The Silent Patient

The Silent Patient

by

Alex Michaelides

The Silent Patient: Part 4, Chapter 3 Summary & Analysis

Summary
Analysis
Christian immediately launches into a diagnosis (“she was highly paranoid, delusional—psychotic”), but Theo is more interested in the facts. Christian believes that the man outside the window was merely a delusion—especially because, soon after her father’s death, Alicia became convinced that a harmless old neighbor was spying on her. 
As always, Christian resorts to scientific terms and biological or medicinal solutions. But Theo does not trust anyone’s analysis of Alicia but his own—even though Christian reveals that in fact, Alicia has long suspected (without basis) that someone is spying on her, making it more likely that she really was hallucinating this new stalker.
Themes
Empathy, Identification, and Boundaries Theme Icon
Silence vs. “The Talking Cure” Theme Icon
Theo wants to find out more about Alicia’s relationship with her father, but Christian is cynical. Though he admits Alicia attempted suicide, he writes it off as “narcissistic” behavior, a pathetic ploy to get Gabriel to notice her. Christian calls Alicia a “total bitch,” and Theo is done. Instead, he tells Christian that he plans to ask Alicia directly for answers, which shocks Christian—how can Alicia answer if she won’t speak?
Christian’s dismissal of Alicia is rife with sexism, as he labels her fear self-involvement and calls her a “total bitch.” At the same time, Gabriel’s use of the word “narcissist” is telling: this is a word Theo uses whenever he wants to discredit someone. Are accusations of narcissism always valid? Or is this a (male) therapist’s way of dismissing someone (a female) with a potentially meaningful point?
Themes
Empathy, Identification, and Boundaries Theme Icon
Childhood Trauma Theme Icon