The Silent Patient

90 pages • 3 hours read

The Silent Patient

Fiction | Novel | Adult | Published in 2019

A modern alternative to SparkNotes and CliffsNotes, SuperSummary offers high-quality Study Guides with detailed chapter summaries and analysis of major themes, characters, and more. For select classroom titles, we also provide Teaching Guides with discussion and quiz questions to prompt student engagement.

Download PDF

Introduction

Before Reading

During Reading

After Reading

During Reading

Reading Questions & Paired Texts

Reading Check and Short Answer Questions on key points are designed for guided reading assignments, in-class review, formative assessment, quizzes, and more.

EPIGRAPH-PART 1

Reading Check

1. Whose diary is featured in the Prologue?

2. What is Alicia accused of?

3. Where does Theo get a job?

Short Answer

Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.

1. What is the effect of the novel unfolding in first person in both Alicia’s journal entries and Theo’s narration?

2. Why did Theo become a psychotherapist, and how does that differ from what he says in his interview?

3. What happens during Theo’s first individual meeting with Alicia? What does this reveal about both characters?

4. How do Theo and Kathy begin their relationship?

Paired Resource

“Smiling Depression: What You Need to Know”

WebMD explains the term “smiling depression” and discusses the possible consequences of leaving this condition untreated. (Note: Suicide is briefly mentioned.)
Theme connections include The Human Instinct to Hide Weakness and Present a Favorable Façade to the World and The Dangers of Unresolved or Improperly Treated Mental Illness.
How does Alicia’s journal reveal aspects of smiling depression, as listed in the article?

PART 2

Reading Check

1. What does Theo ask Lazarus Diomedes to do for Alicia?

2. How does Alicia’s second meeting with Theo end?

3. What play is Kathy in?

4. Who is Ruth?

5. What does Paul ask Alicia for, and why?

6. What does Alicia give to Theo?

Short Answer

Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.

1. How did Alicia’s mom die, and how did this ultimately impact Alicia?

2. How does Theo react to Kathy’s affair?

3. What does Alicia’s diary reveal about Max Berenson?

4. Who recommends that Theo read Euripides’ Alcestis? What parallels does Theo discover between the play and Alicia?

5. How does Alicia react when Theo gets permission for her to paint in her own space?

Paired Resource

“Smiling Depression: When Things Aren’t Quite What They Seem”

In this article by Verywell Mind, author and psychotherapist Amy Morin explains why some people hide depression. (Note: This article discusses suicide.)
Theme connections include The Human Instinct to Hide Weakness and Present a Favorable Façade to the World and The Dangers of Unresolved or Improperly Treated Mental Illness.
What are some of the signs and symptoms of smiling depression? How does the novel reveal differences between how characters act outwardly and their true feelings?

PART 3

Reading Check

1. What frightens Alicia enough to stay inside for three straight days?

2. How does Alicia’s diary end?

Short Answer

Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.

1. Why does Alicia refuse to take the medication Dr. West prescribes?

2. What is the effect of this part being solely Alicia’s diary entries?

Paired Resource

“Many Americans Are Reaching Out for Mental Health Support—but Can’t Get It”

NPR explores problems with the mental health industry that leave some people suffering.
A theme connection is The Dangers of Unresolved or Improperly Treated Mental Illness.
What are some of the most common challenges people face when seeking care for their mental health? Where do characters in the novel encounter barriers to strong mental health care?

PART 4

Reading Check

1. Who is Dr. West?

2. What does Alicia ask Theo for in the middle of telling her story?

3. What happens to Alicia after she tells Theo her story?

4. Who was Alicia’s stalker?

Short Answer

Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.

1. What additional trauma did Alicia experience after her mother’s death, and what connection does it have to her painting Alcestis?

2. How does Alicia respond when Theo says it is their last chance to work together?

3. How is Theo viewing Lazarus?

Paired Resource

“Are We Ever Authentically Ourselves on the Internet?”

This article from Vox discusses authenticity and perception on social media apps.
A theme connection is The Human Instinct to Hide Weakness and Present a Favorable Façade to the World.
Where have the characters been their authentic selves? Where have they put up a façade?

“Why Betrayal Can Cause Trauma and How to Start Healing”

This resource from Healthline examines the physical and mental effects of betrayal and discusses ways to begin healing.
Theme connections include The Destructive Force of Betrayal, The Dangers of Unresolved or Improperly Treated Mental Illness, and The Human Instinct to Hide Weakness and Present a Favorable Façade to the World.
What is betrayal trauma, as outlined in the article? How have different characters handled betrayal?

PART 5

Reading Check

1. For how long has Alicia recognized Theo?

2. Who injected Alicia with morphine?

Short Answer

Answer each question in at least 1 complete sentence. Incorporate details from the text to support your response.

1. What role did Theo play in Gabriel’s murder? What happened that night?

2. How does Theo finally get caught?

Recommended Next Reads

The Girl on the Train by Paula Hawkins

The lives of Rachel, Megan, and Anna intertwine as they face infidelity, mental health issues, abuse, and murder.
Shared themes include The Dangers of Unresolved or Improperly Treated Mental Illness, The Destructive Force of Betrayal, and The Human Instinct to Hide Weakness and Present a Favorable Façade to the World.
Shared topics include infidelity, different perspectives, therapy, suspense, mystery, unreliable narrators, substance abuse, the past, and murder.
The Girl on the Train on SuperSummary

Sharp Objects by Gillian Flynn

When Camille returns to her hometown to report on the murder of two girls, she finds herself confronting a painful past.
Shared themes include The Dangers of Unresolved or Improperly Treated Mental Illness, The Destructive Force of Betrayal, and The Human Instinct to Hide Weakness and Present a Favorable Façade to the World.
Shared topics include family, mental illness, self-harm, treatment, suspense, mystery, the past, work, and murder.
Sharp Objects on SuperSummary

Reading Questions Answer Key

EPIGRAPH-PART 1

Reading Check

1. Alicia’s (Prologue)

2. Murdering her husband (Part 1, Chapter 1)

3. The Grove (Part 1, Chapter 3)

Short Answer

1. Alicia’s journal entries provide insights she did not reveal to others, giving the reader a look into her inner thoughts. Theo tells most of the story from his point of view, which keeps other people’s perspectives largely hidden. The reader sees things as Theo wants to reveal them. (Part 1)

2. He reflects that he became a therapist because of his traumatic childhood with an abusive father, but he says in his interview that he wanted to help people. (Part 1, Chapter 3)

3. Theo asks Alicia’s nurse to wait outside, showing Theo’s willingness to break the rules. Alicia remains silent, demonstrating her unwillingness or inability to participate in individual therapy. (Part 1, Chapter 7)

4. Theo and Kathy begin their relationship with betrayal because they are both already in a relationship when they meet on a double date. They leave with each other, betraying their partners. (Part 1, Chapter 10)

PART 2

Reading Check

1. Lower her medication dosages (Part 2, Chapter 2)

2. She attacks him. (Part 2, Chapter 4)

3. Othello (Part 2, Chapter 6)

4. Theo’s therapist (Part 2, Chapter 8)

5. Money to pay off gambling debts (Part 2, Chapter 22)

6. Her journal (Part 2, Chapter 34)

Short Answer

1. Alicia’s mom died by suicide; she drove directly into a wall with Alicia in the backseat. Alicia wonders if her mom tried to kill her, too. Ultimately, Alicia thinks she should not have children, as she worries that there are some of her mom’s instincts in her. (Part 2, Chapter 1)

2. Theo seeks out counseling from Ruth, whom he has not seen in a long time. He does not confront Kathy. He also turns to drugs and alcohol. (Part 2, Chapters 6-10)

3. Max has forced himself on her twice, but when he has dinner with her and Gabriel, he pretends it never happened. This reveals that Max is both abusive and deceptive. (Part 2, Chapter 13)

4. Jean-Felix recommends that Theo read Euripides’ play. When he does, Theo notices parallels between the play and Alicia: Alcestis cannot speak after being betrayed and returning from death, and since Alicia has also stopped speaking, Theo realizes that something killed a part of her, too. (Part 2, Chapters 20-21)

5. Once she has permission, Alicia dives into painting and seems to block out the rest of the world. She paints The Grove on fire and Theo carrying her, though it is not clear whether the image depicts him rescuing her or about to kill her. (Part 2, Chapters 22-28)

PART 3

Reading Check

1. Seeing a stalker outside (Part 3)

2. “He’s inside the house.” (Part 3)

Short Answer

1. Alicia is unwilling to take the medication prescribed by Dr. West because she is afraid of the man outside; she fears that if she takes the drugs, she will not be aware of what is going on around her and may become susceptible to danger. (Part 3)

2. Part 3 contains only Alicia’s diary entries, which emphasizes the importance of the events being recounted within them. The reader discovers what Alicia went through right before killing Gabriel, while Theo, who is also reading the journal, searches for clues about how to reach Alicia. This creates tension and anticipation as the reader looks for clues about the mystery alongside Theo. (Part 3)

PART 4

Reading Check

1. Christian (Part 4, Chapters 1-2)

2. A cigarette (Part 4, Chapter 12)

3. She is injected with an overdose of morphine and falls into a coma. (Part 4, Chapters 17-18)

4. Theo (Part 4, Chapter 21)

Short Answer

1. Alicia overheard her father ranting about how he wished she had died instead of her mother. This connects to Alcestis being condemned to die by someone she loved. Afterward, Alcestis does not speak, just as Alicia does not speak. (Part 4, Chapters 7-8)

2. Alicia begins speaking and asks what he wants. Then, she makes a conscious and visible decision to continue speaking and working with him. (Part 4, Chapter 9)

3. Theo views Lazarus, his boss, as a father figure. Theo’s father was abusive, while Lazarus is older and kind. When Theo reaches a breakthrough with Alicia and Lazarus approves, Theo reflects, “I felt a small flicker of pride—a son congratulated by his father.” (Part 4, Chapter 10)

PART 5

Reading Check

1. Since the second session when she attacked him (Part 5, Chapter 1)

2. Theo (Part 5, Chapter 1)

Short Answer

1. Theo stalked Alicia, causing her intense fear. One night, he attacked her and held her as a prisoner until Gabriel returned. He told Gabriel to choose who would die: Alicia or himself. Gabriel said he wanted to live, and when he chose himself over Alicia, it traumatized her, especially after her father had said he wished she had died instead of her mother. When Theo released Alicia, she killed Gabriel and tried to die by suicide. (Part 5, Chapter 1)

2. Alicia wrote down the truth in her journal and hid it behind her painting. The police find it, and it clearly implicates Theo. (Part 5, Chapter 3)