As with most RPGs, Fallout: New Vegas lets you pick whatever perks you want and just gives them to you if you meet the perk's requirements. Disco Elysium isn't like that. Instead, you have a "Thought Cabinet" that lets you choose which thoughts you'd like to mull over in your mind. Doing so will provide you with both buffs and debuffs while you chew on that thought, and then after you've collected enough XP, you "internalize" that thought for more substantial benefits.
It's an interesting system that results in far more nuanced gameplay and storytelling, and is one of the big reasons why Disco Elysium stands tall as one of the greatest RPGs ever made.
Sweet6Shooter, a New Vegas mod maker, certainly speaks highly of Disco Elysium. That's why they made the Vegas Elysium Perk Pack to bring the best parts of Disco Elysium into the world of Fallout: New Vegas.
"This is a perk/trait pack inspired by Disco Elysium, and it's thought cabinet in particular," writes Sweet6Shooter in the mod description. "It features 23 traits and 13 perks."
There are a lot of perks/traits so we're not going to go over them all, but we'll take a look at a few. Such as "Who Killed The World?," a trait which provides a 25% damage bonus against humans at the cost of a 35% damage reduction to non-humans. There's also some pretty sweet flavor text beside the perk description: "It wasn't the animals; it wasn't the robots; You know who killed the world."
Or how about "What Are You, Stupid?" A Perk that makes you deal more critical hit damage to targets with less Intelligence than you while having less crit damage against targets with more Intelligence than you.
Just like in Disco Elysium, these "thoughts" don't just appear on their own. You'll need to interact with certain items, talk to certain NPCs, or learn vital pieces of information for the "thought" to occur to you. Then you can start working on unlocking the perk through the usual gameplay.
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