"The Tell-Tale Heart" is a suspenseful story based around a murder by a madman. Although murders are traditionally person versus person, the madman's murder is basically person versus himself. The narrator perceives the idea of killing an elderly man with an evil eye that haunts him. The madman believes his madness is a gift and has sharpened his senses, allowing him to perfectly commit this murder. The murderer, being mad, is paranoid of everything during his murder of the old man; in the end it is because of his "gifted" sense of hearing and his madness that he gives away the fact that he killed the old man. Conceived within his mind, the murder has little or none to do with the victim, the motive is unclear and the murder is unprovoked. The "disease" of madness within the person causes the conflict in this story, person versus himself.
The narrator's belief in his madness causes him to believe that he could commit the perfect murder of an elderly man with an "Evil Eye". He convinces himself that his madness and his heightened sense of hearing will aid him in the murder. "Have I not told you that what you mistake for madness is but over acuteness of the senses? - now, I say, there came to my ears a low, dull, quick sound- (Poe 122). He thinks that his disease of madness has not handicapped him, but in fact has heightened his senses. Believing this he thinks he is capable of committing and concealing a murder because he would not make mistakes. He sees himself as the perfect madman, smarter than most and able to see how great madness can be. The idea that he convinces himself of his capabilities enhances the conflict of person vs. himself.
The madman believes that he being mad causes his acute sense of hearing. "The disease has sharpened my senses - not destroyed - not dulled them." (Poe 121). This is only within his mind, his disease of the mind allowed him to be convinced that his hearing was sharpened.