"The Tell Tale Heart" is a story, on the most basic level, of conflict. There is a mental conflict within the narrator himself. Through obvious clues and statements, Poe alerts the reader to the narrator's insanity. The insanity is described as an obsession, which in turn leads to loss of control and eventually results in violence. Ultimately, the narrator tells his story of killing his housemate. Although the narrator seems to be blatantly insane, and thinks he has freedom from guilt, the feeling of guilt over the murder is too overwhelming for him to bear. The narrator cannot tolerate it and eventually confesses his supposed "perfect" crime. People tend to think that insane persons are beyond the normal realm of reason shared by those who are in their right mind, however this is not so. Guilt is an emotion shared by all humans. The most demented individuals are not above the feeling of guilt and the havoc it causes to the psyche. Poe's use of setting, character, and language reveal that even an insane person feels guilt. The emotion of guilt easily, if not eventually, crashes through the seemingly unbreakable walls of insanity. .
On the surface, the physical setting of "The Tell Tale Heart" is typical of the period and remarkably typical of Poe. The narrator and the old man live in an old, dark house: "for the shutters were close fastened, through fear of robbers" (1472). Most of the story takes place at night: "And this I did for seven long nights-every night just at midnight- (1472). Although the physical aspect of the story help create an appropriate atmosphere for the narrator and the actions to take place, the mental and emotional settings of the story are what clearly explain the personality of the narrator. One can assume the narrator is insane. He freely admits to his listener that he is " -nervous-very, very dreadfully nervous- (1471). But he then asks, " but why will you say that I am mad?" (1471).