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
Theo nervously waits in the sparse therapy room for Alicia to arrive. To pass the time, he looks out at the courtyard, where patients are forced to spend 30 minutes of outside time each day. From the window, Theo sees Yuri approach Alicia with Theo’s request for a meeting. To Theo’s surprise, Alicia follows Yuri up the stairs.
Theo’s nervousness about the therapy session is perhaps unusual: though it makes sense that he would fret about doing a good job, his level of anxiety feels perhaps misplaced, given that it will be Alicia’s emotions (and not his) on the table.
Active
Themes
Once Alicia arrives, Theo asks Yuri to leave the room—which is against Grove protocol. Yuri is upset, but he agrees. Now one-on-one, Theo tells Alicia that he has known about her for a while, and that he is an admirer of her work. Alicia does not respond, and Theo tries to channel his old therapist Ruth.
Theo’s emphasis on getting Alicia alone not only puts him in physical danger (the exact kind that Stephanie wants to prevent), but it also hints that there is something secretive in their conversations, something he would rather not have his colleagues overhear.
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Themes
Theo feels that to help Alicia, he will have to help her make sense of the parts of her mind she has hidden from herself. He is determined to understand this patient even if she does not speak, through non-verbal clues. So though it makes him sad, Theo does what Ruth would have done: sit in silence.
In this passage, the novel begins to create a critical link between the structure of Greek tragedy and the structure of therapy. In each case, the protagonist or patient is burdened with some past trauma or fatal flaw, one which they often do not know they possess (think, for example, of Oedipus marrying his mother). As the therapist, Theo sees it as his job to bring this secret out into the open—and thus to prevent tragedy.