Book Review: The Silent Patient by Alex Michaelides

There’s nothing like a good psychological thriller to while away a wet weekend. The Silent Patient ticks all the boxes, combining a troubled narrator who in this case is a psychotherapist, an even more troubled patient and the mystery surrounding the death of her husband.

Theo Faber has recently taken a post at The Grove, a care facility for troubled minds and is particularly interested in one patient. Alicia is a former artist of some note who has remained unable to talk since supposedly murdering her husband, the famous photographer Gabriel Berenson. The media have made a lot of their story which has done heaps to push up the value of Gabriel’s work.

If Theo can persuade Alicia to speak about the night her husband died, Alicia may begin to heal. But because of her suicide attempts, Alicia is highly medicated at The Grove, doesn’t interact with other staff or patients, nor does she respond to any kind of therapy. The story is told mostly through the voice of Theo, himself a survivor of a terrible childhood and for whom psychotherapy has changed his life. He is convinced he can help Alicia and manages to persuade his boss, the avuncular Dr Diomedes and Christian, Alicia’s surly psychologist, to reduce her meds and let him try.

As well as tensions at The Grove, which is under threat of closure, not to mention volatile patients who do violent things, Theo gets into trouble by breaking rules. He interviews Alicia’s friends and relatives – the brother-in-law solicitor, Max, who has a bit of a temper; Alicia’s cousin Paul who still lives in the ramshackle house they grew up in with his monstrous mother; and Alicia’s old friend and art curator, Jean-Felix, who like pretty much everyone else is holding something back. Michaelides also allows Alicia’s own voice to tell the story through a hidden diary, which throws up some interesting questions. Then there’s Alicia’s symbolic and dramatic art. Her last picture is titled Alcestis after the Ancient Greek story popularised by Euripides about another wife driven to silence by love.

We have all the ingredients for a suspenseful and nuanced thriller, drawing you in through the thoughts of the therapist/patient combo of Theo and Alicia. In the background there are dangers lurking and a sense of impending doom. But it wouldn’t be a good thriller without a few interesting plot twists and Michaelides is a master at this. Already known for his work as a screenwriter, this is his first novel and it would be easy to see the book as a movie. But I also really enjoyed the writing and am happy to learn he’s sticking with fiction for now and has a new book on the horizon. For me the pages whizzed by as I raced to find out what really happened to Alicia and Gabriel. A four out of five read from me.

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