The Silent Patient

The Silent Patient

by

Alex Michaelides

The Silent Patient: Part 5, Chapter 1 Summary & Analysis

Summary
Analysis
The final section begins with a quote from the Bible: “If I justify myself, mine own mouth will condemn me.” The novel then jumps forward to Alicia’s most recent diary entry, dated February 23rd. She explains how she recognized Theo as the masked man—“the same smell of cigarettes,” the same phrase (“I want to help you see clearly”).
Even as Alicia’s stalker, Theo claimed to be her therapist, arguing that he wanted to help her; seen through this light, Theo’s desire to understand (to “see clearly”) is terrifying and abusive. Furthermore, it is telling that cigarette smoke—which Theo has long identified as a symbol of his own failures as a therapist—becomes a giveaway to Alicia. 
Themes
Empathy, Identification, and Boundaries Theme Icon
Childhood Trauma Theme Icon
As soon as Alicia recognized Theo, she had tried to kill him. But she had failed, and after the failure, doubt set in; was she just imagining all of it? Once she told a falsified story of Gabriel’s death, however, Alicia was sure that Theo was the man who had been watching her. And so she was not surprised when, a few minutes earlier, he had come in with a needle and injected her. Already, Alicia can feel herself losing consciousness, so she has to write this diary entry quickly.
The psychological idea of “splitting” (as mentioned by Theo and Diomedes earlier in the novel) dictates that a person, having committed terrible acts, often struggles to reconcile those acts with the good parts of themselves. By accusing Christian of his attempted murder, Theo was perhaps trying to punish the “split”-off side of himself; why else would he tell anyone that Alicia had been injected?
Themes
Empathy, Identification, and Boundaries Theme Icon
Theo really had tied Alicia up, and he really had threatened to kill Gabriel. While they both waited for Gabriel, Theo had asked Alicia whether or not Gabriel loved her. When she replied that he did, Theo was skeptical: “we’ll see.” Alicia feels that Theo is not quite human, that he is pure evil.
But though Theo preaches that each person is complex, comprised of good and evil, Alicia sees Theo less as a complicated human and more as a demonic figure. His questions about Gabriel in Alicia’s house parallel his questions in the therapy room at the Grove—and while Theo claims he wants to help, Alicia only feels tortured.
Themes
Empathy, Identification, and Boundaries Theme Icon
When Gabriel finally returns, Theo lectures him: “I’m a married man. So I know what it’s like to love someone. And I know what it’s like to be let down.” Gabriel does not understand, so Theo gives him a choice—“either you die,” Theo tells him, “or Alicia does. You decide.” Theo counts down from 10, while Alicia pleads for Gabriel to spare her life. But at the end of the 10 seconds, Gabriel softly admits it: “I don’t want to die.”
Gabriel’s decision to sacrifice Alicia’s life in place of his own directly parallels the plot of Alcestis, in which Admetus sacrifices his wife’s life to protect himself. On the one hand, Theo should have understood the allusion all along, suggesting that he was directly lying to (or at least misleading) readers. But on the other hand, Theo’s statement that he “knows what it’s like” to be betrayed shows, again, just how unable he is to separate his own feelings from Alicia’s.
Themes
Empathy, Identification, and Boundaries Theme Icon
Tragedy and Destiny Theme Icon
Childhood Trauma Theme Icon
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Alicia smells jasmine, as she feels every cell in her body die and give out. Theo explains that Gabriel was having an affair with Kathy, and then he shoots the gun into the ceiling. Before he leaves, he unties Alicia’s wrists and softly kisses her on the cheek.
When Theo went to visit Paul at Alicia’s childhood home, he took in the jasmine—the very smell that Alicia experienced when Vernon metaphorically “killed” her. So just as Theo predicted, Alicia feels that Gabriel’s betrayal is a direct repeat of her father’s: two versions of Admetus, sacrificing the same, silent Alcestis.
Themes
Empathy, Identification, and Boundaries Theme Icon
Tragedy and Destiny Theme Icon
Honesty vs. Deception Theme Icon
Gabriel begs Alicia to untie him, to forgive him, to talk to him. But Alicia stays silent—“Gabriel had sentenced me to death. The dead don’t talk.” In the present day, Alicia wishes that Gabriel had become her father in her mind, a tyrant. But “the truth is Gabriel had my eyes, suddenly—and I had his.” Alicia picks up the gun. “I didn’t kill Gabriel,” she explains. “He killed me. All I did was pull the trigger.”
Greek tragedies end in death; in Alcestis, the Greek tragedy at the heart of this novel, the titular character is murdered midway through the tragedy, and though she goes on living, she never really revives. Alicia experiences something similar here—though she technically murders Gabriel, emotionally, she feels that he has already killed her off. And most importantly, this passage shows the truth behind Alicia’s silence: by not speaking, Alicia is communicating her symbolic death to the rest of the world, showing them the emotional truth that she already knows.
Themes
Tragedy and Destiny Theme Icon
Honesty vs. Deception Theme Icon
Silence vs. “The Talking Cure” Theme Icon
Quotes