The Silent Patient

 Alicia is the most obvious example of a character struggling with mental health issues. Opposite Alicia, Christian and Theo represent different approaches to mental health treatment. While Christian medicates Alicia into a stupor, Theo insists on digging for a root childhood trauma. In the novel, both approaches result in tragedy. What commentary might the novel be making about mental health treatment in the larger picture beyond the narrative at hand?

The Silent Patient relies on the epistolary technique to give Alicia a “voice” well before she begins speaking, through the inclusion of her diary entries. The diary entries reveal not only details of Alicia’s personality but also details of the weeks before Gabriel’s murder (such as Alicia’s altercation with Max). The reader is privy to this information before Theo is. It’s not until the end of Part 2 that Alicia gives Theo the diary. What is accomplished by giving the reader a more intimate look at Alicia’s character while withholding those details from Theo? 

The start of the novel has the feel of a traditional novel—a story recounted in past tense. As Theo investigates Alicia’s silence and Kathy’s infidelity, however, the novel starts to take on the feel of an action-driven detective novel. Theo is even compared to a “detective” by other characters, like Jean-Felix and Lazarus. How does the novel’s style reflect this shift, for instance in terms of pacing, chapter lengths, dialogue, and setting? 

The Silent Patient is a clear reference to Alicia. In light of the narrative, what is the significance of using the word “patient” (rather than, say, “girl” or “woman”)—a word that implies a being to be cured or fixed? Take into account Theo’s approach to Alicia and his need to “rescue” her.

Each of the novel’s five parts begins with at least one quote. Choose one part and examine the quote(s) prefacing it, explaining how it/they complement(s) that part of the novel thematically. Why would the author insert these quotes? The narrative could stand without them; technically, they aren’t necessary to the story. What do these quotes add for the reader? 

Choose one of the plays alluded to in the novel (Alcestis, Othello, The Mourning Bride, or A Winter’s Tale), read a summary, and consider why the author would choose to reference this work. What themes does the play address that are relevant to the narrative? What else does the play reveal about these themes?

Gabriel is a photographer, while Alicia is a painter. Photography is about capturing true-to-life images as they are presented or constructed; for example, Gabriel shoots models for Vogue. Painting allows for greater creativity as the painter can imagine any number of unrealistic scenarios; for example, Alicia paints Jesus with Gabriel’s face. How do Gabriel’s and Alicia’s respective art forms parallel their personalities, the dynamic evident in their relationship, and their ultimate outcomes?

Choose one of Alicia’s portraits and explore its significance within the novel’s story, tracing its representation throughout the narrative.