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
When Theo re-enters the therapy room, Alicia is sitting in his chair—though normally he would have pushed back on this, he is well aware that she has the upper hand in their relationship. Alicia begins to describe the fear she felt while tied up with wire: she recalls feeling terror “like fire.” The man asked Alicia questions while she waited for Gabriel to come home. At exactly 11 p.m., his car rolled into the driveway.
Just a few pages earlier, Theo admitted that he could no longer tell “who was who” in his professional relationship with Alicia. Now, having effectively confessed his sexual feelings for her, Theo returns to his office to find Alicia sitting in the chair—she has taken control, and she will now set the terms of their engagement (as she maybe always has).
Active
Themes
As soon as Gabriel approached, the man swung Alicia around, telling her he would shoot Gabriel in the head if she made any sound. The man then used the gun to knock Gabriel out, tying him up and shooting Gabriel six times in the face. He left without saying a word.
Perhaps more interesting than Alicia’s shocking, likely untrue claim to innocence is her reflection that the invader asked her questions. Was it Gabriel in disguise, trying to find out his wife’s true feelings? Was it Max, using his lawyerly skills to cross-examine Alicia? Or was it Christian, a therapist accustomed to asking questions of his patients?