Theo Faber, a psychotherapist and the first-person narrator of Alex Michaelides’s book The Silent Patient, believes that pain and rage originate “in the land before memory, in the world of early childhood, with abuse and mistreatment”; thus, to solve the mystery of an adult’s psyche, Theo opines, one must retrace their history. It is unsurprising, then, that when Theo decides to help a troubled painter named Alicia Berenson, the first thing he writes down on his notepad is the word “CHILDHOOD.” Over the course of the narrative, Theo revisits Alicia’s childhood home—“the roots of her adult life,” he reflects upon arrival, “were buried here”—and obsesses over her relationships with her parents.
But while Theo pries into the details of his patient’s childhood, he also struggles to break free from his own youthful traumas. As a young boy, Theo’s father made him feel worthless; as an adult, he seeks out the same feeling, choosing a wife (Kathy) who makes him believe he is “useless, ugly, worthless, nothing.” And even in smaller ways, Theo’s childhood patterns repeat themselves: the book begins with a young Theo catching snowflakes on his tongue, and it ends with the adult Theo trying desperately to do the same. Ultimately, through both Theo and Alicia, The Silent Patient shows the importance that childhood trauma and joy play in adult life—and the impossibility of ever fully shedding one’s past.
Childhood Trauma ThemeTracker
Childhood Trauma Quotes in The Silent Patient
I’m getting ahead of myself. I must start at the beginning and let events speak for themselves. I mustn’t color them, twist them, or tell any lies. I’ll proceed step by step, slowly and cautiously. But where to begin? I should introduce myself, but perhaps not quite yet; after all, I am not the hero of this tale. It is Alicia Berenson’s story, so I must begin with her—and the “Alcestis.”
[Diomedes] pulled out a little box from his desk, sliding off the cover to reveal a row of cigars. He offered me one. I shook my head.
“You don’t smoke?” He seemed surprised. “You look like a smoker to me.”
“No, no. Only the occasional cigarette—just now and then…I’m trying to quit.”
“Good, good for you.” He opened the window. “You know that joke, about why you can’t be a therapist and smoke? Because it means you’re still fucked up.” He laughed and popped one of the cigars into his mouth. “I think we’re all a bit crazy in this place. You know that sign they used to have in offices? ‘You don’t need to be mad to work here, but it helps’?”
Diomedes laughed again. He lit the cigar and puffed on it, blowing the smoke outside. I watched him enviously.
She was right. I have been groping for the right words to express that murky feeling of betrayal inside, the horrible hollow ache, and to hear Ruth say it—“the pain of not being loved”—I saw how it pervaded my entire consciousness and was at once the story of my past, present, and future. This wasn’t just about Kathy; it was about my father, and my childhood feelings of abandonment; my grief for everything I never had and, in my heart, still believed I never would have. Ruth was saying that was why I chose Kathy. What better way for me to prove that my father was correct—that I’m worthless and unlovable—than by pursuing someone who will never love me?
I buried my head in my hands. “So all this was inevitable? That’s what you’re saying—I set myself up for this?”
Leaving Kathy would be like tearing off a limb. I simply wasn’t prepared to mutilate myself like that. No matter what Ruth said. Ruth wasn’t infallible. Kathy was not my father; I wasn’t condemned to repeat the past. I could change the future. Kathy and I were happy before; we could be again. One day she might confess it all to me, tell me about it, and I would forgive her. We would work through this.
I would not let Kathy go. Instead I would say nothing. I would pretend I had never read those emails. Somehow, I’d forget. I’d bury it. I had no choice but to go on. I refuse to give into this; I refuse to breakdown and fall apart.
After all, I wasn’t just responsible for myself. What about the patients in my care? Certain people depended on me. I couldn’t let them down.
This was the house where Alicia had been born. It was where she spent the first eighteen years of her life. Within these walls her personality had been formed: the roots of her adult life, all causes and subsequent choices, were buried here. Sometimes it’s hard to grasp why the answers to the present lie in the past. A simple analogy might be helpful: a leading psychiatrist in the field of sexual abuse once told me she had, in thirty years of extensive work with pedophiles, never met one who hadn’t himself been abused as a child. This doesn’t mean that all abused children go on to become abusers, but it is impossible for someone who is not abused to become an abuser. No one is born evil. As Winnicott put it, “A baby cannot hate the mother, without the mother first hating the baby.” As babies, we are innocent sponges, blank slates with only the most basic needs present: to eat, shit, love, and be loved. But something goes wrong, depending on the circumstances into which we are born, and the house in which we grow up. A tormented, abused child can never take revenge in reality, as she’s powerless and defenseless, but she can and must harbor vengeful fantasies in her imagination. Rage, like fear, is reactive. Something bad happened to Alicia, probably early in her childhood, to provoke the murderous impulses that emerged all those years later.
Gabriel keeps asking me how I’m doing—if I’m okay. I can tell he’s worried, despite me insisting I’m fine. My acting doesn’t seem to be convincing him anymore. I need to try harder. I pretend to be focused on work all day, whereas in fact work couldn’t be further from my mind. I’ve lost any connection with it, any impetus to finish the paintings. As I write this, I can’t honestly say I think I’ll paint again. Not until all this is behind me, anyway.
I knew I should hide. I was exposed and in plain sight—if Kathy turned around, she’d be sure to see me. But I couldn’t move. I was transfixed, staring at a Medusa, turned to stone.
Eventually they stopped kissing and walked into the park, arm in arm. I followed. It was disorienting. From behind, from a distance, the man didn’t look dissimilar to me—for a few seconds I had a confused, out-of-body experience, convinced I was watching myself walking in the park with Kathy.
I watched his wife through the windows. As I watched, I felt increasingly sure I had to do something to help her. She was me, and I was her: we were two innocent victims, deceived and betrayed. She believed this man loved her—but he didn’t.
Perhaps I was wrong, assuming she knew nothing about the affair? Perhaps she did know. Perhaps they enjoyed a sexually open relationship and she was equally promiscuous? But somehow I didn’t think so. She looked innocent, as I had once looked. It was my duty to enlighten her. I could reveal the truth about the man she was living with, whose bed she shared. I had no choice. I had to help her.