In Review: The Silent Patient by Alex Michaelides

I am VERY new to the thriller genre, as in this book is only the third book within the genre that I have read. While it’s possible that this newness is shaping my review, I would like to think I am well-read enough to know a good book when I read one, and this was GOOD!

Psychotherapist Theo Faber is fascinated by the story of a painter who shoots her husband in the head and then never speaks a word thereafter. She is kept at a psychiatric unit, and as soon as the opportunity arises, Theo takes it upon himself to get her to not just speak, but explain the mystery of the murder. Two things are striking about Alex Michaelides’s The Silent Patient: psychological realism and the theme of sacrifice.

Alex Michaelides takes the psychological very seriously in the subgenre of psychological thriller by placing a psychoanalyst as our main ‘detective.’ Michaelides immerses you into Theo himself through the precision of how he describes Theo’s mind. We get a preliminary sense of Theo’s worldview when he says,

“We are shaped and compleated by unseen, unremembered forces: namely our parents. This is frightening for obvious reasons. Who knows what indignities we suffered, what torments and abuses, in this land before memory?” (p. 14)

While none of us can corroborate the frightening nature of being formed before memory exists with an actual baby, I do think it tells us that for Theo, the world has always been a frightening place. But his psychoanalytic education allows him to create distance, and in some part justify, his experience of the world and then his actions—including the decision to work with Alicia. His ability to use psychological theory to justify himself becomes important to the subtext of one of the biggest plot twists in the book.

I have yet to read a work of fiction that integrates the reader and the narrator’s inner world with the same clarity and ease that Michaelides does: he takes the human mind, a concept that often feels nebulous and evasive, and turns it into a tangible, navigable terrain through Theo.

The second element of this book I find compelling is the way that Michaelides weaves in the theme of sacrifice through visual art. I promise I’m not ruining anything when I say this. Alicia paints a Jesus figure and then also names one of her paintings Alcestis, after the tragic figure of one of Euripides’ plays. I don’t have anything profound to say (yet) about the choice to present the theme of sacrifice through paintings in particular, but it was a detail that I find myself mulling over.

All in all, this is a book I know I will continue to think about, and I would recommend this to my fellow armchair therapists who got their psychology degrees from the University of Instagram!