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.