In Edgar Allan Poe’s most famous short story "The Tell-Tale Heart" (1843) Poe gives a psychological portrait of a mad narrator who recounts his murder of an old man. "The Tell-Tale Heart" is merely a "tale of conscience," in which Poe exposes the dark side of humankind by giving this short story a psychological thrill. The narrator or madman in this story tells the story in first- person, therefore, the reader can not determine how much of what he says is true. Although the narrator repeatedly states that he is sane, the reader suspects otherwise because of his bizarre reasoning, behavior, and speech. Psychotic reasoning, psychotic illusions, and psychotic behavior are three causes in the story that lead up to the effect and that also prove the narrator’s insanity.
Psychotic reasoning or thinking of the narrator is one of the significant causes of the murder in "The Tell-Tale Heart." The narrator speaks with alarm in the first line of the story: "True-nervous-very, very dreadfully nervous I had been and am; but why will you say that I am mad?" (1). Therefore, the narrator expounds at once that he suffers from a disease, but he only implies that because it has not dulled his senses. Through Poe’s description of the narrator’s state of mind in the beginning of the story, the reader soon realizes that the narrator has in fact plunged into madness. The narrator’s stated purpose is not a confession, but the hunger to prove his sanity. In trying to prove this, Poe writes the narrator speaking "I heard all things in the heaven and in the earth. I heard many things in hell. How, then, am I mad? Hearken! And observe how healthily—how calmly I can tell you the whole story" (1). The narrator speaks of sanity in the story, but in reality knows nothing of it. The significant reason that psychotic thinking is a cause of the outcome of the story is that the narrator portrays and thinks of himself to be something that he is not. The narrator provides his own proof about straightforward betrayal of his own conscience.
A psychotic illusion is another significant cause of the outcome of the story. There are many different illusions that the narrator gives to the readers to visualize. One of the illusions or physical manifestations that the narrator gives the readers is the illusion of the virtual eye on the old man. Poe writes, " I think it was his eye! Yes, it was this! He had the eye of a vulture—a pale, blue eye with film over it" (1). The narrator gives the readers a visualization of a filmy pale, blue eye on the old man that he wants to discharge of. Also, Kopley quotes that "The mad narrator seems dammed at the beginning of the story, having ‘heard many things in hell,’ and the ‘Evil Eye’ apparently recognizes his damnation" (5). The narrator also gives another psychotic illusion of the sound of an interminable heartbeat. Once the narrator psychotically visualizes the heartbeat is that the sound causes the narrator to have an overwhelming sense of guilt, which eventually leads to the outcome of the story.
The last cause that leads to the effect or outcome of the story is psychotic behavior of the narrator. There are many different psychotic and bizarre behaviors that the narrator shows the readers at the end of the story that he is actually insane, but only one really stands out. The major psychotic behaviors in the story are a repetition of behaviors, which is the seven nights of sneaking in on the old man. The narrator or madman behaves repeatedly sneaking for seven nights, in which he places his head in the chambers of the old man with the evil eye each night tentatively. He also shines a light upon the old man’s evil eye so that the madman might be able to see it. Nevertheless, on the eighth night of the lurking the madman is more cautious than ever before, but the sound of his chuckling voice startles his sleeping victim. Kopley quotes "The young man open his lantern ‘stealthily’ and shines it upon the ‘Evil Eye,’ then jumps into the room and kills the ‘old man’ because of his ‘Evil Eye’ and his loudly beating heart (3). The murderer (narrator) then mutilates the body into pieces. Then, the madman places the body under the flooring of the chamber. Shortly after the murder, three men come into the old man’s chambers and charmingly introduce themselves as policemen. The policemen explain to the narrator that there had been suspicion of foul play. Then, the narrator smiles and explains that the shriek was his own dream. Next, the policemen were satisfied because the narrator had convinced them, but they continued to ask him questions. In the process of the policemen-asking questions, the narrator grew weary and very pale. He was anxious that the policemen might know of his crime. Last but not least, the narrator then hears his victim’s heartbeat again that Poe quotes becomes "louder! louder! louder! louder!" (3). Due to the narrator overwhelming sense of guilt of his murder, his shouts his confession to the police. Finally, the reader realizes the narrators perfect insanity.
Zimmerman quotes "The author, Poe, puts various rhetorical figures of speech and thought, as well as argumentative appeals, into the narrator’s explanations of the horrible events he has initiated, and then Poe sits back with his perceptive readers to watch the narrator fall short in his attempts at persuasion" (2). In the "Tell-Tale Heart," Poe gives us a story with an unreliable narrator, which turns out to be insane. This "tale of conscience" gives the readers of the story a psychological thrill and horror. The thrill is caused by a variety of factors that evenally lead up to the outcome. The factors are in progressive order in which the narrator’s actions cause the effect. The narrators actions are the psychotic thinking of the narrators, his psychotic illusions, and last, but not least his psychotic behavior. These progressive actions eventually lead up to the outcome in the story, which is the murder of the old man and also the proof that the narrator is actually insane. Again, "The Tell-Tale Heart" deals with psychological realism as well as exposing the dark side of humankind.

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