The narrator experiences an increasing sense of anxiety and fear, which he recognizes as a progression of psychological distress. He identifies the stages of mental breakdown, starting with tremors and escalating to more severe states like freak-outs and eventual isolation from the outside world. This contemplation reflects a journey through mental illness and its implications.

Initially, the narrator acknowledges a phase of denial or concealment, which he refers to as the "cover-up." This suggests that before reaching the critical points of mental collapse, one often hides their struggles, delaying acknowledgment until the symptoms become overwhelming. Kesey's exploration of these themes highlights the complex nature of psychological challenges.