The Silent Patient

The Silent Patient

by

Alex Michaelides

The Silent Patient: Part 4, Chapter 15 Summary & Analysis

Summary
Analysis
Theo doesn’t “believe a word” of Alicia’s story. The facts don’t line up: Gabriel was only shot five times, and Alicia was found untied, for example. But Alicia doesn’t want to say anything else. Instead, she tells Theo that there is one more detail to the story, but she will tell him tomorrow, when she has had time to recover.
Greek tragedy often makes use of foreshadowing, patterns, and repetition, and this novel is no different: the facts of the case at the beginning were insufficient, and the facts Alicia presents now are (at least in Theo’s mind) equally faulty.
Themes
Tragedy and Destiny Theme Icon
Childhood Trauma Theme Icon
Theo speaks to Diomedes, admitting he needs some supervision in figuring out Alicia’s case. Theo shares that he is deeply invested in—and frustrated by—Alicia. Indeed, Theo often leaves their sessions with a splitting headache. Diomedes is understanding, and he offers to share a cigarette with Theo.
Earlier, Theo acknowledged that a headache was a sign that he was successfully taking on Alicia’s pain. But now the headache has grown too strong, proving again (as does the return of the cigarette symbolism) that Theo is perhaps over-identifying with his patient.
Themes
Empathy, Identification, and Boundaries Theme Icon
Diomedes believes that Alicia’s entire encounter with the man is an elaborate fantasy; he is much less sympathetic to her than Theo is. “You’re in deep with Alicia,” Diomedes cautions, “and your feelings are bound up with hers like a tangled ball of wool.” Diomedes also feels that Alicia has been “performing” for Theo, offering him an image of a damsel in distress that will make him want to be her savior.
Diomedes makes two crucial points in this passage. First, in kinder language, he affirms Christian’s point that Theo has lost a sense of separation between himself and Alicia; instead, the two have become “a tangled ball of wool.” Second, Diomedes echoes the idea—first expressed by Jean-Felix—that Alicia is an actress, playing a part much as Kathy might do for work.
Themes
Empathy, Identification, and Boundaries Theme Icon
Childhood Trauma Theme Icon
Diomedes theorizes that Alicia and the man are “one and the same”; she cannot face what she has done, so “she splits, dissociates, fantasizes.” He encourages Theo to force Alicia to face the truth. Theo vows that he will do so tomorrow—and Diomedes implies that tomorrow is Theo’s final chance.
Just as Theo cannot distinguish between himself and Alicia, Diomedes feels that Alicia might not be able to distinguish between the reality of herself (which includes the murder) and her “fantasy” of herself. In both cases, Theo and Alicia struggle to understand their boundaries and borders as individuals.
Themes
Empathy, Identification, and Boundaries Theme Icon
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