That's why they have compulsive thoughts like "Follow etiquette, follow the rules, I must stick to the rules, I cannot make any mistakes."
Immediately thereafter, things got even worse at Wayne Manor. Not being able to listen, look, or speak meant that the person felt they were being watched, that the monster had fully invaded their life, no longer just appearing in certain fragments or specific scenes, but beginning to feel its omnipresence.
From this, one could infer that the person was someone living within Wayne Manor, since a hallmark of hallucinatory monsters fully invading a life is the invasion of one's most private space; patients often feel watched in the bedrooms or bathrooms of their homes, which completely destroys their sense of safety.
Shiller believed that Alfred wasn't actually watching anyone, but the butler had become the embodiment of fear, similar to when a paranoia sufferer feels like everyone around them is out to kill them. And this butler, who frequently moved about Wayne Manor, was obviously the first suspect for a patient lacking a sense of safety, as he was always silent and ubiquitous.
As such, the person imagined Alfred was a monster or had already been manipulated by one, so in front of him, they could not speak, reveal expressions, or even react in any way, lest they be discovered by the monster.
This was also a sign of the deterioration of their condition, from initially experiencing hallucinations to becoming suspicious of real people in the real world, with aggressive behavior only a step away.
This was just Shiller's analysis based on clinical psychology and psychiatry, assuming that there really were no monsters in this world.
Unfortunately, there are monsters in this world, and clearly, the person had provoked not just any monster but Nyarlathotep itself, which revels in toying with the human race.
As expected, Nyarla appeared before the person, but not initially in the form of a monster.
However, it was different later on. Nyarla must have revealed its true form to the patient, even becoming a full-fledged monster and constantly stalking him, following him, appearing in his life's moments.
From the sound of the elevator bell, it could be guessed that the first time the patient saw the monster might have been in the elevator, hence the elevator's arrival bell became a condition triggering the hallucinations.
Subsequently, Nyarlathotep began harassing the patient more frequently, possibly during his everyday life or work, causing him to make many mistakes and affecting his real life, which gradually started stripping away his sense of safety.
And if expectations held, Nyarlathotep had not revealed itself to anyone else, only to the patient, meaning no matter whether he sought confirmation from doctors or loved ones, he would receive no answers, and the only conclusion would be that he was insane.
Then, the invasion into the patient's life reached a point of being all-pervasive, constant surveillance, long-term spying, and whenever the patient made any sort of movement, such as speaking, looking at something else, or even thinking, the monster would appear.
In the end, the patient felt that even the most familiar places were no longer safe, and allowed chaotic thoughts to control their exhausted body, heading off to an unknown faraway place.
This bears some similarity to mind manipulation as discussed in psychology, only that Outer Gods are sophisticated life forms that don't need to resort to human methods like hypnosis. Instead, they have more sophisticated methods at their disposal.
If Shiller guessed correctly, Nyarla revealing itself wasn't just to frighten; the very appearance of an Outer God is a form of contamination, where even a single glance could lead to mental disturbance, thus Nyarla's presence acted as a sort of punitive mechanism.
The minute one saw the monster, they would feel confusion and pain, yet the monster was ever-present, appearing regardless of what one did, turning their current life into chaos, while others remained blind and unable to understand, leaving one without recourse.
Upon deducing all this, Shiller didn't feel anger, only a sense of pity. If this patient had encountered a better psychologist, perhaps things might not have progressed to such a severe state.
Because good psychologists, having seen too many such cases, wouldn't immediately tell the patient they are sick, or that the monster is fake and they just need to stay lucid. Those are amateurs, like telling someone with depression to just cheer up.
A psychologist would inquire in great detail about the monster's appearance, properties, the details of its attack, the patient's reaction at the time, their feelings, and even sensations in various limbs.
And this would be with repeated, long-term questioning, using all kinds of methods, including but not limited to descriptions, drawing, controlled brainwave drawing, until the patient had nothing more to say.
A good doctor can use all the above to determine what exactly is wrong with a patient's psyche.
If it were Shiller, he could determine from all that information that the monster was real, not a hallucination, as there's a significant difference between the two.
It would be possible to discern from various reports whether the patient's logic was flawed, whether they were lucid, and whether their reason was sound.
If all the above were normal and only the hallucination monster was the anomaly, no matter how ludicrous, Shiller would believe in the monster's existence because he trusts his own judgment.
Therefore, the type of scene in movies where a victim of a real monster describes it to a psychologist who won't believe them is almost impossible, as no psychologist would dare to skip the aforementioned evaluations or jump to conclusions without long-term observation, unless they didn't care about their career anymore.
In other words, for psychologists, the moment someone says they see a monster, they know their work is cut out for them.
Because such psychiatric patients are the most dangerous, once their sense of safety is completely stripped away, unchecked paranoia can likely lead to aggressive behavior, and if their patient gets involved in a lawsuit, they definitely can't escape responsibility, with the mildest outcome being a waste of time testifying in court.
Shiller sighed again and glanced back at Gordon, contemplating whether to share his conjectures with Peter.