SOURCE: '"Moral Insanity' or Paranoid Schizophrenia: Poe's 'The Tell-Tale Heart,'" Mosaic, Vol. 25, No. 2, Spring, 1992, pp. 39-48.

[In the essay that follows, Zimmerman analyzes the ways in which "The Tell-Tale Heart" anticipates the psychological concept of paranoid schizophrenia, and concludes that Poe belongs to that group of "modern artists who find in science not a threat but an ally."]

In our time, creative writers are expected to do their "homework," and consequently to find "modern" scientific accuracy in a literary text comes as no surprise. To discover similar scientific accuracy in a text from an early period is a different matter—one which involves not only questions about the sophistication of the artist but also about the sophistication of the science of his/her time. A case in point is Poe's short story of 1843, "The Tell-Tale Heart." Narrated in retrospect, Poe's confessional tale features a "mad" protagonist who recalls his grisly murder of an old man, his living companion, and who tries to explain the reasons for both this abominable act and his ultimate confession. My purpose in the following essay is to demonstrate the extent to which Poe's characterization of this narrator corresponds with current psychoanalytic profiles of the "paranoid schizophrenic" personality. Subsequently, my purpose is to consider the "science" of Poe's time in order to show how it "anticipates" current thinking and so provides the context for Poe's own acute insights into the nature, cause and consequences of this kind of mental illness.

… . .

According to current psychological theory, the "active" phase of paranoid schizophrenia is preceded by a "prodromal" phase during which premonitory symptoms occur, one of which is "superstitiousness" (DSM 195).¹ In Poe's tale, what precipitated the narrator's insanity and the subsequent murder was his irrational obsession with the old man's so-called "Evil Eye." The narrator freely admits to his auditors that this was his primum mobile: "yes, it was this! He had the eye of a vulture—a pale blue eye, with a film over it. Whenever it fell upon me, my blood ran cold; and so by degrees—very gradually—I made up my mind to take the life of the old man, and thus rid myself of the eye forever" (88). Although it might be argued that the madman's comments about the "Evil Eye" constitute his rationalization about his decision to murder, the way he describes the object suggests that the "Eye" was indeed the thing which drove him to commit his atrocities. Although mad, he is not entirely an unreliable narrator, for what we should consider is the way his idée fixe, his superstition concerning the "Evil Eye," generated a kind of anxiety or "overwhelming stress" which, according to current theories, can lead to a full schizophrenic breakdown (Sue 441-42).

A major symptom of the active phase of schizophrenia involves hallucinations, and it is here that Poe critics have come closest to identifying the specific nature of the narrator's mental condition. For example, before she abandons herself to a Freudian interpretation, Marie Bonaparte refers to "auditory hallucinations of paranoia" (498). Similarly, in their anthology of short fiction, The Abnormal Personality Through Literature, Alan Stone and Sue Smart Stone include "The Tell-Tale Heart" in a chapter on psychotic symptoms—specifically, hallucinations. Closest to a more precise identification of the narrator's condition is John E. Reilly, who indeed describes the protagonist as a paranoid schizophrenic (5-6). To Reilly, the key index to the narrator's condition is his "hyperacusis," but it is at this point that his analysis falls short and the directions from current research become important.

According to modern researchers, paranoid schizophrenics often experience sensory perceptions that are not directly attributable to environmental stimuli. They also note that 74% of schizophrenics suffer from auditory hallucinations: they hear sounds that are not real to others (Sue 428). Usually these sensorial illusions involve voices which the victim perceives as originating outside his/her head, but occasionally "the auditory hallucinations are of sounds rather than voices" (DSM 189).

Poe's narrator insists that his "disease had sharpened [his] senses—not destroyed—not dulled them," and that "Above all was the sense of hearing acute." Yet when he goes on to add "I heard all things in the heaven and in the earth. I heard many things in hell" (88), his absurdly grandiose claim encourages us to suspect related claims he makes regarding his auditory capacity. He explains, for example, that "there came to my ears a low, dull, quick sound, such as a watch makes when enveloped in cotton" (91). He interprets this sound as the beating of the old man's heart, but it would have been impossible for him to hear such a noise unless his ear were against the old man's chest. Some scholars argue, in turn, that the narrator was in fact hearing his own heart (Shelden 77; Hoffman 232; Howarth 11). While such an interpretation is possible, the narrator's claim to hear things in heaven, hell and the earth makes it more logical to conclude that the sound he heard was not the beating of his own heart, but rather was an auditory hallucination.

To Reilly, the cause of the sound was actually an insect called the "lesser death-watch," but he also admits that there are certain discrepancies in his theory: "Whereas the narrator heard the sound on two occasions during the night of the murder, the ticking of the lesser death-watch is said to continue for hours. Moreover, the narrator reports that the sound he heard increased in tempo just before the murder and grew in volume on both occasions, whereas the ticking of the lesser death-watch is uniformly faint" (5). Reilly then tries to account for the discrepancies by saying that the narrator's "subjective sense of time accelerated the regular ticking of the lesser death-watch" and its volume (7). Such a convoluted explanation is, however, entirely unnecessary if we view the protagonist as a paranoid schizophrenic. If we see him as suffering from auditory hallucinations, then we do not need to suggest any material source, whether insect or heart, for the sounds he claims to have heard—they originated inside his head.

The narrator, of course, insists that "the noise was not within my ears" (94), but such a disclaimer simply highlights another, the most common, symptom of schizophrenia—a lack of insight: "during the active phase of their disorder, schizophrenics are unable to recognize that their thinking is disturbed" (Sue 426). Although Poe's narrator admits to having some kind of sensorial disease, he is obviously unaware that it is in fact a mental aberration: "why will you say that I am mad?"; "You fancy me mad. Madmen know nothing. But you should have seen me"; "have I not told you that what you mistake for madness is but over acuteness of the senses?"; "If still you think me mad, you will think so no longer when I describe the wise precautions I took for the concealment of the body" (88, 91, 92). One of the greatest sources of irony—and perhaps pathos—in the tale is the narrator's vehement insistence that he is sane, rather than insane.

The protagonist's inflated opinion of himself is also in keeping with the current view that a "common delusion among paranoid schizophrenics involves exaggerated grandiosity and self-importance" (Sue 439). Poe's narrator brags and boasts specifically of his brilliant circumspection in preparing to murder the old man: "You should have seen how wisely I proceeded—with what caution—with what foresight—with what dissimulation I went to work! … Never before that night, had I felt the extent of my own powers—of my sagacity. I could scarcely contain my feelings of triumph" (88-89). The narrator believes that he has engaged in what Thomas de Quincy thinks of as "the fine art of murder." He would agree with the facetious de Quincy that a murder can be a very meritorious performance—when committed by a man of superior powers.

Not only was the murder performed with circumspection and with finesse, but so was the disposal of the corpse; Poe's narrator believes that in hiding the evidence of his crime he had considered every possible contingency:

If still you think me mad, you will think so no longer when I describe the wise precautions I took for the concealment of the body.…

I then took up three planks from the flooring of the chamber, and deposited all between the scantlings. I then replaced the boards so cleverly, so cunningly, that no human eye—not even his—could have detected any thing wrong. There was nothing to wash out—no stain of any kind—no blood-spot whatever. I had been too wary for that. A tub had caught all—ha! ha!

(92-93)

Then this narrator gloriosus boasts of the "enthusiasm of my confidence" and of "my perfect triumph."

Other symptoms of paranoid schizophrenia include shifts of mood (Sue 433-34), and Poe's madman exhibits these in a number of ways. When he begins his recall, he boasts of "how calmly I can tell you the whole story" (88), and indeed his recollection starts calmly enough. As soon as he begins to recall the alleged beating of the old man's heart, however, he becomes frenetic and he loses his composure: "The old man's terror must have been extreme! It grew louder, I say, louder every moment! … Yet, for some minutes longer I refrained and stood still. But the beating grew louder, louder! I thought the heart must burst. And now a new anxiety seized me—the sound would be heard by a neighbour! The old man's hour had come!" (92). As James W. Gargano has demonstrated, "there is often an aesthetic compatibility between [Poe's] narrators' hypertrophic language and their psychic derangement …" (166). In "The Tell-Tale Heart" Poe dramatizes the madman's shift from calmness to hysteria by the increased use of such rhetorical devices as repetition (diacope, epizeuxis, ploce), exclamations, emphatic utterances (italics), and the dash. After he confesses how he murdered the old man, Poe's narrator calms down again—until he relates how the police entered his house and the sound of the "heartbeat" recommenced, at which point he becomes one of the most hysterical, most frenzied narrators in all of Poe's fiction.

Associated with the narrator's mood alterations are other symptoms of schizophrenia, including the display of emotions that are at variance with the normal reaction to a given situation: "Schizophrenic patients may exhibit wild laughter or uncontrollable weeping that bears little relationship to current circumstances.…Schizophrenics may express the wrong emotions or may express them inappropriately" (Sue 433-34). Evidencing this trait, Poe's protagonist recalls with delight the artful way he performed the most hideous of crimes. He assumes, as well, that his audience shares similar emotions; relating his stealth and patience while putting his head into the old man's chamber, he explains: "Oh, you would have laughed to see how cunningly I thrust it in! … To think that there I was, opening the door, little by little, and he not even to dream of my secret deeds or thoughts. I fairly chuckled at the idea …" (89-90). Although he pitied his intended victim, he nevertheless "chuckled at heart." In addition, the care he displayed in avoiding blood stains is for him a great source of complacency and humor: "A tub had caught all—ha! ha!" (93).

Complications of schizophrenia include "violent acts" (DSM 191), and, of course, the murder of the old man is clearly the ultimate manifestation of such a tendency. Not all paranoid schizophrenics are homicidal maniacs, however; often if they are violent at all the violence is turned against themselves rather than others. Clearly, though, Poe's schizophrenic is the most dangerous kind: his violence is turned outward, and he originally had no intention of coming to harm himself.

Features of paranoid schizophrenia associated with violence include anxiety, anger and argumentativeness (DSM 197). The anxiety of Poe's narrator is something he admits to and, indeed, stresses at the outset: "True!—nervous—very, very dreadfully nervous I had been and am …" (88). Anger and argumentativeness are also evidenced in his response to the police: "I arose and argued about trifles, in a high key and with violent gesticulations…. I foamed—I raved—I swore!" (94). Such symptoms constitute what is currently labeled "dysphoric mood" (DSM 190).

Unfortunately for Poe's paranoid schizophrenic, what finally proved his undoing is yet another symptom of his disease—delusions of persecution. Psychologists note that "deluded individuals believe that others are plotting against them, are talking about them, or are out to harm them in some way. They are constantly suspicious, and their interpretations of the behavior and motives of others are distorted" (Sue 438-39). When Poe's narrator invited the three officers in, he was at first certain that they suspected nothing; then his auditory hallucination began again, and eventually he became convinced that they could not fail to hear the sound which was tormenting him:

It grew louder—louder—louder! And still the men chatted pleasantly, and smiled. Was it possible they heard not? Almighty God!—no, no! They heard!—they suspected!—they knew!—they were making a mockery of my horror!—this I thought, and this I think. But anything was better than this agony! Anything was more tolerable than this derision! I could bear those hypocritical smiles no longer! I felt that I must scream or die! and now—again!—hark! louder! louder! louder! louder!

(94)

Just as current researchers note the way paranoid schizophrenics might see a "friendly, smiling bus driver … as someone who is laughing at them derisively" (Sue 439), so the smiles of the police served only to convince Poe's narrator that they were conspiring against him—with the end result being his confession: " 'Villains!' I shrieked, 'dissemble no more! I admit the deed!' "

What especially recommends a view of the narrator as a paranoid schizophrenic is that it uncovers the most plausible reason why he confessed. Contrary to the explanations usually given, I would argue that Poe's madman revealed his crime not because of a guilty conscience, not because some "imp of the perverse" goaded him into confessing, not because he hates himself and really wanted to be caught—not because he has self-destructive tendencies, in other words—but because he suffers from delusions of persecution. He believed that the officers had discovered his crime, and he could not bear the thought that they were mocking him. As Reilly notes, "the narrator purged his rage by exposing what be believed was the hypocrisy of the police," and thus "self-incrimination" was merely the by-product (7).

The time span of "The Tell-Tale Heart"—from the time Poe's narrator began looking in on the old man every night at midnight, until the consummation of the murder, and even while he is confessing and insisting upon his sanity—corresponds nicely with the active phase of paranoid schizophrenia. According to psychiatrists, the active phase is of at least a week's duration and is characterized by the manifestation of psychotic symptoms (DSM 194). Poe's narrator had been suffering such symptoms for this same time period: he speaks of "the whole week before I killed him" (89), and when he mentions the "low, dull, quick sound" which he attributes to the old man's heart, he says that he "knew that sound well" (91). In other words, he had been experiencing his auditory hallucinations during the week before the murder, not just on the night of the crime.

It is one thing to apply twentieth-century psychology to Poe's tales, but it is quite another to account for the fact that Poe has given us a paranoid schizophrenic in the absence of twentieth-century psychology. In Poe's day the field of scientific psychology was relatively young, and schizophrenia did not even have a specific name; it was not until 1898 that Emil Kraepelin labeled the disease "Dementia Praecox," and it was given its modern name by Eugen Bleuler only in 1911. Thus, Poe portrayed a paranoid schizophrenic decades before nosologists labeled and separated that disease from other mental abnormalities.

Several explanations for this situation are possible. One is that Poe himself had experienced symptoms of paranoid schizophrenia, and used these as the basis for his narrator in "The Tell-Tale Heart." Another hypothesis is that Poe's portrait is purely a product of his imagination (and it is therefore a matter of coincidence that he portrayed what twentieth-century psychology calls a paranoid schizophrenic). The explanation I would like to advance and support, however, is that Poe acquired his knowledge of the symptoms by familiarizing himself with the scientific theories of his time.

The allusion to the phrenologist Spurzheim in "The Imp of the Perverse"; the references to the "moral treatment" of the insane in "Dr. Tarr and Prof. Fether"; the review of Mrs. L. Miles's Phrenology in the Southern Literary Messenger—these and other references to coeval theories of psychology in Poe's works show that he was very much a student of mental diseases. He may have learned a great deal from his discussions with medical men like his acquaintance Pliny Earle (a physician who dealt extensively with the insane at asylums in both Pennsylvania and New York), but probably he gleaned information from literary sources as well.

I. M. Walker is only one of several scholars (Elizabeth Phillips, Allan Gardner Smith, Robert D. Jacobs) who insist that Poe was familiar with the works of the psychologists of his day: "With his passion for scientific fact and his interest in abnormal mental states, Poe would have been likely to turn to systems of contemporary psychology in the same way that modern writers have turned to Freud and Jung. Moreover, in Poe's day … information regarding both mental and physical diseases was readily available to the intelligent layman, not only in the original works of the scientists, but also in popular journals and encyclopaedias" (588). A specialized publication, the American Journal of Insanity, began appearing in 1844 (only a matter of months before the final publication of "The Tell-Tale Heart" in the Broadway Journal on 23 August 1845). As for books, Paige Matthey Bynum notes that "Between 1825 and 1838, the Philadelphia publishing house of Carey and Lea published almost twice as many medical books as those in any other category except fiction, and mental health was a staple concern in these works" (150). In the bibliography to The Analysis of Motives Smith lists many works on psychology which were extant in Poe's America—books in English that describe the various symptoms which characterize the abnormal mental state of his narrator in "The Tell-Tale Heart."

Such descriptions are scattered, however. Because the science of psychology was in its infancy, there was much confusion and disagreement between medical men on how to classify and relate the symptoms of insanity. While twentieth-century students can find entire chapters devoted solely to schizophrenia in various manuals and textbooks, it is more difficult to find specific chapters which group only the features of this disease in the books by Poe's contemporaries—their categories were very broad and often vague.

Occasionally, however, we can find three or more of the symptoms listed together. One of the earlier texts available to Poe was John Haslam's Observations on Madness and Melancholy (1809). In a general chapter on insanity—"Symptoms of the Disease"—Haslam refers to suspiciousness (42) and later to auditory hallucinations and violence (69). In the next chapter he provides particular case studies. One of these. "Case XVI," concerns a man whose "temper was naturally violent, and he was easily provoked.…He would often appear to be holding conversations: but these conferences always terminated in a violent quarrel between the imaginary being and himself. He constantly supposed unfriendly people were placed in different parts of the house to torment and annoy him" (118-19). Here we have not only violence and argumentativeness, but also the two essential features of paranoid schizophrenia that modern psychologists have identified (DSM 197): delusions (of persecution) and the most common kind of auditory hallucination—that which involves voices.

Haslam's "Case XX" involves a woman who, like the male patient, evinced violent tendencies and delusions of persecution, in addition to mood shifts and optical and olfactory hallucinations: "At the first attack she was violent, but she soon became more calm. She conceived that the overseers of the parish, to which she belonged, meditated her destruction.…She fancied that a young man, for whom she had formerly entertained a partiality, but who had been dead some years, appeared frequently at her bed-side, in a state of putrefaction, which left an abominable stench in her room" (126-27). Haslam also notes that the woman began to suffer her mental affliction "shortly after the death of her husband." The likelihood that the demise of her spouse created the extreme stress which triggered her breakdown corresponds with the current view that a "psychosocial stressor" may trigger the active phase of schizophrenia (DSM 190).

In his Introduction to a recent edition of Haslam's work, Roy Porter observes that "Historians of psychiatry have credited Haslam with giving the first precise clinical accounts of … schizophrenia" (xxvii). Prior to the publication of "The Tell-Tale Heart," however, there were also other works which described the illness. In his Treatise on Insanity and Other Disorders Affecting the Mind (1837), for example, the American physician James Cowles Prichard records the case of a young man who suffered from what he calls "moral insanity":

He frequently changed his residence, but soon began to fancy himself the object of dislike to every person in the house of which he became the inmate…. On being questioned narrowly as to the ground of the persuasion expressed by him, that he was disliked by the family with which he then resided, he replied that he heard whispers uttered in distant apartments of the house indicative of malevolence and abhorrence. An observation was made to him that it was impossible for sounds so uttered to be heard by him. He then asked if the sense of hearing could not, by some physical change in the organ, be occasionally so increased in intensity as to become capable of affording distinct perception at an unusual distance.… This was the only instance of what might be termed hallucination discovered in the case after a minute scrutiny [by physicians].

(38)

Apparent in this case are delusions of persecution and voice hallucinations. The young man's query about the possibility of hearing sounds at great distances, furthermore, certainly recalls Poe's insane narrator. Finally, the patient's hypothesis that his disorder is physiological rather than mental also indicates that he too lacks insight into his true psychical condition—another symptom of paranoid schizophrenia.

Other works on abnormal mental states written during Poe's day that describe symptoms of schizophrenia include Isaac Ray's A Treatise on the Medical Jurisprudence of Insanity (1838), in which he cites Joseph Mason Cox's Practical Observations on Insanity (1804). In a chapter on "General Moral Mania" Ray quotes Cox's report of a certain variety of "maniacs" who

take violent antipathies, harbor unjust suspicions … are proud, conceited and ostentatious; easily excited … obstinately riveted to the most absurd opinions; prone to controversy … always the hero of their own tale, using … unnatural gesticulation, inordinate action…. On some occasions they suspect sinister intentions on the most trivial grounds; on others are a prey to fear and dread from the most ridiculous and imaginary sources.…If subjected to moral restraint, or a medical regimen, they yield with reluctance to the means proposed, and generally refuse and resist, on the ground that such means are unnecessary where no disease exists.…

(172-73)

The symptoms Cox describes correspond very closely to those current psychologists associate with paranoid schizophrenia, just as they also closely match those evinced by the narrator of "The Tell-Tale Heart": violence, delusions of persecution and of grandeur, mood shifts, nervousness, and a lack of insight into his own psychopathy.

Clearly, then, Poe and his contemporaries were describing paranoid schizophrenia, even if its symptoms were classified under the broad heading "Moral Insanity," which, as Norman Dain observes, "served as a catch-all for many forms of mental illness" in the early nineteenth century (73)—and which, as Bynum confirms, would indeed have been the way Poe's contemporaries would have diagnosed the condition of his narrator. Accordingly, although romanticists may like to see Poe as a tormented artist who wrote "The Tell-Tale Heart" to explore or to purge himself of his own psychotic or self-destructive tendencies, it seems better to regard him as a sophisticated writer who consulted scientific books and journals in an attempt to achieve accuracy and verisimilitude in his own works—the same Poe who familiarized himself with, for instance, the writings of Sir John Herschel, Thomas Dick and John P. Nichol for the astronomy in Eureka; and whose reviews of Washington Irving's Astoria and J. N. Reynolds's "South Sea Expedition" informed Pym. For Poe to consult psychology texts for the sake of scientific precision in "The Tell-Tale Heart" would have been typical of his standard practice.

In many ways, therefore, Poe is a precursor of modern artists who find in science not a threat but an ally, and the sophistication of his insights might encourage us to be more humble about our own sophistication. His insights might make us wonder whether the major contribution of twentieth-century psychology has taken the form of new knowledge or whether it consists instead in naming and classification, for it appears that Poe and his contemporaries knew a good deal about paranoid schizophrenia—even if they did not use this terminology.

Notes

¹ The abbreviation refers to the standard reference work in the field of psychology—Diagnostic and Statistical Manual of Mental Disorders (see my first entry in Works Cited).

Works Cited

American Psychiatric Association. "Schizophrenia." Diagnostic and Statistical Manual of Mental Disorders. 3rd ed, rev. Washington, D.C.: American Psychiatric Association, 1987. 187-98.

Bonaparte, Marie. "The Tell-Tale Heart." The Life and Works of Edgar Allan Poe: A Psycho-Analytic Interpretation. Trans. John Rodker. 1949. New York: Humanities, 1971. 491-504.

Bynum, Paige Matthey. " ' Observe How Healthily—How Calmly I Can Tell You the Whole Story': Moral Insanity and Edgar Allan Poe's 'The Tell-Tale Heart'." Literature and Science as Modes of Expression. Ed. Frederick Amrine. Boston Studies in the Philosophy of Science 115. Boston: Kluwer, 1989. 141-52.

Dain, Norman. Concepts of Insanity in the United States, 1789-1865. New Brunswick, NJ: Rutgers UP, 1964.

Gargano, James W. "The Question of Poe's Narrators." Poe: A Collection of Critical Essays. Ed. Robert Regan. Englewood Cliffs: Prentice, 1967. 164-71.

Haslam, John. Observations on Madness and Melancholy. 2nd ed. London, 1809.

Hoffman, Daniel. "Grotesques and Arabesques." Poe Poe Poe Poe Poe Poe Poe Garden City: Doubleday. 1972. 226-32.

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Jacobs, Robert D. "The Matrix." Poe: Journalist & Critic. Baton Rouge: Louisiana State UP, 1969. 3-34.

Phillips, Elizabeth. "Mere Household Events: The Metaphysics of Mania." Edgar Allan Poe: An American Imagination. Port Washington: Kennikat, 1979. 97-137.

Poe, Edgar Allan. "The Tell-Tale Heart." In vol. 5 of The Complete Works of Edgar Allan Poe. Ed. James A. Harrison. 1902. New York: AMS, 1965. 88-94.

Porter, Roy. Introduction. Illustrations of Madness. By John Haslam. New York: Routledge, 1988. xi-lxiv.

Prichard, James Cowles. A Treatise on Insanity and Other Disorders Affecting the Mind. Philadelphia, 1837.

Ray, Isaac. A Treatise on the Medical Jurisprudence of Insanity. Boston, 1838.

Reilly, John E. "The Lesser Death-Watch and 'The Tell-Tale Heart'." American Transcendental Quarterly 2 (1969): 3-9.

Shelden, Pamela J. " 'True Originality': Poe's Manipulation of the Gothic Tradition." American Transcendental Quarterly 29.1 (1976): 75-80.

Smith, Allan Gardner. "Chapter Two: Edgar Allan Poe."The Analysis of Motives: Early American Psychology and Fiction. Amsterdam: Rodopi, 1980. 38-75.

——. "The Psychological Context of Three Tales by Journal of American Studies 7.3 (1973): 279-92.

Stone, Alan A., and Sue Smart Stone. "Psychotic Symptoms." The Abnormal Personality Through Literature. Englewood Cliffs: Prentice, 1966. 126-31.

Sue, David, Derald Sue, and Stanley Sue. Understanding Abnormal Behavior. 2nd ed. Boston: Houghton, 1986. 425-45.

Walker, I. M. "The 'Legitimate Sources' of Terror in 'The Fall of the House of Usher'." Modern Language Review 61 (1966): 585-92.