The Silent Patient

The Silent Patient

by

Alex Michaelides

Ruth is Theo’s long-time therapist, whom he met in college. Ruth helps Theo work through his traumatic upbringing, shedding the tears Theo cannot when he describes his father’s abusive behavior. Years after their therapeutic relationship has ended, Ruth remains a resource—and a friend—to Theo; after he learns that Kathy has cheated on him, he seeks out Ruth’s advice (though he ultimately ignores her suggestion to end things with Kathy). Above all else, Ruth emphasizes the value of honesty in both a therapist and a partner. Ruth also teaches Theo how to empathize with his patients without blurring the lines: “you must be receptive to your patient’s feelings,” she instructs, “but you must not hold onto them—they are not yours.” In accordance with the tragic form of the novel, Ruth often acts as a voice of dramatic irony—her advice might save Theo, if only he would take it.

Ruth Quotes in The Silent Patient

The The Silent Patient quotes below are all either spoken by Ruth or refer to Ruth . For each quote, you can also see the other characters and themes related to it (each theme is indicated by its own dot and icon, like this one:
Empathy, Identification, and Boundaries Theme Icon
).
Part 1, Chapter 3 Quotes

As I talked, I found that no matter how distressing the details I related, I could feel nothing. I was disconnected from my emotions, like a hand severed from a wrist. I talked about painful memories and suicidal impulses—but couldn’t feel them.

I would, however, occasionally look up at Ruth’s face. To my surprise, tears would be collecting in her eyes as she listened. This may seem hard to grasp, but those tears were not hers.

They were mine.

At the time I didn’t understand. But that’s how therapy works. A patient delegates his unacceptable feelings to his therapist; and she holds everything he is afraid to feel, and she feels it for him. Then, ever so slowly, she feeds his feelings back to him. As Ruth fed mine back to me.

Related Characters: Theo Faber (speaker), Ruth
Page Number: 17
Explanation and Analysis:
Part 2, Chapter 4 Quotes

As we sat there in silence, my head started to throb at the temples. The beginnings of a headache. A telltale symptom. I thought of Ruth, who used to say, “In order to be a good therapist, you must be receptive to your patients’ feelings—but you must not hold on to them—they are not yours—they do not belong to you.” In other words, this thump, thump, thumping in my head wasn’t my pain; it belonged to Alicia. And this sudden wave of sadness—this desire to die, die, die—did not belong to me either. It was hers, all hers. I sat there, feeling it for her, my head pounding, my stomach churning, for what seemed like hours. Eventually, the fifty minutes were up.

Related Characters: Theo Faber (speaker), Alicia Berenson, Ruth
Page Number: 76
Explanation and Analysis:
Part 2, Chapter 9 Quotes

She was right. I have been groping for the right words to express that murky feeling of betrayal inside, the horrible hollow ache, and to hear Ruth say it—“the pain of not being loved”—I saw how it pervaded my entire consciousness and was at once the story of my past, present, and future. This wasn’t just about Kathy; it was about my father, and my childhood feelings of abandonment; my grief for everything I never had and, in my heart, still believed I never would have. Ruth was saying that was why I chose Kathy. What better way for me to prove that my father was correct—that I’m worthless and unlovable—than by pursuing someone who will never love me?

I buried my head in my hands. “So all this was inevitable? That’s what you’re saying—I set myself up for this?”

Related Characters: Theo Faber (speaker), Kathy Faber, Ruth
Page Number: 102
Explanation and Analysis:
Part 2, Chapter 10 Quotes

Leaving Kathy would be like tearing off a limb. I simply wasn’t prepared to mutilate myself like that. No matter what Ruth said. Ruth wasn’t infallible. Kathy was not my father; I wasn’t condemned to repeat the past. I could change the future. Kathy and I were happy before; we could be again. One day she might confess it all to me, tell me about it, and I would forgive her. We would work through this.

I would not let Kathy go. Instead I would say nothing. I would pretend I had never read those emails. Somehow, I’d forget. I’d bury it. I had no choice but to go on. I refuse to give into this; I refuse to breakdown and fall apart.

After all, I wasn’t just responsible for myself. What about the patients in my care? Certain people depended on me. I couldn’t let them down.

Related Characters: Theo Faber (speaker), Kathy Faber, Ruth
Page Number: 107
Explanation and Analysis:
Part 5, Chapter 3 Quotes

Even worse than the shock or repulsion, or possibly even fear, in Ruth’s eyes as I told her this would be the look of sadness, disappointment, and self-reproach. Because not only had I let her down, I knew she would be thinking she had let me down—and not just me, but the talking cure itself. For no therapist ever had a better shot at it than Ruth—she had years to work with someone who was damaged, yes, but so young, just a boy, and so willing to change, to get better, to heal. Yet, despite hundreds of hours of psychotherapy, talking and listening and analyzing, she was unable to save his soul. Perhaps I was wrong. Perhaps some of us are simply born evil, and despite our best efforts we remain that way.

Related Characters: Theo Faber (speaker), Ruth
Page Number: 320
Explanation and Analysis:
Get the entire The Silent Patient LitChart as a printable PDF.
The Silent Patient PDF

Ruth Quotes in The Silent Patient

The The Silent Patient quotes below are all either spoken by Ruth or refer to Ruth . For each quote, you can also see the other characters and themes related to it (each theme is indicated by its own dot and icon, like this one:
Empathy, Identification, and Boundaries Theme Icon
).
Part 1, Chapter 3 Quotes

As I talked, I found that no matter how distressing the details I related, I could feel nothing. I was disconnected from my emotions, like a hand severed from a wrist. I talked about painful memories and suicidal impulses—but couldn’t feel them.

I would, however, occasionally look up at Ruth’s face. To my surprise, tears would be collecting in her eyes as she listened. This may seem hard to grasp, but those tears were not hers.

They were mine.

At the time I didn’t understand. But that’s how therapy works. A patient delegates his unacceptable feelings to his therapist; and she holds everything he is afraid to feel, and she feels it for him. Then, ever so slowly, she feeds his feelings back to him. As Ruth fed mine back to me.

Related Characters: Theo Faber (speaker), Ruth
Page Number: 17
Explanation and Analysis:
Part 2, Chapter 4 Quotes

As we sat there in silence, my head started to throb at the temples. The beginnings of a headache. A telltale symptom. I thought of Ruth, who used to say, “In order to be a good therapist, you must be receptive to your patients’ feelings—but you must not hold on to them—they are not yours—they do not belong to you.” In other words, this thump, thump, thumping in my head wasn’t my pain; it belonged to Alicia. And this sudden wave of sadness—this desire to die, die, die—did not belong to me either. It was hers, all hers. I sat there, feeling it for her, my head pounding, my stomach churning, for what seemed like hours. Eventually, the fifty minutes were up.

Related Characters: Theo Faber (speaker), Alicia Berenson, Ruth
Page Number: 76
Explanation and Analysis:
Part 2, Chapter 9 Quotes

She was right. I have been groping for the right words to express that murky feeling of betrayal inside, the horrible hollow ache, and to hear Ruth say it—“the pain of not being loved”—I saw how it pervaded my entire consciousness and was at once the story of my past, present, and future. This wasn’t just about Kathy; it was about my father, and my childhood feelings of abandonment; my grief for everything I never had and, in my heart, still believed I never would have. Ruth was saying that was why I chose Kathy. What better way for me to prove that my father was correct—that I’m worthless and unlovable—than by pursuing someone who will never love me?

I buried my head in my hands. “So all this was inevitable? That’s what you’re saying—I set myself up for this?”

Related Characters: Theo Faber (speaker), Kathy Faber, Ruth
Page Number: 102
Explanation and Analysis:
Part 2, Chapter 10 Quotes

Leaving Kathy would be like tearing off a limb. I simply wasn’t prepared to mutilate myself like that. No matter what Ruth said. Ruth wasn’t infallible. Kathy was not my father; I wasn’t condemned to repeat the past. I could change the future. Kathy and I were happy before; we could be again. One day she might confess it all to me, tell me about it, and I would forgive her. We would work through this.

I would not let Kathy go. Instead I would say nothing. I would pretend I had never read those emails. Somehow, I’d forget. I’d bury it. I had no choice but to go on. I refuse to give into this; I refuse to breakdown and fall apart.

After all, I wasn’t just responsible for myself. What about the patients in my care? Certain people depended on me. I couldn’t let them down.

Related Characters: Theo Faber (speaker), Kathy Faber, Ruth
Page Number: 107
Explanation and Analysis:
Part 5, Chapter 3 Quotes

Even worse than the shock or repulsion, or possibly even fear, in Ruth’s eyes as I told her this would be the look of sadness, disappointment, and self-reproach. Because not only had I let her down, I knew she would be thinking she had let me down—and not just me, but the talking cure itself. For no therapist ever had a better shot at it than Ruth—she had years to work with someone who was damaged, yes, but so young, just a boy, and so willing to change, to get better, to heal. Yet, despite hundreds of hours of psychotherapy, talking and listening and analyzing, she was unable to save his soul. Perhaps I was wrong. Perhaps some of us are simply born evil, and despite our best efforts we remain that way.

Related Characters: Theo Faber (speaker), Ruth
Page Number: 320
Explanation and Analysis: