The Silent Patient by Alex Michaelides is a psychological thriller about a brilliant female artist whose name is Alicia. One evening after her husband comes home from work, she shoots him five times in the face at point-blank range, killing him. Then immediately afterwards, Alicia stops speaking. Through her murder trial, conviction, and eventual admittance to a mental rehabilitation facility, she continues to remain one-hundred-percent silent. Not too long afterwards we are introduced to a psychotherapist that becomes infatuated with Alicia’s case and feels that he may be the only one who can help this woman through her trauma, and thus, convince her to open up to him and start talking again. However, the journey to such a feat shall prove to be far more disturbing for the doctor than he anticipated.
I read The Silent Patient back in September, but I never got around to writing a review for it because I didn’t feel that I could really do it justice. The novel was a complete and total surprise for me. It was being hyped spectacularly nearly at every corner of the literary community and that hype had left me feeling very sceptical about it, more so given that it is the author’s debut novel. However, every ounce of doubt that I may have been able to spew about it was quite powerfully shoved back down my throat once I actually sat down and allowed myself to freely get lost within its pages. The book is bloody brilliant. I feel such awe for it both as an aspiring author and as a passionate aficionado of psychological thrillers. It takes the very essence of the word “psychological” and crafts a narrative that is powerfully intoxicating on multiple levels.
Alicia is a fascinating character. She’s a woman who seems to have a rather content life with a husband who is hard-working and strives to provide for his family. When I first read some of the pages with Alicia, I became really infatuated with her. Like many readers, and even our psychotherapist, I felt wholly compelled to understand the emotions that would drive a person to kill their spouse in such a cold manner. When Alicia’s curious situation is combined with, the exceptionally candid and personal, first-person perspective of our psychotherapist, the mystery surrounding her just seems to become more and more enthralling. This was the biggest factor in the novel’s irresistibility and a testament to the author’s writing talents.
Rather than piecing all of the clues together in a tangible and straightforward style, they are provided as thought-provoking evaluations of the psyche, which included trauma that the characters (the psychotherapist, Alicia, and a couple of others) had underwent or via impactful events in the characters’ lives, whether from their childhood or later in adulthood. It’s methodical yet wickedly voyeuristic as the private threads of these people’s personal lives are unravelled to reveal the elements that make them tick with rage, fear, paranoia, or obsession. A lot of the psychotherapist’s thoughts are akin to crime-solving dynamics of detectives, so there is an investigative air to his POVs that help you forget for a second that he’s actually not a cop himself.
If you look at the structure of the storytelling separately and the intricate way that bits and morsels of the whole mosaic of the crime is revealed to the reader, it can be intimidating and made me wonder at times if everything would actually fit together by the end, or if it would be a jumbled, untidy mess. However, I was surprised by how every element really complemented the others. I was empathetically rivetted by the characters’ plights and their individual narratives as much as their mutual ones. Their experiences and trauma were so sincere that when the big twist came out to scream “BOO” in my face, my jaw hit the floor with apt tension and grotesque intrigue.
The postmodern and somewhat polyphonic prose styles of The Silent Patient also highlighted the brilliance of the psychological motifs that kept me thinking about the story long after I had finished reading it. It deeply examines the notion of relationships between people, whether they are long-time friends, random acquaintances or in-between, and how the imprint of those interactions can impact the bonds we may share with others. This is actually a common quality found in crime fiction, and one of the traits that makes me love the genre so much.
Another motif that I had fun dissecting with my partner once I finished reading was the value of trust, especially when it comes to people who are covered in red flags. On some mental level, we as humans want to trust people or to try and see the best in others, even when our instincts are screaming at us to run the other direction as fast as we possibly can. By placing trust, sometimes it’s not about us, but about the hope that whatever negative things we are feeling can be cured away with a little faith. Yet, that almost always leads to complications and those initial feelings of wrongness and discomfort only get exasperated due to our denial of accepting the warning signs. This is one of the many ways that we end up accumulating insecurities, emotional instabilities, phobias, trauma, obsessive tendencies, and more.
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.”
When I was in a terrible relationship, I always excused away the red flags that other people had seen, or the warning signs that I had noticed but didn’t want to admit were serious issues. I was afraid of confrontation and I was also afraid of the social consequences from loved ones if I admitted that the decisions I had made were terribly wrong. So, to read about something a little similar happening within the pages of The Silent Patient and then watching the train wreck, so to speak, unfold so intensely was morbidly spellbinding.
Excellent writing and complex characters aside, other facets that I appreciated was how fast paced it was. Because it’s supremely curious and incredibly absorbing, it’s beyond easy to fly through page after page after page without realising that hours have gone by. Additionally, the story didn’t feel unnecessarily dragged out and the plot twists and story turns didn’t come off as being filler, shock value fluff either. A couple sections of the book are predictable; however, the finale was one that I didn’t see coming and it felt really wonderful to feel so astonished with a thriller. That hasn’t happened for me in a few years.
Overall, The Silent Patient is an outstanding debut novel from Alex Michaelides, and I highly recommend this to all fans of psychological crime thrillers. Just please be aware that the subject matter is heavy and extremely dark. As such there are quite a few triggers to keep an eye out for, which I’ve listed below. My recommendation is to pick this up when you can set aside an evening or two for a marathon reading. That really is the best way to enjoy this story. I look forward to seeing what Mr Michaelides concocts next.
5 paintbrushes outta 5!
Triggers: References to child abuse, grief, and infidelity. Graphic discussion of attempted suicide. Depiction of mental illness including anxiety, schizophrenia, and paranoid delusions.
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