The story opens with a clear image of the unnamed narrator's fragile mind set, proving his mental disease. The narrator admits to being: "dreadfully nervous" though addressing the reader boldly in his defense through the usage of rhetorical questions: "but why will you think I am mind? " Subsequently, Pope's elements of tension plunges the readers into the middle of the narrator's unstable mindset.
The narrators fragile mind set is proven through the usage of hyphens in the opening entente in order to create a sense of confession as well as to emphasis the unnamed narrator's devious fractured mind, and is shown in the following quotation: "True! - nervous- very, very dreadfully nervous. " Linking back to madness and obvious paranoia. The narrator is shown to be speaking to himself and ranting over an unknown Justification of a 'dreadful' act, to create a sense of confession as aforementioned.
This point links back to the title of the story: "The Tell Tale Heart" which immediately points the readers towards the subject of confession, as your earth is supposed to free yourself of all sins through confession, furthermore personifying the heart. Tension is built through the story through the on-going contradictions occurring inside the narrator's fractured mindset, arguing against the reader regarding his obvious paranoia.
It is proven clearly that he is mad, however he contradicts such information, and modern society has acknowledged the fact that when a person loses such sanity, they do not believe themselves to have committed such a deed. His sanity does compose as the story progresses, however becomes motionless by the time the old man has been murdered.
However again, confession is the consequence of committing such crimes, and collapses under his own thoughts and paranoia towards the end of the story, as the quotation shows: "They were making a mockery of my horror! " summarizing this entire analysis by the ending paragraph: I shrieked, 'dissemble no more! I admit the deed! - tear up the planks! Here, here! - It Is the beating of his hideous heart! "