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
The book begins with a quote from Alcestis, a play by the ancient Greek writer Euripides: “Why does she not speak?” It then jumps to the first entry in Alicia Berenson’s diary, where she explains why she has decided to keep such a journal in the first place. Her husband Gabriel is concerned for her mental health, and he has given her the diary in the hope that it will help her find some peace.
Right away, the novel introduces a contrast between speech and silence. Alcestis, the tragic heroine who will prove to be an important allusion throughout the story, is known for her baffling muteness—the central question of both this novel and Euripides’s play is “Why does she not speak?” But when readers first meet Alicia, she is urgently trying to tell them something, scribbling in her diary to ensure she leaves a record behind.
Active
Themes
Alicia admits that she is mostly writing in the diary in an attempt to please Gabriel. Currently, she is sitting in the kitchen while Gabriel cooks. Alicia admires her beloved’s elegance, reflecting that, “I love him so totally, completely, sometimes it threatens to overwhelm me.” But before she can write down her more obsessive thoughts, Alicia cuts herself off, vowing that the diary will only contain happy ideas and inspirations.
This prologue, like many of the chapters in the novel, ends with a moment of foreshadowing: what are the darker thoughts that Alicia does not want to write down? Such foreshadowing is a characteristic of Greek tragedy—which is important, given that Theo often explicitly frames his life in tragic terms.