What does the narrator fear in "The Tell-Tale Heart"?

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The narrator in this story is, by his own very early admission, "dreadfully nervous." He argues that he is not mad, but he is quite clearly mentally unstable. He does not understand why he suddenly felt so "haunted" by the eye of the old man whom he had previously loved. He decides he is going to kill the man because he is inexplicably so afraid of his eye.

When it comes time to commit the murder he has planned, the narrator is then afraid of waking him while he sleeps. To prevent this possibility, he opens the door very carefully and puts a light into the room for more than one night. He also states that he hears a "groan of mortal terror" arising from the old man in his bed, and that this is a familiar sound to him because it is a sound he has himself made in the middle of the night when he is distracted by "terrors." The narrator does not specify what these terrors are, but they potentially pertain to death or simply existential angst.

After he has killed the old man and the police officers arrive at his house, the narrator is at first calm, but then he becomes so terrified that the policemen suspect him. He becomes convinced that he can hear the beating of the old man's heart under the floorboards and also that surely the police will eventually hear this, too. Eventually, his guilt and fear over this causes him to admit his crime to the policemen.

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The narrator is afraid of being seen as mad or insane, but beneath that lies his almost unbearable fear of his own terrors. He projects them on to the old man:

Presently I heard a slight groan, and I knew it was the groan of mortal terror. It was not a groan of pain or of grief—oh, no!—it was the low stifled sound that arises from the bottom of the soul when overcharged with awe. I knew the sound well. Many a night, just at midnight, when all the world slept, it has welled up from my own bosom, deepening, with its dreadful echo, the terrors that distracted me. I say I knew it well. I knew what the old man felt, and pitied him.

The narrator protests too much when he says it could not be pain or grief that made the old man groan: "oh, no!" Of course, the narrator has no way of knowing why the old man groaned. He simply decides the old man is feeling the same terror he feels. This is called projection. He does to the old man what he wishes he could do to himself: stifle the terrors. He hopes that by killing the old man, he will kill his own terrors. Of course, ironically, he simply makes them worse and ends up confessing his guilt.

This fear of his own terrors also relates to his dread and fear of the old man's eye. The eye is a place associated with perception and insight. The narrator projects onto the old man's "Evil Eye" his own perception of his guilt and wants to snuff it out.

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The narrator of "Tell-Tale Heart seems frightened throughout, opening the story with the line "True!—nervous—very dreadfully nervous I had been and am." Even when he thinks up the idea of killing the old man, he says "it haunted me day and night." He suffers, he says, from the "over acuteness of the senses."

His idea of killing the old man revolves around wanting to rid himself of what's been scaring him all these years of working for him: namely, his master's eye, which he says is the eye of a vulture. He says, "Whenever it fell upon me, my blood ran cold."

When he actually kills the old man, he displays more pleasure than fear and says he is glad that his master's eye will no longer haunt him.

However, in the aftermath, his master's death does affect him deeply, and it is the imagined beating of his master's heart that eventually drives him insane.

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The narrator feels the fear that he will be pronounced insane, followed by the fear that he will be caught. He tells the reader multiple times at the beginning of the story that he is not insane and even gives his own version of proof—would an insane man go to such great lengths to hide the body, being careful not to even spill any blood? The narrator is also afraid that he will be exposed by a heart that everyone should be able to hear, but apparently he is the only one that can hear it. Thus, he rationalizes this as his own acute sense of hearing but he does not make any mention of other sounds that he hears. He is trying to rationalize his guilt.  

He even justifies his action at the beginning of the story by talking about the old man's vulture-like eye, and by explaining that the eye is evil, the narrator justifies killing the old man. He even goes into detail to explain that he did not kill the man for material gain or out of hatred for him personally.

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In Poe's story, The Tell-Tale Heart, the narrator fears several things. On the surface, he fears the old man especially because of the eye. When the narrator can stand the eye no longer, he kills the old man and buries him beneath the floor.  Then his fear becomes one of discovery because if the old man's body is discovered, the narrator will be arrested.  At the core of the story, however, is the fear that he will be considered insane.  That is why he makes reference to proving that he cannot be considered insane.  The title also refers to the heart which will tell the tale of the murder.  Hearing the heart beating with his guilt when no one else can hear it, the narrator's insanity becomes clear to the reader and reveals the narrator's greatest fear.

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