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 goes to Diomedes’s office and requests that Alicia’s medication (16 milligrams of risperidone) be reduced. Diomedes explains that Christian is the head of Alicia’s care team, so Theo should talk to him, but Theo wants Diomedes to make the call. Diomedes picks up on the hostility between Theo and Christian and wonders what their relationship at Broadmoor was like.
Having been treated by Ruth, Theo is firmly of the mind that therapy should be a “talking cure.” But Christian, responsible for Alicia’s high doses of medication, seems to believe that a silent, tranquilized patient is best. Perhaps this difference is at the root of the past tension between the two men, which has still never been fully explained.
Active
Themes
Diomedes warns that taking Alicia off her medicine could make her suicidal again, but Theo is persistent. As the meeting winds down, Diomedes offers Theo a cigar, to Theo’s surprise. “I think we’re all a bit crazy in this place,” Diomedes says, chuckling and smoking.
While Theo worked to hide his use of cigarettes, Diomedes is more comfortable admitting that the doctor-patient boundary is not always so firm. Instead, he acknowledges that everyone is a “bit crazy”: the important thing, he seems to suggest, is to own up to one’s one imperfections.