Karamthulhu overlords can be found roaming the spirit plane during the Familiarisation distractions and diversion. While normally docile, as the activity progresses, they may decide to target the player and weaken their connection to the spirit plane, reducing the amount of time they are able to spend there. The familiars currently targeting a player can be viewed on the interface at the top of the screen. Karamthulhu overlords will always be one of the two familiars that initially target players in the form of a giant chinchompa.

It is the only creature in the spirit plane to not share its name with its familiar counterpart.

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