The Silent Patient by Alex Michaelides

Orion | 2019 (7 February) | 352p | Review copy | Buy the book

Alicia Berenson had a life many might envy. She had a beautiful house in London, was a famous artist and was happily married to the sought-after photographer Gabriel. Then one August day, the hottest day of the year, Alicia shot Gabriel in the face five times. From that moment on she didn’t speak a word. Six years later forensic psychotherapist Theo Faber begins work at the Grove, the facility where the still silent Alicia is held alongside other violent and damaged women. Theo is obsessed by Alicia’s case and he believes that he will be the one who will finally be able to discover why Alicia did what she did. He will break Alicia’s silence.

The Silent Patient is one of those psychological thrillers that is next to impossible to put down. The reader is grabbed by its irresistible premise and then cannot put it down until they discover how it ends. It’s partly being sold as a thriller with a twist that you won’t work out. Psychological thrillers are often described like this but The Silent Patient is one of the very, very few that I’ve read that actually did catch me out. That was a very pleasant surprise!

There’s not much I can say about the novel because, like most psychological thrillers, they work best when the reader knows little about them in advance, but I will say how much I liked the background to the characters – the fact that Alicia is an artist and the way that Theo can’t stop analysing everything and everyone around him. Alicia and Theo drive this novel on, even though one is silent (although we are given extracts from Alicia’s journal, which does give her some voice). You can’t help but wish Alicia would speak. That adds such tension.

I’m still in two minds about how much I enjoyed some elements of The Silent Patient. But, on reflection, I think this might be because of how disturbing the novel actually is. We are immersed in this world and it’s a damaged, frightening and untrustworthy place. The author does a fine job of evoking an almost claustrophobic fear. Initially, I wondered if the reader is being manipulated by the novel’s end but I’m now coming to the conclusion that it’s really rather cleverly done. This is one of those books – it makes you think, possibly in a quite anxious way. It’s a book you may well respond to.

I’m extremely picky with psychological thrillers, having read too many of them. The Silent Patient, even though it caused me some conflicted feelings as I read it, is one I’m very glad I read.