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Part 1, Chapter 4
Themes
Key
LitCharts assigns a color and icon to each theme in The Silent Patient, which you can use to track the themes throughout the work.
Empathy, Identification, and Boundaries
Tragedy and Destiny
Honesty vs. Deception
Childhood Trauma
Silence vs. “The Talking Cure”
Summary
Analysis
In Community, all the patients, about 30 in total, are drinking tea or coffee. Diomedes holds this meeting as “an attempt to involve the patients in their own treatment,” though Theo notes that Diomedes likes group therapy in part because he is “happiest with an audience.” Theo quickly assesses that Diomedes is handsome, youthful for someone in his 60s, and very devoted to his work.
Even though Alicia is widely thought to have committed the horrible murder, no person is completely safe from suspicion; she could have had an accomplice, or someone could have framed her for the crime. To that end, it is important to pay attention to each new character’s quirks: Diomedes likes “an audience,” suggesting there is something performative or self-involved about his behavior.
Themes
Theo recognizes the other therapists. There is Indira, who interviewed him, and Christian, a former colleague from Broadmoor. Theo and Christian have never gotten along. Theo searches the crowd for Alicia, but he does not see her…until he realizes that she is directly in front of him, making herself “invisible.”
Christian is another character to treat with suspicion: why did he and Theo spar at a previous job? But more importantly, why is Theo—who ostensibly should be focused on all of the patients at his new job—so single-mindedly concentrated on Alicia?
Themes
Alicia is in terrible shape. She was once beautiful, but now her hair is matted and unclear; she is highly drugged on risperidone, which causes saliva to constantly drip from her mouth. Before Theo can take in more details, Diomedes pushes him to introduce himself.
Later, several of the therapists will describe Alicia as “seductive,” so her beauty—or lack of it—is a key detail. Risperidone is an antipsychotic drug that aims to treat bipolar and schizophrenia.
Themes
Suddenly, a Turkish woman named Elif charges into the room, throwing what looks like spears into the center of the circle. Theo realizes that Elif is actually throwing pool cues; she is mad that the cues are broken and have yet to be repaired. Diomedes asks Theo to lead the session, and Theo encourages Elif to come to Community on time. Across the circle, Christian jokes that Theo himself was late.
Theo demonstrates his skill as a therapist here: even in the face of Elif’s sudden violence, he is able to remain calm, pushing her to talk. Despite Theo’s professionalism, however, Christian seems more interested in renewing their grudge, suggesting that the tension runs deep for both men.
Themes
Get the entire The Silent Patient LitChart as a printable PDF.
Theo and Indira are able to work together to shift the conversation, inviting Elif to discuss the difficulties of anger management. But Theo’s mind is elsewhere. He can’t stop thinking about how the once-dazzling Alicia has become a “broken shell.” Determined to take Alicia on as a patient, Theo reflects that, “Alicia was lost. She was missing. And I would stop at nothing to find her.”
By ending the chapter with this determined message (“I would stop at nothing”), Theo again positions himself as a tragic hero: he feels that he is destined to help Alicia, and so he is destined for whatever the consequences of that help might be.
Themes
