The Silent Patient
by Alex Michaleides
Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word.
Alicia’s refusal to talk, or give any kind of explanation, turns a domestic tragedy into something far grander, a mystery that captures the public imagination and casts Alicia into notoriety. The price of her art skyrockets, and she, the silent patient, is hidden away from the tabloids and spotlight at the Grove, a secure forensic unit in North London.
Theo Faber is a criminal psychotherapist who has waited a long time for the opportunity to work with Alicia. His determination to get her to talk and unravel the mystery of why she shot her husband takes him down a twisting path into his own motivations—a search for the truth that threatens to consume him….
In 2019, The Silent Patient, psychological thriller and Alex Michaelides’ debut novel, quickly became one of the most talked about novels of the year, making countless “Best of 2019” lists and, according to many, earning itself a place among the most shocking thrillers of the past decade.
The premise of The Silent Patient is nearly irresistible; a seemingly happy, successful woman brutally murdered her husband and has refused to speak in the six years since. It’s a story that demands to be told, that readers need to see unraveled before their eyes. Lauded as it was, it can be difficult for readers to go into the story without something nearing high expectations. Inadvertent as it was, such was the case for me.
Told from both Alicia and Theo’s points of view—Alicia’s being diary entries leading up to the murder—The Silent Patient gives readers a glimpse into a murderer’s mind and history that is unique. While the much of the page-to-page focus of the novel is on unraveling what drove Alicia to murder her husband and why she has remained silent since, there is also a significance placed on Theo’s personal life and history with mental health challenges. Despite being a psychotherapist, he doesn’t fall into an archetypal version of a therapist sometimes portrayed in entertainment; condescension and superiority don’t color his interactions with Alicia. Instead, there is an understanding beyond that of just a therapist as someone who has also struggled. This enables Theo to relate to Alicia in a deeper way than perhaps a therapist should and leads to him crossing boundaries in his desire to learn the truth of Alicia’s history, propelling the novel into a dizzying unraveling of Alicia’s life and motives.
The first 150 pages or so of The Silent Patient were rather unremarkable—a worrying sign that this novel would descend into the trap of so-called twisted domesticity that is truly nothing more than a recycled tale of husbands and wives and their unhappiness, misunderstandings, and secrets. These are themes that can be worthwhile to explore, but are so often predictable and banal. At nearly halfway through this novel, I was mildly intrigued but relatively unimpressed and failing to see the ways in which The Silent Patient would suddenly have me hooked. The threads of the story were beginning to make themselves clear through Theo’s introspection, his interactions with fellow employees at the Grove as he pursued understanding Alicia’s mental state, and his unprecedented rule-breaking in order to learn about Alicia’s past. Thoroughly convinced I knew exactly the ways in which the intriguing leads of the story threads would come together, I was prepared to finish the novel sure of its middle-of-the-road status.
Related: The Harpy by Megan Hunter Review
The turnaround began with my own outrage and growing appreciation for the way Alicia’s history was being presented to readers. As Theo delved into Alicia’s life before the murder, it became clear that Alicia was the object of several men’s grotesque “good intentions.” While their aggressions toward each other ranged from subtle (in the everyday way men might try to assert themselves in a woman’s life) to outright aggressive, their interactions with Alicia herself were often, but not always, marked by something even subtler; a sort of “I know what’s best for you” attitude that pervaded every exchange with her. Each tried to assert their dominance over her in quiet ways. I became hyperaware not just of the obvious ways these men played a role in her undoing, but of every word they said and how so much of it reeked of jealousy and entitlement. While there were surprising revelations within Alicia’s past that increased my interest, I couldn’t take my mind away from how this aspect of her life was portrayed. This novel held a magnifying glass to an often quiet experience within a woman’s life and did it in such a way that reflected how it happens within real life by not making it the obvious main focus of every relationship it existed in. It was quiet manipulation, the subtle insistence that HE (whoever “he” might be at the time) knew her best and what was best for her, the gaslighting coming from all angles even after she was locked up in the Grove.
Already suspicious of everyone in Alicia’s past and everyone at the Grove, my experience was even further skewed as I felt the web of gaslighting grow tighter and ever more tangled around Alicia. We know how part of her story unfolds from the outset—she murders her husband, she is “crazy”—but what I hadn’t expected was to sympathize so fiercely with her. Without realizing it as it happened, I was suddenly firmly on Alicia’s side, outraged at nearly everything in her past and more understanding than ever. And though my impression of Theo had never been favorable—I felt rather bored with the inclusion of his personal life and felt his interest in helping Alicia was somewhat self-serving—my opinion of him took a sharp decline as I realized how well he fit in with the other men in Alicia’s life, trying to “save” her and be the hero who got her to speak. It was infuriating.
And it was brilliant.
The subtle manipulation of the reader within The Silent Patient is remarkable. Strong emotions were drawn out in me and I felt confident in my reactions and theories—until I was reminded that I, of course, could not actually trust any of what I was reading. Was I being made to sympathize with Alicia only to have her flip on readers à la Gone Girl? Was I looking at Theo through the wrong lens, being a bit cynical in regards to his motives? I truly could not trust my own opinions. Though I still had my own theories for how The Silent Patient would unravel, I couldn’t be sure of anything at this point. I couldn’t stop reading and, in the end, I was blown away. Plot twists can often be surprising enough to pique an otherwise unimpressed reader’s interest, just unexpected enough to add enough a thin layer of flimsy interest to an unremarkable story. I’ve seen it many times, felt myself wonder if I should continue a series or if my overall opinion has really changed based on the shock value of a decent plot twist. Whenever I read such a book, the fact that the plot twist swept in to save the rest of the book cheapens the whole experience in my mind. While the plot twist in The Silent Patient suddenly increased my appreciation for the rest of the book, it wasn’t cheap in the slightest. It was the brilliance of the twist–the absolute shock of it and the sharp relief it threw the rest of the book into–that made it so well done. While it felt as if it came out of the blue, the seeds were woven into the story from the outset and, through my shock, made me view the rest of the book through a completely different lens. While The Silent Patient had already begun digging itself out of the trench I’d placed it in, this twist swept in with such undeniable impact that revealed the brilliance of how the novel was crafted on the whole. It was fantastic.
While Michaelides’s writing style was perfectly fine—unobtrusive, basic writing that’s enjoyable without being worth any stylistic praise—it’s the structure of The Silent Patient that allows the plot to shine. Through Theo’s current day POV and Alicia’s diary POV, we think we’re seeing and understanding all that is before us. But we are not. The story flipped on its head and left me wanting to reread it immediately just to understand the ways in which it came together that I didn’t recognize were happening at the time.
What I feared would be a run of the mill, unimpressive psychological thriller managed to extract itself from the crowd of disappointments I’d prematurely placed it in with a plot twist I don’t think anyone could see coming. It’s well worth the read. The Silent Patient was brilliantly crafted, a rare thriller that actually thrills.
Wonderful review. I also enjoyed this book.
Thank you, Carla! It was such a shocking end–I loved it! Happy to hear you enjoyed it, too.