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
A few hours later, Theo runs into Indira in the halls; she jokes that the place is like a maze, and brings him to the “goldfish bowl,” the glass station where all the nurses work. As Indira makes a cup of tea, Theo notes that the “goldfish bowl” is the hub of the entire hospital. Indira also gives Theo a slice of walnut cake and encourages him to share it with his patients, putting them in a better mood.
Unlike Christian, Indira views therapy as a fundamentally social practice—her use of walnut cake to cheer her patients up suggests that her sessions are cozy and friendly.
Active
Themes
Christian walks into the “goldfish bowl,” and he and Theo share a tense exchange; Christian predicts that the Grove is about to be shut down. Theo has heard that Christian got married and had a baby, and he wonders what kind of father this serious, irritating man is.
By thinking about Christian’s child, Theo (probably inadvertently) calls attention to the fact that he does not have a child of his own. In a line of work so fascinated by childhood, what does it mean to raise a kid—and what does it mean to remain childless?
Active
Themes
Elif comes into the station and begins hammering on the glass, asking to have her medication reduced. Christian tells her they will talk about it at another time. After Elif leaves, Christian informs Theo that Elif committed double murder, suffocating her mother and sister in their sleep.
This exchange between Christian and Elif affirms several of the main dynamics at the Grove. First, Christian is often the primary medicator, preferring biology over sociology. And second, Stephanie is right to care about security: lots of these patients are very high risk.
Active
Themes
Christian then angrily accuses Theo of going behind his back to change Alicia’s medication, insisting that Alicia is “borderline” and needs to be on a high dose. Indira pushes back, saying such general terms are not helpful. Indira expresses her gratitude that Theo is now taking care of Alicia, while Christian is skeptical that therapeutic progress can happen if the patient won’t talk.
Whereas Theo emphasizes personal narrative as the key to his patients’ psyches, Christian believes in broader diagnoses like “borderline.” And though Indira has Theo’s back, Christian makes a good point: how do you practice the “talking cure” on somebody who refuses to speak?