Book Review: The Silent Patient by Alex Michaelides

The Silent Patient by Alex Michaelides

A compelling mystery and powerful look at psychotherapy

The Silent Patient by Alex Michaelides is a dark book, but a compelling mystery and powerful look at psychotherapy and the connection between a patient and a doctor. In spite of the strict bounds of ethics, it's a strangely deep connection which takes somebody's life into account...
  • Publisher: Celadon Books
  • Genre: Psychological Thriller
  • First Publication: 2019
  • Language: English
  • Major Characters: Alicia Berenson, Theo Faber, Gabriel Barenson
  • Setting Place: London, England
  • Theme: The Dangers of Unresolved or Improperly Treated Mental Illness, A failing system caused by Doctor biases
  • Narration: First Person from Theo and Alicia’s point of view

At first, I wasn’t sure that I would like this book; The Silent Patient seemed, for all intents and purposes, like just another generic psychological thriller books. In many ways it was, but in other ways, it stood out because of its excellent characters and the depth of the story and its themes. Looking beyond the façade of a picture-perfect married couple to see the dysfunction beneath the veil of modern life, The Silent Patient calls into question the horrific events which left one dead and another living a mute existence in a mental hospital.

“Remember, love that doesn’t include honesty doesn’t deserve to be called love.”

Alicia Berenson is a famous painter who has been admitted to the Grove, a forensic unit in North London. She has been charged with murdering her husband, Graham, who is a fashion photographer, after he returns home late one evening. After shooting Graham, Alicia has never spoken again.

Theo Faber is a criminal psychotherapist who accepted a job at the Grove in the hopes of working with Alicia. He is obsessed with learning her motive. He knows he can get her to talk. Others have tried – others have failed. Will he be successful?

Although Alicia does not speak, the reader gets a glimpse into her life through Theo’s discussions with those in her life. Well, more to the point, we get their impressions of her, things they know about her and their own assumptions about her. The reader gets to learn even more about Alicia through her diary entries. Finally, Alicia “speaks” via the written word. But what could have led her to shoot her husband? Will she ever speak? Why isn’t she speaking now? Is it by choice? Is it due to trauma?

“There’s so much pain everywhere, and we just close our eyes to it. The truth is we’re all scared. We’re terrified of each other.”

We have sections mostly from Theo’s point of view as he tries to get Alicia to talk and then snippets from Alicia’s journal. This helps up piece together pieces of the puzzle from the past along with Theo talking to Alicia’s friends and family — almost like a detective. Interesting to learn that these actions aren’t recommended for psychotherapists, you are meant to just treat the patient.

Theo is also an interesting character. Most of the novel is told through him. The reader also gets a glimpse into his life, his thoughts and the inner workings of his mind. I was curious as to why he was so obsessed with learning her motive. Why is he so driven to learn the truth? Is he a fan or her artwork? Will learning the truth advance his career?

There are many secondary characters that add depth to the story. Some pop up briefly, several have recurring roles & others lurk in the background. Each brings something to the table, even in their absence. But make no mistake…this is the Alicia & Theo Show.

“Choosing a lover is a lot like choosing a therapist. We need to ask ourselves, is this someone who will be honest with me, listen to criticism, admit making mistakes, and not promise the impossible?”

Alicia is an enigma from the start. In the present, she is a shadow of her previous self. But through her thoughts & memories, we begin to put flesh on her bones as we learn about her childhood & subsequent relationship with Gabriel. Friends & colleagues chime in with their observations & put a slightly different slant on her perfect life. Whatever your impression of her, one thing is clear…her voice may be lost but there is absolutely nothing wrong with her mind.

It’s up to Theo to carry the conversation during their regular sessions. And initially he’s more than up for the task. It’s not just about the satisfaction of helping a damaged soul. He’s well aware his colleagues have tried & failed to reach Alicia. If he can get her to speak, it would mean validation of his abilities & a huge feather in his cap. As time goes by, we watch as he becomes obsessed with cracking his famous patient & desperation leads to questionable judgement on his part. You begin to wonder if its a quest for professional glory or a classic case of hubris.

“You know, one of the hardest things to admit is that we weren’t loved when we needed it most. It’s a terrible feeling, the pain of not being loved.”

The Silent Patient by Alex Michaelides is a dark book, but a compelling mystery and powerful look at psychotherapy and the connection between a patient and a doctor. In spite of the strict bounds of ethics, it’s a strangely deep connection which takes somebody’s life into account; and as Theo tries to fit the scattered puzzle pieces of Alicia’s life together, what he finds is totally unexpected. In spite of being vaguely far-fetched and over-dramatic at times, The Silent Patient by Alex Michaelides mostly carries a genuine, honest and realistic feature which makes it all-the-more gripping and engaging.

From the opening pages I knew that I would read to the final page because I had to understand why Gabriel was snuffed in such convincing fashion. It’s one of those books where it’s best to go in blind. Although this is a first novel, the author has written screen plays & it definitely shows in the expert pacing & story telling. I can easily imagine this as a film. I had my suspicions about Gabriel’s death but the motive is only revealed near the end. And what an end it is. There’s something really satisfying about a character getting what they so karmically deserve.

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  • Publisher: Celadon Books
  • Genre: Psychological Thriller
  • First Publication: 2019
  • Language: English

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The Silent Patient by Alex Michaelides is a dark book, but a compelling mystery and powerful look at psychotherapy and the connection between a patient and a doctor. In spite of the strict bounds of ethics, it's a strangely deep connection which takes somebody's life into account...The Silent Patient by Alex Michaelides