Author: Alex Michaelides · Published: 2019 · Genre: Psychological Thriller
The Silent Patient has a terrific hook and a twist that made it one of the biggest thrillers of its year; it debuted at number one on the New York Times best-seller list. It is quick, readable and built for a weekend. But the characters are thin, the psychotherapy is often implausible, and the whole book exists to serve its final turn. Read it for fun, not for depth.
What it’s about Alicia Berenson is a successful London painter, married to Gabriel, a fashion photographer. One evening she shoots him dead, and from that moment she never speaks again: not to the police, not in court, not to her doctors. Shortly after the killing, she paints a self-portrait and titles it Alcestis, after the Greek tragedy by Euripides in which a woman dies in her husband’s place and returns from death unable to speak. Instead of prison, Alicia is sent to The Grove, a secure psychiatric unit in north London.
Years later, Theo Faber, a psychotherapist with a troubled past of his own, takes a job at The Grove because he is determined to be the one who makes her talk. The chapters alternate between Theo’s narration and entries from Alicia’s diary in the weeks before the murder. As Theo digs into her past, including her childhood and her marriage, he becomes more and more personally involved, bending rules and visiting people from her life outside the hospital walls.
Alicia’s silence, and the painting, have already made her case notorious. Theo narrates in the first person, and his own history of an unhappy childhood and years in therapy is woven into his account from the start.
What works – The hook. A woman who kills and then falls silent is an irresistible premise. Michaelides states it on page one and keeps it front and centre, so every chapter feels like it might bring her voice back. – Speed. Short chapters, clean prose and frequent small revelations make it very hard to stop reading. It is ideal for a flight or a long evening. – Setting. The Grove, with its locked doors, tired staff and tense group sessions, gives the story an oppressive institutional feel that suits a book about confinement. – The twist. For many readers it lands hard, and it does recast earlier chapters on reflection. A few clues are planted with genuine care. – The Greek frame. The Alcestis myth gives the book an elegant symbolic centre and a smarter texture than most airport thrillers.
What doesn’t Critics were split. Some praised its tight prose and tension; others were harsh, with Kirkus Reviews calling it clumsy and contrived, and a Washington Post review complaining about hackneyed horror tropes. Both camps have a point.
The main problem is plausibility. Theo’s conduct would breach basic professional ethics many times over, and his colleagues at The Grove are stock types, from the hostile manager to the eccentric clinical director. The investigation also leans on convenient coincidences to keep moving. Alicia, the most interesting character, is kept at arm’s length because the plot needs her silent, so she never becomes more than a mystery box. The dialogue is functional, and the diary entries rarely sound like a painter’s.
Then there is the twist itself. Some readers find it ingenious; others feel the book achieves it by withholding information in a way that is not quite fair. Either way, once you know it, there is little reason to reread.
Who should read it Readers who enjoy fast psychological thrillers in the vein of Gone Girl or The Girl on the Train, and anyone who wants a single-sitting read. If you want complex characters or a believable portrait of psychotherapy, look elsewhere.
Rating: 3/5
Image credits — Cover image via Open Library. Cover design © the publisher, shown for review purposes.
