The Silent Patient
Alex Michaelides
Contributed by Carey Speaks
Themes are described as ideas that dominate a particular piece of literature. In almost all cases, pieces of literature will be centered a theme or a number of them.

The author highlights the theme of love in the novel through the marriages of the protagonist and the antagonist. Theo was deeply in love with Kathy, while Alicia had fallen in love with Gabriel. Sadly, this love is threatened by the betrayal of their partners. Even though both their partners were promiscuous, the author outlines how both Alicia and Theo were afraid of being abandoned by them. Having grown up with heartless fathers, both characters would rather cling on to the little love in their marriages than to abandon their partners. Theo, for instance, fails to confront his wife about her affair because he is afraid that she will leave him, “Without Kathy, I’d return to that empty, solitary existence I had endured before. I’d never meet anyone like her again, never have that same connection or experience that depth of feeling for another human being” (Michaelides, 85). For Alicia, she pretends that Dr. West’s treatment is working because she feared that, if it did not, Gabriel would drift away from her. In her diary, she writes, “The thought of losing him, I couldn’t bear it. I’d do anything to keep him—even pretend I’m crazy when I know I’m not” (Michaelides, 183).


The author outlines this theme by representing how the characters deal with the deaths of their loved ones. He portrays how death is not easily accepted and can have a nasty toll on those that are affected. At an early age, Alicia loses her mother, which leaves her and her father in a melancholic state. Alicia’s condition is further worsened when her father wishes that she had died instead of her mother. The trauma of this childhood scene is attributed to the death of Gabriel, where she is once again condemned to death by another man so that he could save his own life. Alicia is remorseful and grief-stricken by Gabriel’s death, making her unable to speak — and thus, she is the silent patient. In addition, Alicia tries to commit suicide twice — after the death of her father, and after she murders Gabriel. In both scenarios, the author shows how her character is agonized by their deaths. This creates a sympathetic mood for the readers.

Good versus Evil

Through character assassination, the author describes how innocent characters struggle to remain good. Theo describes how his lovely wife had come into his life at a crucial time and transformed him into a loving husband. Sadly, Kathy’s infidelity creates a wedge between them. Theo must choose whether to confront his wife or ignore her promiscuity — and by choosing to ignore it, Theo becomes self-loathing and spiteful. He seeks revenge on the man that is having an affair with his wife. Theo’s rage transforms him from a good husband to an insatiable psychopath who stalks his wife and threatens to kill her lover. This marks the beginning of his perverseness. From the final sections of the book, it is evident that Theo has become evil. He attempts to kill Alicia and falsely blames Christian for it. When confronted by the inspector at his house, it is also evident that Theo is not remorseful for his actions. In his inner battle between good and evil, the latter prevails.

Alicia’s conscience is also split in the divisive struggle between good and evil intentions. Initially, the author describes Alicia as a timid character that is incapable of hurting anyone. In fact, her neighbor, Barbie, doubts that she was capable of killing anyone. Nonetheless, Alicia dreadfully kills her husband and admits to this in her diary. In her rage, Alicia had let evil get the best of her.

Desire to Escape

Alicia is raised by a ruthless aunt, Lydia, that she hates. Throughout her childhood, her aunt torments her together with her cousin, Paul. In addition, Theo also had an aggressive drunk of a father who constantly harassed him and his mother. The author describes how both Alicia and Theo hated living in their childhood homes. The option of escaping from their homes, therefore, presents a solution to their oppressive guardians: at the first chance they get, both characters move out of their childhood homes.


The antagonist in the novel is first portrayed as a helpful and supportive husband whose only intentions lie in the improvement of Alicia’s state of mind. Furthermore, Theo presents himself as an innocent victim of mental health. As he describes how he struggles to get away from his aggressive father, the audience perceives him to be a good man. Conversely, Theo is narcissistic and deceives the Grove’s administration that he only wanted to help Alicia out of good intentions. For instance, Indira advocates for Theo, “Alicia has begun to talk. She’s communicating through Theo—he is her advocate. It’s already happening” (Michaelides, 71). However, he only intended to get rid of her and any incriminating evidence that could tie him to the night that Gabriel was murdered. Theo manages to fool everyone in the hospital.

Alicia also deceives Theo into thinking that she did not recognize him from the night that he had intruded into her house and attacked her. She uses her diary to send Theo on a wild-goose chase. Furthermore, she describes a false account of the night that Gabriel died so that she can confirm that Theo was her attacker, “That first time I met him in the therapy room, I wasn’t sure—there was something familiar about him, but different—I recognized his eyes, not just the color but the shape” (Michaelides, 253). Alicia’s deception ensures that the audience is uncertain of the identity of the masked intruder until the final part of the novel — thereby creating suspense.

Deception is also outlined through the role of the media, which is represented to be more speculative rather than informative. The theories formed by radio and morning chat shows, about Alicia’s involvement in the murder, were not entirely factual. Speculative news is aired since it sells more to their target audience. With the need to remain profitable, media organizations deceive masses.

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