Review: The Silent Patient

The Silent Patient by Alex Michaelides
My rating: 5 of 5 stars

“As you will see, it’s an incredible story - of that there is no doubt. Whether you believe it or not is up to you.”

Theo Faber is a psychotherapist who develops an intense interest in, if not an obsession with, the case of Alicia Berenson, a relatively famous artist who, having murdered her husband has refused to speak a word and has been confined to a secure psychiatric unit in London. Despite the clinic’s shaky financial viability, Faber sets his sights on, and succeeds in gaining, a position there purely for the opportunity to treat Alicia and, in the process, perhaps persuade her to speak and reveal the truth about why she shot and killed the husband whom she appeared to love.

Alex Michaelides has written a very competent, entertaining mystery. The short chapters propel the story along with the added technique in which the last line of one chapter feeds straight into the first of the next, often contradictorily. “‘She won’t like it one bit.’” … “‘I think it’s a great idea.’” The author uses this sparingly but enough that it makes you smile when it happens and anticipate the next one. The book begins with extracts from Alicia’s diary and these reappear at stages to break up Theo’s narrative and reveal elements of her past and of her state of mind leading up to the murder. And then there is a twist.

I’m not a huge fan of ‘the twist’. There is a vogue at the moment to elevate ‘the twist’, to make it the reason to read a novel. And often it is contrived and disappointing. However, when the moment arrives in ‘The Silent Patient’ it is so unexpected and so well done that it makes the reader question everything that has gone before. I stopped and re-read the chapter. And then I read it again. I took a moment before moving on to the conclusion of the story. It is excellent and turns a good, competent mystery into a five-star thriller. The key to this is that Michaelides has laid the groundwork - the climax arises naturally from the plot, and it rings true. It is like the camera changes and you see what has gone before through a different lens. And, crucially, it makes you want to go back and read it again.

I enjoyed this a lot and it deserves to sell and to be talked about. I look forward to what comes next from Alex Michaelides.


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