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
Wanting to understand what happened to provoke Alicia, Theo and Yuri head to the makeshift studio. The whole thing immediately becomes clear: Elif has vandalized Alicia’s painting of the burning building, writing the word “SLUT” across the image.
If Alicia is usually restrained and reserved at the Grove, the one thing that sets her off is her art being destroyed.
Active
Themes
Theo visits Elif in the emergency ward, where she tells him to “fuck off.” When Theo makes it clear that he is not trying to blame Elif, Elif owns up to defacing the painting. But she did more than that: she tells Theo that she knows he is “soft” on Alicia, and she taunted Alicia with this information (“Theo and Alicia, sitting in a tree”). Elif begins to laugh “a horrible, shrieking laugh.” Theo begins to wonder if Alicia really is completely insane.
Christian is not the only one to notice that the close connection between Theo and Alicia feels inappropriate. Here, Elif suggests that Theo is sexually interested in Alicia, further blurring the line between therapist and patient (and further linking Theo’s relationship to Alicia to his bond with Kathy).