This essay examines Edgar Allan Poe's "The Tell-Tale Heart" through a clinical psychological lens, identifying multiple symptoms of mental illness in the narrator's behavior and thoughts. The analysis traces delusions of grandeur, hallucinations of the old man's "vulture eye," loose associations, delusions of reference, and insomnia across the story's narrative. By connecting these symptoms to diagnostic criteria from the National Institute of Mental Health and the DSM-IV-TR, the paper argues that the narrator likely suffers from schizophrenia, concluding that the protagonist's true conflict is internal—a battle against his own deteriorating mental stability rather than simply against the old man's eye.
"The Tell-Tale Heart" is a story of a troubled man who is insistent on destroying something that has been tormenting him. The man, or the narrator, is driven mad—either by the white eye of the old man, or by his own psychological impulses. He finally kills his old landlord as a result of a plethora of symptoms that suggest the narrator has a psychological dilemma that he must resolve.
The first symptom that suggests the narrator has a disorder is delusion of grandeur. Although this can sometimes be viewed as extreme confidence or cockiness, the actual delusion suggests that the grandness cannot be proven. In this case, when the narrator stated that "you cannot imagine how stealthily [he snuck]" (Poe 9), or when he states how "wise" (Poe 7, 9) he is, these statements insinuate that the narrator is so sneaky or wise that whoever might observe this story would either be in awe, or they would not believe his level of skill—thus making his claims impossible to be proven or disproven. At the end of the story, it is easier to see the delusion when the narrator invites the police officers in to inspect the house: he not only welcomes them inside, but he also brings them to the very room in which the old man was murdered. He does this because he knows that nobody could solve the crime he has committed. He is too clever.
The most noticeable symptom that the narrator exhibits is his primary hallucination: that the old man's eye is bringing suffering and pain to the narrator's life. Considering the time period in which the story takes place and the lack of medicinal advancements, there were certainly many people who had physical disabilities and deformities that did not affect the narrator in the same way that the old man's eye did. Three times the narrator refers to the eye as a "vulture eye" (Poe 9), thereby embodying the eye with a characteristic that is related to a bird of prey—specifically, one known to hide until a weak enemy can be taken advantage of. The narrator even states that it is not like a human eye (Poe 7) when explaining that only a supernatural or animalistic eyeball could visualize things the way the old man's could.
The other hallucination—the one from which this story derives its name—is the narrator's hallucination of the tell-tale heart. It is constantly directing the narrator which way to go, much like a conscience would guide a mentally healthy person. Whether it be the narrator's need to kill the old man in order to "rid [himself] of the eye forever" (Poe 7), or the way the old man's supposed beating heart led the narrator to finally confess to the constables what took place that night, the idea of a bodily organ—whether the narrator's or the old man's—being responsible for guiding a person in their moral pathways is consistent with a hallucination experienced by a person with mental illness.
Another indication of the narrator's illness is that he has loose associations with the central topic. This could be a result of the story's brevity compared to the amount of information Edgar Allan Poe attempted to include. However, if the fragmentation is not solely due to compression, it would better demonstrate that the narrator "jumps around" when explaining his thought processes. Jumping around between different ideas and topics is a common manifestation of certain psychological disorders. This is mostly noticeable when the narrator first mentions his exaggerated heart right before he kills the man. He is standing at the other side of the room before he believes that his heart is becoming louder and louder—becoming so loud, in fact, that it should have been heard by the neighbors (Poe 9). Because of this, a "new anxiety seized [him]" (Poe 9), making him feel that he must end it by eliminating his frustration with the old man's eye. In order to resolve this problem, he leaps onto the old man and kills him. Again, this seemingly rash and sudden act could be a result of the story's short length, but having a tendency to jump around in his thoughts is consistent with the other symptoms he is experiencing.
Another noteworthy symptom is that of the narrator's delusion of reference: unless the narrator is the only person who comes in contact with the old man, the narrator believes that the man's eye must only be affecting him in the diabolical way that he believes it is. Besides the indication that the eye is a personal bother to the narrator, Edgar Allan Poe also leaves a hint about the personification of the eye—he capitalizes the name for the eye: the "Evil Eye" (Poe 8). Whether this is by chance or not, it is intriguing to imagine that the author would portray the man's "Evil Eye" as an antagonist rather than the old man's simple body part. From the reader's perspective, this personification of an object justifies the possibility for the narrator to have a suspicion about it. In other words, objects do not attack people themselves—only actual people do. This rationalizes the possibility that the narrator believes the object is targeting him—a form of delusion of reference.
"Diagnostic synthesis of symptoms supporting schizophrenia diagnosis"
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