The Silent Patient, by Alex Michaelides

I didn’t know it then, but it was too late—I had internalized my father, introjected him, buried him deep in my unconscious. No matter how far I ran, I carried him with me wherever I went. I was pursued by an infernal, relentless chorus of furies, all with his voice—shrieking that I was worthless, shameful, a failure.


It’s not hopeless. You’re not a boy at the mercy of your father anymore.

It all started out so well: The narrator, Theo Faber, is a psychotherapist who goes out of his way to help Alicia, the “Silent Patient”. Alicia has been put into a psychiatric hospital after her husband was murdered with her standing next to him, the weapon at her feet. She refuses to (or can’t) speak at all.

Theo himself is damaged as well by an overbearing father who has always made him feel insufficient, worthless and a failure (cf. opening quotation). He feels like he’s pretty much the only person on earth who can help Alicia find her voice – metaphorically and literally – and so he sets out to help her.

The setting I described above intrigued me – it sounded exciting and promised suspense and I strongly related to Theo with whom I felt I shared some “history”.

Psychotherapy had quite literally saved my life.

The entire first part of the book struck me deeply and the narrative “vibes” resonated within myself:

I could feel myself thawing in the heat, softening around the edges, like a tortoise emerging into the sun after a long winter’s sleep, blinking and waking up. Kathy did that for me—she was my invitation to life, one I grasped with both hands. So this is it, I remember thinking. This is love.

I vividly remember a few situations (e. g. the restaurant in Amsterdam, C., where they “shot” me 😉 ) with my wife of almost 20 years now that triggered similar feelings and reminded me of similar experiences.

About love. About how we often mistake love for fireworks—for drama and dysfunction. But real love is very quiet, very still. It’s boring, if seen from the perspective of high drama. Love is deep and calm—and constant.

These “autobiographic connections” and the expectations they raised are, undoubtedly, part of why I feel so let-down by and disappointed in this book.

Soon, though, there were discordant tones within the narration that had rung true so far:

I wanted to reach out and pull her close. I wanted to hold her. But I couldn’t. Kathy had gone—the person I loved so much had disappeared forever, leaving this stranger in her place.

This is quite obviously delusional – Theo simply confuses his picture of Kathy with the real person. Sure, this is certainly a literary device but crudely wielded and, thus, it annoyed me slightly in the beginning.

Later in the book, Theo’s own issues become even more prevalent and, to me at least, more and more annoying. They escalate in their narrational crudeness as well:

Perhaps he wasn’t human at all, but the instrument of some malevolent deity intent on punishing me. Was God punishing me?

What?! Yes, sure, whatever…

Spoiler title
There are quite a few characters as well who take quite some space in the book but never really get used: There’s Jean-Felix, a caricature of a gallery owner and Alicia’s friend, there’s her brother-in-law, the latter’s wife, Tanya (his assistant, how cliched is that…), Alicia’s cousin Paul and others who pretty much all have something to hide or to be embarrassed about but who only ever serve as a means to an end – to distract us, the reader, from the simple truth which you begin to sense early on and which leads to “the big twist”.

Some characters, like the hospital’s director, Diomedes, are pretty much caricatures of themselves, so shallowly are they depicted.

On the other hand, Michaelides does get a few things right: Short, engaging chapters that keep you glued to the book (“just one more chapter and then I’ll sleep!”), inserting excerpts from Alicia’s diary helps as well and all in all, it’s still an interesting read – at least in the beginning.

The middle parts of the book are rather slow and uneventful. Lots of stuff is going on but only few things happen that actually drive the story forward. Towards the end, things are being rushed and the story, after “the big twist”, deflates as quickly as a punctured balloon.

Ultimately, this book has good ideas and an interesting premise but it feels sensationalist and simply can’t live up to the hype that’s been generated about it. Alex Michaelides is, first and foremost, a screen writer and it definitely shows in this book.

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