The Silent Patient by Alex Michaelides

Back in October I tried my hand at a genre that was fairly obscure to me at the time: psychological thrillers. The first book recommended to me was The Silent Patient by Alex Michaelides. The Silent Patient is Michaelides’s debut novel with a heavy focus on the effects of childhood trauma as we age and how sometimes even ‘good’ people can do bad things as a result of unresolved issues. 

The Silent Patient begins with murder. English psychotherapist, Theo Faber recounts the sensational story of Alicia Berenson and how she shot her husband to death one July night. It’s been years since that night and Alicia has remained mute. No one knows why she shot her husband or how the murder truly went down. Under the guise of wanting to provide Alicia with proper treatment to unveil the truth, Theo applies for a position at the clinic where she is being held, and he gets the job. What follows is a dark journey into the fragility of the human psyche. 

I thoroughly enjoyed the examination of childhood abuse and how it can steer our decision making on a subconscious level. Michaelides excels at deconstructing ideas like ‘fate’ or ‘destiny’ and analyzing how humans will pick and choose paths that their trauma thrusts them down. Is this the traditional idea of fate where some divine magic is at work? Or are we actively replicating how we were treated as children or following old coping mechanisms? Are our futures decided from the moment we are born or is there the possibility to change things? 

The dichotomy of childhood trauma and the why’d-she-do-it mystery make for an intriguing read. However, where the story falls flat for me is the finale. The twist is meant to be….well definitely a twist, and to say I didn’t see it coming is an understatement. I felt thrown by the reveal and a little disappointed. I think sometimes authors try to shock a reader rather than feeding into a satisfying climax. Predictability is not always a bad thing. Then even more unsatisfyingly the book ended abruptly. 

The Silent Patient deserved at least a handful more chapters to feel properly fleshed out to me. Would I recommend this to a friend? No, I don’t think so. Was it entertaining? Heck yeah...until it made me angry. I enjoyed the psychology deep dives rather than the plot, but this read has made me curious to delve deeper into the thriller genre so not all was lost.

My Score: 3/5