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
Yuri sets up a makeshift art studio for Alicia in the room next to the nurses’ station. He and Theo have become friends, and before Yuri leaves Theo alone with Alicia, he gives him a sort of good luck wink. Excitedly, Alicia examines the paints and paintbrushes, entering a sort of “reverie.” At last, she touches the brush to the canvas, adding red stroke after red stroke. He also notices that Alicia is looking over at him every so often, “as if she was studying me.”
Thus far, even as Theo has crossed boundary after boundary, Alicia has mostly remained firmly in the role of patient (besides when Theo talked about “hating” his wife). Now, though, the dynamic begins to flip: Alicia is “studying” Theo, trying to understand him through her artistic lens even as he tries to analyze her through his own therapeutic one.
Active
Themes
A few days later, the painting is complete. It is a photo-realistic depiction of the Grove on fire. Two figures emerge from the burning building: Theo and Alicia. Theo is carrying Alicia in his arms while the fire licks at their heels. Theo does not know if the painting depicts him as “rescuing Alicia—or about to throw her into the flames.”
Because Alicia refuses to speak, her painting presents an interpretive challenge to Theo: is she thanking him or condemning him? And what to make of the idea that she is in his arms, which suggests an intimate (or romantic, or even sexual) component to their relationship?