The Silent Patient

The Silent Patient

by

Alex Michaelides

The Silent Patient: Part 3, Chapter 1 Summary & Analysis

Summary
Analysis
The two epigraphs before this chapter are both about diaries and confessions. One is a Jean-Paul Sartre quote on “the danger of keeping a diary”; Sartre feels that writing in such a journal causes the writer to exaggerate or “stretch the truth.” The other quote is from Shakespeare’s A Winter’s Tale: “though I am not naturally honest, I am sometimes so by chance.”
These two epigraphs, both from playwrights, argue that human beings do not always intend to reveal their darkest thoughts. But just as the Freud quote at the beginning pointed out, people betray themselves inadvertently, often communicating the things they try most desperately to hide.
Themes
Childhood Trauma Theme Icon
Silence vs. “The Talking Cure” Theme Icon
On August 8th, Alicia notices a man standing outside her house. She does not understand the man’s motivations, nor can she make out his features. She tries to paint, but finds herself distracted by the sense of the man’s presence.
This man is clearly the man that Barbie talked about to Theo—so though she is self-involved, Barbie does not seem to be a total liar.
Themes
Childhood Trauma Theme Icon
On August 10th, Alicia goes to the play Alcestis with Jean-Felix, against her husband’s wishes. Jean-Felix suggests they get a drink beforehand, and Alicia sees him sitting at the bar, filled with rage. He brings up all of their old memories, but Alicia feels frustrated by these “rehearsed little reminiscences.” She is firm in her decision to break from the gallery.
If Theo has trained in psychology for years, Alicia is almost as naturally perceptive: she sees through Jean-Felix’s attempts at guilting her, frustrated with his “rehearsed” performance of friendship. It’s worth noting how many characters are “acting”: Jean-Felix and Alicia each feel the other is lying, while Kathy actually acts for a living.
Themes
Empathy, Identification, and Boundaries Theme Icon
Childhood Trauma Theme Icon
Fortunately, Alicia loves the play, which has been restaged in a contemporary suburb of Athens. She finds herself moved to tears by the idea that Alcestis literally comes back from the dead, though she cannot quite articulate what about that trajectory is so powerful. But instead of allowing Alicia to focus on the play, Jean-Felix leaves her with a vague warning about Gabriel, telling her she is “too trusting.” Unsettled, Alicia gets home late and wakes Gabriel up so they can have sex.
The tragedy of Alcestis again parallels the form of the novel, as Jean-Felix ominously hints that Alicia should not “trust” her beloved husband. More importantly, Theo has earlier reflected that Alicia, still alive, nevertheless metaphorically identifies with Alcestis’s death. Now, Alicia confirms that link, once again proving how much the therapist and patient are of the same mind.
Themes
Empathy, Identification, and Boundaries Theme Icon
Tragedy and Destiny Theme Icon
Honesty vs. Deception Theme Icon
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The next day, Alicia sees the man again, wearing a cap and sunglasses. She wonders if he is a burglar, and then, strangely, she wonders if he is a painter, too. Alicia almost calls Gabriel, but then decides she does not want to bother him with her stress. She begins to think that the man is not watching the house—maybe he is watching her, instead.
In addition to showcasing Alicia’s lack of comfort with Gabriel, the idea that the man might be a painter—just like Alicia—suggests that she is beginning to identify with this seeming stalker. It also mirrors the moment in which Theo, watching Alicia paint, can’t tell who is “studying” who.
Themes
Empathy, Identification, and Boundaries Theme Icon
Silence vs. “The Talking Cure” Theme Icon
Quotes
On August 13th, the man appears again, and Alicia finally shares her anxieties with Gabriel. He wonders if the man is Jean-Felix, and privately, Alicia wonders the same thing. Gabriel claims he believes Alicia, but she feels that he is only humoring her; he seems convinced that she is imagining the whole thing. This makes Alicia angry.
Gabriel’s insistence that Alicia is imagining is antithetical to the empathy Theo shows her in therapy. And this refusal to listen to her (what might, in popular discourse, be known as “gaslighting”) causes Alicia to express real anger at her husband for the first time.
Themes
Empathy, Identification, and Boundaries Theme Icon
The following morning, Alicia looks for the man, but he is gone. However, when she goes for a walk in a nearby park, she notices that the man has followed her. She panics, telling him that if he is Jean-Felix, he should go away; she also tries to take a picture, though she realizes the photo hasn’t captured anything meaningful. When she gets home, the man is standing in front of the house.
The photo that Alicia takes at the park seems to be the photo that she then shows Barbie. Alicia is a painter, so it makes sense that she would want to visually capture this frightening man—and her failure to do so is understandably frustrating.
Themes
Silence vs. “The Talking Cure” Theme Icon
Barbie Hellman comes over, and even though Alicia detests her, she confesses her fear about the man. Barbie encourages Alicia to go to the police, believing that the man is either a burglar or a rapist. When Barbie asks if Alicia has told Gabriel about the whole thing, she lies and says no. At 4:00 a.m. that night, Alicia hears a noise. She thinks it is the man, and Gabriel, who has gotten home late from work, is frustrated. When Alicia goes to check, no man is outside.
Alicia’s perception of Barbie once again lines up with Theo’s. And though there are many candidates for the man outside the window (Jean-Felix, Max, Paul, or even Yuri), in this moment, Alicia seems to confuse the man at the window with Gabriel himself. Admetus was responsible for Alcestis’s death; is it possible that Gabriel is similarly a real, flesh-and-blood threat to his wife?
Themes
Empathy, Identification, and Boundaries Theme Icon
Tragedy and Destiny Theme Icon
On August 15th, Gabriel sits Alicia down and begs her to go see a doctor; he thinks she is hallucinating the whole thing. Alicia feels intense rage, and she wants to tell Gabriel that she is anything but crazy. Instead, she calmly agrees to see Dr. West, a therapist, and she visits his office the next morning.
Presumably, Dr. West is the therapist that Max mentioned Alicia seeing. Alicia’s feelings of rage are a precursor to the angry murder a few days away, while her hesitance to go to therapy even before the scandal perhaps explains her initial desire to attack Theo.
Themes
Empathy, Identification, and Boundaries Theme Icon
Tragedy and Destiny Theme Icon
Alicia knows that Dr. West and Gabriel are close friends, which surprises her, given that Gabriel is so warm and Dr. West is so cold. When Alicia tells him about the man, the doctor reminds her that “we’ve been here before”—after her father’s death, Alicia became deeply paranoid and was convinced that she was being spied on or followed. Whereas Alicia admits that she was sick after her father’s death, she is certain that this man is real. But Dr. West refuses to believe her.
Theo is not the first therapist in Alicia’s life to cross boundaries—because he is a friend of Gabriel’s doing a favor, Dr. West seems more loyal to Alicia’s husband than to Alicia herself. It is also important to note that Dr. West, like almost everyone in Alicia’s life, is a man—and that none of these men (with the exception of Theo) seem to believe even her most credible pleas for help, reflecting the widespread sexism around her.  It is with good reason, then, that Michaelides has expressed that his novel has a place in a larger #MeToo conversation.
Themes
Empathy, Identification, and Boundaries Theme Icon
Dr. West prescribes Alicia some pills, which she does not want to take. To encourage her, Dr. West hints that Gabriel might leave her if she does not accept treatment. Terrified of losing her beloved, Alicia agrees to take the pills. Gabriel is thrilled, telling her that “we’ll get through this,” but Alicia knows that she will have to get through this alone. She regrets telling anybody, and she resolves to tell Barbie to forget the whole thing.
Like Christian and Stephanie, Dr. West favors a medicinal approach to therapy over a talk-based approach. Interestingly, then, Alicia’s silence seems to have begun in part before the murder ever happened: fearing medication, she withdraws from Gabriel and Barbie, resolving to solve all her problems herself.
Themes
Silence vs. “The Talking Cure” Theme Icon
When they get home, Gabriel holds out the pills to Alicia; she resents that he is treating her like a child. As soon as Gabriel turns his back, Alicia spits the pills out, in part because she remembers how over-medicated she was the first time she saw Dr. West. “I’m not going to risk that again,” she vows, “I need to be prepared.”
Alicia’s refusal to be treated like a child is especially fraught given how troubled her childhood was. Theo has always theorized that Alicia was taking out childhood anger on Gabriel—and if Gabriel is making her flash back to her youth, Theo’s theory seems even more likely to be right.
Themes
Honesty vs. Deception Theme Icon
On August 17th, Alicia admits to hiding her diary, as she does not want Gabriel to discover it. The diary increasingly feels like her only source of solace. On August 21st, Alicia admits that she has stopped going outside, out of a desire to track the man’s movements. On August 22nd, Alicia moves Gabriel’s gun to a more easily accessible location.
Alicia hid her diary from Gabriel, but she gave it to Theo, suggesting that she trusts Theo more than her husband; Theo can understand her in a way Gabriel cannot. And just as Theo has compared Kathy to Alicia, readers now must compare Theo to Gabriel. Structurally, Alicia’s rapid-fire diary entries (and her focus on the gun) foreshadow the more dramatic, more violent murder that is now only three days away.
Themes
Empathy, Identification, and Boundaries Theme Icon
Tragedy and Destiny Theme Icon
Silence vs. “The Talking Cure” Theme Icon
The next day, Alicia begins to fret that she will never work again. Gabriel keeps checking in, but his concern is not making Alicia feel any better. Worse still, Gabriel announces that that night, they will go out to dinner with Max and Tanya. Alicia begins to fear that the man outside the window is Max, and she decides to confront him at dinner that night. 
At first, it seemed that Alicia was only hiding a few parts of her life from Gabriel. But as she starts to spend her days consumed by fear of the watching man, it is clear just how little Gabriel knows about the woman he sleeps next to. This lack of marital communication is then mirrored in Theo’s relationship with Kathy.
Themes
Empathy, Identification, and Boundaries Theme Icon
Childhood Trauma Theme Icon
Silence vs. “The Talking Cure” Theme Icon
Going back into the outside world is overwhelming for Alicia. Everything feels different: even Augusto’s, their regular spot, no longer feels comforting and safe. At dinner, Max is all over Tanya, as if he is trying to make Alicia jealous. But both Alicia and Tanya notice the obsessive way that Max is staring at his brother’s wife. When they are alone, Alicia accuses Max of following her, but he is genuinely livid and confused. Alicia slaps Max, only to realize that Tanya has seen the whole thing.
Despite Alicia’s suspicions, Max’s reaction makes it clear that he is not the man outside the window—and neither is Jean-Felix, given that he didn’t reveal himself when Alicia called his name at the park. That leaves Paul Rose, Yuri, and potentially even Gabriel as suspects.
Themes
Childhood Trauma Theme Icon
On August 25th, Alicia hears a sound coming from outside. Gradually, the sound gets closer and closer; someone is trying the windows and the doors. Alicia calls Gabriel, but he doesn’t answer his phone. With dread, Alicia realizes that the man has gotten inside the house.
August 25th is the day of the murder—and now, Alicia’s stalker is trying to get inside. For the first time, it seems that Barbie Hellman might have been right: maybe Alicia really is innocent, and this mysterious man is responsible for Gabriel’s death.
Themes
Empathy, Identification, and Boundaries Theme Icon
Silence vs. “The Talking Cure” Theme Icon