Book Review | The Silent Patient by Alex Michaelides

“The facts, such as they were, were simple: Alicia was found alone with Gabriel’s body; only her fingerprints were on the gun. There was never any doubt she killed Gabriel. Why she killed him, on the other hand, remained a mystery.”

Alicia Berenson has been locked away in a psychiatric unit in a supposedly cut and dry case of husband murder. She’s not said a word since the crime took place, and Theo Faber, psychotherapist and self-aggrandising narcissist, is convinced he is the one to ‘save’ her.  

“I became resolved to stop at nothing until Alicia became my patient. There was no time to waste: Alicia was lost. She was missing. And I intended to find her.”

What follows is a in equal parts intriguing and meandering narrative to get to the bottom of what really happened the night that Gabriel was found riddled with bullets while his wife sat covered in his blood. We alternate between past and future, Theo’s unreliable narration slotted between entries from Alicia’s diary – and it’s a good job we got out of Theo’s head at times, because this protagonist really wound me up.

There were the bones here of a really good, gripping tale. The parts where Michaelides talks about the development of personalities and psychiatric disorders, embedding quotes from the likes of Freud, add an extra dimension to an otherwise fairly thin story, where it feels as if we only scratch the surface of the relationships and personal histories and motivations. And whilst the psychological grounding worked well for dramatic effect at the beginning, I’m less convinced that it pulled off what it was trying to do, particularly when key to a final denouement plot point.

You have to overlook a lot. And honestly, sometimes I do. Sometimes plot holes aren’t a deal breaker to me if the narrative can sustain my attention regardless, if there’s a reasonable balance of credibility and incredulity. But here, I’m afraid, it just didn’t entirely work for me. Clever, yes – and full of potential. But not quite clever or deep enough to live up to my expectations.


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