Book Review: THE SILENT PATIENT by Alex Michaelides

THE SILENT PATIENT by Alex Michaelides

Celadon Books; 2/5/19

CBTB Rating: 5/5

The Verdict: A sly, hypnotic character study - a stellar debut

A gruesome murder, a woman held captive in her own mind, and a therapist determined to unlock her secrets - what’s not to love about Alex Michaelides’ THE SILENT PATIENT? This sophisticated debut suspense novel is every bit deserving of the effusive early praise it’s already receiving. Reading more like a character study than a psychological thriller, THE SILENT PATIENT is a maze-like exploration of the psyches of both a woman convicted of murdering her husband and the therapist determined to treat her. The impactfulness of Michaelides’ exceptional first novel lies not in mile-a-minute pacing or whiplash-inducing twists, but in the author’s masterful, methodical building - and breaking down - of his characters. Just as his protagonist explores and unveils the mental state of his subject, so, too, does Michaelides methodically reveal to his readers the psychology of the characters upon which THE SILENT PATIENT is built. Rather than investigating a crime, THE SILENT PATIENT investigates the mind of a criminal - and what a gripping investigation it is. THE SILENT PATIENT is immersive and hypnotic—the kind of confidently drawn suspense story that doesn’t need big, flashy twists to keep you hooked… but that delivers an exceptional twist or two anyway. Believe the hype: THE SILENT PATIENT may well be the debut crime novel of the season.

Plot Summary:

Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word.

Alicia’s refusal to talk, or give any kind of explanation, turns a domestic tragedy into something far grander, a mystery that captures the public imagination and casts Alicia into notoriety. The price of her art skyrockets, and she, the silent patient, is hidden away from the tabloids and spotlight at the Grove, a secure forensic unit in North London.

Theo Faber is a criminal psychotherapist who has waited a long time for the opportunity to work with Alicia. His determination to get her to talk and unravel the mystery of why she shot her husband takes him down a twisting path into his own motivations―a search for the truth that threatens to consume him....

If there’s one phrase I use most often in my reviews, it’s got to be “expectations are everything.” (If you’ve been around CBTB for a while, you will know just how often I discuss this topic - but bear with me here!) Much of the early buzz I’ve seen for THE SILENT PATIENT refers to it as a “psychological thriller” - and while there’s certainly nothing technically wrong about this categorization, I do want to begin this review by offering up another lens through which to view this outstanding read. I realize I’m a stickler for categorization, and that may not apply to you as a reader, which is totally fine—but I consider categorization crucial to setting appropriate expectations and helping you figure out which books are up your alley. So, to that end, how would I categorize THE SILENT PATIENT? Rather than calling this a “psychological thriller,” I would call it a character study with a strong psychological focus. When I hear “psychological thriller,” I personally expect to pick up something pacey, twisty, and perhaps even a bit juicy or dramatic. THE SILENT PATIENT is a different beast entirely—though it’s no less addictive. Michaelides’ writing is hypnotic and immersive, drawing you bit by bit into a mystery defined not by shocking twists throughout, but rather by the tantalizing promise of peeling back, layer by layer, the darkest secrets of an enigmatic woman. And deliver on that promise, Michaelides does; the patient reader will be rewarded with a mind-blowing reveal that more than satisfies. But the best part? The slow-burning journey to that reveal is just as rewarding as the reveal itself.

The real impact of THE SILENT PATIENT comes not in flash or drama, but in the quiet, methodical way in which Michaelides lays bare the innermost workings of his characters. At its core, THE SILENT PATIENT is an exceptional character study: not just of the story’s titular patient, but also of the therapist who makes it his mission to treat her. So who are these characters? Painter Alicia Berenson is the “patient” for whom the book is named. Alicia had a picture-perfect life… that is, until the day she shot her husband five times, leaving him for dead. After this gruesome act, Alicia never spoke another word. For psychotherapist Theo Faber, Alicia is the most intriguing of patients; Theo finds himself drawn to Alicia’s story, determined to treat her and help her find her voice again. There is something deeply tragic and almost mythic about Alicia: Michaelides crafts a character whose complexity and inner turmoil is belied not through verbal communication, but through vivid descriptions of her physical appearance and the artwork she creates at Theo’s urging. So enigmatic is Alicia that she begins to feel like an almost mythic character—a quality I have to believe the author developed intentionally, as he draws parallels between Alicia’s story and that of Alcestis, the woman at the heart of Euripides’ tragedy of the same name. Throughout THE SILENT PATIENT, Alicia is a presence just out of reach and yet everywhere all at once. It’s a fascinating thing to read a book that revolves around a character who can’t tell her own story directly to the reader; Alicia becomes almost like a blank canvas, a place where readers will collect what has been said about her in order to gain a glimmer of insight into the terrible crime she has committed.

By contrast, readers get up close and personal with psychotherapist Theo. It’s Theo’s story that we follow most closely for the duration of the read: we watch him begin his new job at the Grove, the secure psychiatric unit in which Alicia resides; we watch as he begins his sessions with Alicia, seeking to break through her silence; we watch as he navigates the bureaucracy of the Grove and his colleagues. At the same time as Theo is slowly but surely seeking out meaningful connection with Alicia, so too are readers seeking out a meaningful understanding of Theo’s personal life. For a character who is determined to unveil the secrets of his patient, Theo is, himself, quite hidden from the reader; Michaelides adds yet another layer of mystery here, keeping readers hooked on the gradual unveiling of Theo’s secrets even as Alicia’s secrets are also coming into the light. And when the secrets at the heart of this novel are guaranteed to make your jaw hit the floor.

It’s work taking a moment to appreciate the intelligence and complexity of plotting that makes THE SILENT PATIENT so richly entertaining. Michaelides makes it look easy, but there is so much at work here, including (but not limited to) multiple timelines and storytelling mediums—and when readers experience the story’s mind-boggling conclusion, they will finally fully realize just how complex a story this really was. Like a literary magician, Michaelides takes a simple premise and, in plain sight, turns it into something greater than the sum of its parts. The final reveal of THE SILENT PATIENT is worth the price of the book alone; it was the most shocking and intelligently plotted reveal I’ve read in ages, and I’m a picky reader when it comes to reveals. If you love a jaw-dropping - yet still totally fair-play - plot twist, the conclusion of THE SILENT PATIENT will deliver. And, the best part: even if you somehow do guess the final reveal of THE SILENT PATIENT, this book is so much more than just “twisty”—the twist is just the cherry on top of a book that is riveting in its own right.

There is so much I could write about THE SILENT PATIENT: about its immersive, confident prose, its self-proclaimed parallels to the Greek tragedy of Alcestis, its vivid imagery… but I’ve got to cut myself off somewhere, or this review will go on for ages. So let’s leave it at this: THE SILENT PATIENT is an outstanding debut crime novel that forges its own path, delivering intelligent character study and masterful plotting, all wrapped up in hypnotic writing from which you won’t want to tear yourself away. THE SILENT PATIENT has already been optioned for film, and I cannot wait to see it on the big screen—but that movie sure does have a lot to live up to.

I received a free copy of this book from the publisher in exchange for an honest review. This does not affect my opinion of the book or the content of my review. All opinions my own.

---

Book Details:

Hardcover: 336 pages

Publisher: Celadon Books (February 5, 2019)

Language: English

ISBN-10: 1250301696

ISBN-13: 978-1250301697

Crime by the Book is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. This in no way affects my opinion of the above book.