression as laziness, hostility, or lack of humanity.

09

Operational Dependency

A relationship in which safety, identity, resources, or meaning become tightly controlled by a handler or organization.

Operational context

Dependency can be manufactured through isolation, selective rescue, secrecy, and restricted alternatives.

Interpretive caution

Attachment under constraint is not simple loyalty.

20

Overvalued Belief

A strongly held, emotionally important belief that may be unreasonable but remains more open to doubt than a fixed delusion.

Operational context

Helps distinguish passionate theory, ideology, suspicion, and identity-protective belief from psychosis.

Interpretive caution

Conviction exists on a continuum and changes with context.

07

Projection

Attributing unwanted feelings, motives, or failures to another person or system.

Operational context

Can turn private inadequacy or fear into certainty that an employer, handler, or target is uniquely corrupt.

Interpretive caution

Accusing an institution is not evidence of projection; the institution may be corrupt.

36

Reality-Neutral Validation

A response that acknowledges emotion, need, and immediate safety without confirming or aggressively denying an unverified explanation.

Operational context

This is the core of non-collusive dialogue gameplay.

Interpretive caution

Empathy does not require agreement, and honesty does not require confrontation.

23

Secondary Psychosis

Psychotic symptoms caused by or closely linked to another medical, neurological, substance, or medication condition.

Operational context

Creates urgent medical investigation routes before a primary psychiatric explanation is accepted.

Interpretive caution

Late or atypical onset and medical red flags require time-sensitive review.

30

Shared Psychotic Process

A close relationship can support mutual reinforcement of an unshared belief under isolation, stress, dependency, or coercion.

Operational context

The player maps influence and independent evidence without reducing the pair to dominant and passive roles.

Interpretive caution

Agreement may also reflect real shared danger, subculture, coercion, or ordinary belief.

14

Sleep-Deprivation Psychosis

Hallucinations, paranoia, disorganization, or delusional interpretation emerging after severe or prolonged loss of restorative sleep.

Operational context

Shift work, forced overtime, circadian disruption, stimulants, and cumulative sleep debt can impair perception and working memory before a crisis becomes obvious.

Interpretive caution

A temporary episode should not be written as a permanent identity, supernatural awakening, or automatic predictor of aggression.

27

Thought Disorganization

Difficulty maintaining conventional links among ideas, speech, or goal-directed thought.

Operational context

Dialogue may require slower pacing, clarification, and multiple ways to communicate.

Interpretive caution

Unusual language is not automatically meaningless or dishonest.

31

Trauma Re-experiencing

Intrusive memories, nightmares, sensory reliving, or flashbacks connected to a traumatic event.

Operational context

These experiences can overlap with current threat detection and must be separated from hallucination or delusion.

Interpretive caution

Do not demand repeated retelling to unlock progress.

10

Vicarious Trauma

Psychological impact from repeated exposure to other people's trauma through imagery, testimony, or analytic work.

Operational context

Analysts and clinicians can develop intrusive imagery, emotional numbing, sleep disruption, and altered assumptions about safety.

Interpretive caution

Physical distance from an event does not eliminate psychological exposure.