How does the difference between the characters spoken words and internial thought affect the story

it creates dramatic tension.

Explanation:  

Often the authors use the thoughts and words spoken by the characters to create a dramatic tension in the story. For example, a character may be experiencing a terminal illness and he is very worried, sad and hopeless, but when someone asks how he is he smiles and says that he is great. This creates a dramatic tension in the story because the reader knows what is happening and what the character says is different than what he is thinking.

smh

explanation:

in the shadow of war