The novel tells the story of Norman Bates, a caretaker at an isolated motel who struggles under his domineering mother and becomes embroiled in a series of murders.

Meanwhile, a young woman named Mary Crane is on the run after stealing $40,000 from a client of the real estate company where she works.

Convinced that his mother killed her, Norman considers letting her go to prison, but changes his mind after having a nightmare in which she sinks in quicksand, only to turn into him as she goes under.

Sam and Lila go to Fairvale to look for Arbogast, and meet with the town sheriff, who reveals that Mrs. Bates has been dead for years, having committed suicide by poisoning her lover and herself.

It is revealed that Bates and his mother lived together in a state of total codependence ever since his father deserted them when he was still a young child.

He retrieved her corpse from the cemetery and preserved it and, whenever the illusion was threatened, would get drunk, dress in her clothes and speak to himself in her voice.

In November 1957, two years before Psycho was first published, Ed Gein was arrested in his hometown of Plainfield, Wisconsin for the murders of two women.

When police searched his home, they found furniture, silverware, and even clothing made of human skin and body parts.

Psychiatrists examining him theorized that he was trying to make a "woman suit" to wear so he could pretend to be his dead mother, whom neighbors described as a puritan who dominated her son.

Though Bloch was not aware of the Gein case at that time, he began writing with "the notion that the man next door may be a monster unsuspected even in the gossip-ridden microcosm of small-town life".

Bloch was surprised years later when news of Gein's living in isolation with a religiously fanatical mother came to his attention.

Bloch "discovered how closely the imaginary character I'd created resembled the real Ed Gein both in overt act and apparent motivation".

[citation needed] In the novel Psycho House, murders begin again when the Bates Motel is reopened as a tourist attraction.

A "contemporary prequel" television series, Bates Motel was developed by Carlton Cuse, Kerry Ehrin, and Anthony Cipriano.