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The significance of this detail deals with the reliability of our narrator. Considering that the narrator himself has admitted to becoming "affected" by Usher's sickness, we must realize that a person isolated from the real world can become infected by the same mental "sickness" as another isolated person. There are many stories that deal with isolation leading to mental disorders. My personal favorite is The Shining, but "The Fall of the House of Usher" runs a close second. This is because from the very moment that the narrator admits his tendency towards the malady, all of his future thoughts must be questioned. This allows a reader's imagination to run wild with possibility, even to the point of wondering whether the narrator truly witnessed "the mighty walls rushing asunder" at the end. Poe was always a fan of making a reader's imagination do most of the work. What a genius of single effect!
The narrator in Edgar Poe's story The Fall of The House of Usher can be and has been seen by alot of commentators as a psychic counterpart of Usher. These psychic doubles of self and the Other are ever-present in Poe's fiction.
Seen from this angle, the narrator is like a foil to Usher's character and the whole story can then be seen as a horrific unification of the self and the Other whereby the self realizes its affinity with the Other and resultantly its own alterity. This is the crux of the kind of alienation that Poe produces in the story. The final efforts of the narrator are to flee away from the House, which is a horrid psychic space of this identification. In the fianal moments when Madeline comes back from the vault and dies, a strange madness, the seeds of which were always there in Usher's Melancholia, takes complete hold on him and it is at this point that the narrator feels horridly similar to him, in terms of the common state of extreme nervous tension, on the verge of going mad.
It shows how real it is
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