Themes
Key
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
Barbie lives in a gigantic house, a token of her divorce settlement with her investment banker ex-husband. The home is overwhelming, filled to the brim with plants and knick-knacks; though each thing is expensive on its own, crowded together, it all looks cheap. “It suggested a disordered inner world,” Theo notes, “it made me think of chaos, clutter, greed—insatiable hunger.” He wonders how Barbie’s childhood went.
Perhaps because of his time with the mute Alicia, Theo is skilled at understanding someone’s “inner world” from the way they externally present themselves. Even in passing, he feels that Barbie’s “disordered” state could probably be linked back to something unpleasant or chaotic in her childhood.
Themes
Barbie offers Theo a drink, but he refuses, so she pours herself a giant glass of red wine. Theo then begins to ask his questions: did Alicia ever mention seeing a doctor? Barbie doesn’t know of a doctor, and instead, she launches into a long tangent about her own doctor, a dietician of sorts. Theo reflects that she is “entirely narcissistic,” and he imagines that Alicia probably experienced this same difficulty of getting a word in edgewise.
Theo really is annoyed by Barbie’s narcissism—but at the same time, by emphasizing over and over again how self-involved she is, Theo is implying to readers that he is the exact opposite. In other words, this is a moment to focus on whether Theo is a reliable narrator; is Barbie really so awful, or is he just trying to make himself look good by comparison?
Themes
Barbie does have something useful to offer, however. Having seen Alicia just a few hours before the murder, she is convinced of her friend’s innocence. Moreover, she asserts to Theo that there had been a mysterious man watching Alicia for quite some time. Alicia had shared her fears with Barbie, even sending her a blurry picture of the man standing outside the house.
This is the first time anyone has mentioned a mysterious man, who will become a key figure in the rest of the book. Indeed, Alicia was frightened by many men: Jean-Felix, Paul, and Max, to name a few. But could it also be Yuri, who told Theo early on that he once waited outside a neighborhood woman’s window for weeks on end?
Themes
Alicia was reluctant to tell Gabriel at first, fearing that he wouldn’t believe her—and indeed, when she finally worked up the nerve, Gabriel dismissed her. A few days later, Alicia had come to Barbie, asking her to forget the whole thing. And though Barbie had shown the picture to the police in the days after the murder, they had been similarly uninterested in investigating.
Even before the murder, it seems, no one had taken Alicia’s private thoughts seriously—not even Gabriel, who should have been the most attentive of all. This lack of belief is in part a symptom of sexism, but it also adds new weight to Theo’s therapy sessions: for all his flaws, he is the first person to really try to listen to Alicia, to give her pain its due.
Themes
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As Theo makes his way back home, he reflects on what Barbie has told him. He is certain that Alicia never felt close to Barbie, so this man must have scared her badly to make her want comfort from a woman she couldn’t stand. Suddenly, Theo thinks back to his childhood: “a little boy close to bursting with anxiety, holding in all my terrors […] no one to tell. No one who’d listen.” He thinks that “Alicia must have felt similarly desperate.” For a brief moment, he wonders if someone is watching him—but no one is there.
Christian was probably right that Theo has begun to “overidentify” with Alicia. He imagines her perceptions of Barbie alongside his own; he pictures her childhood as akin to his experience as a scared “little boy.” And indeed, his sense of identification is so strong that as soon as he learns Alicia was being watched, he assumes the same must be true for him.
Themes
