Book Review

The Silent Patient by Alex Michaelides

the silent patient

The Silent Patient is one of those novels that I heard a lot about in the run up to publication, and I have to admit that I was in two minds about reading it.  There was a lot of hype around this one, and I was worried that it wouldn’t live up to my expectations as a result.  I needn’t have worried – The Silent Patient is a brilliant novel, and may well feature on my best books of 2019.


Alicia Berenson writes a diary as a release, an outlet – and to prove to her beloved husband that everything is fine. She can’t bear the thought of worrying Gabriel, or causing him pain.

Until, late one evening, Alicia shoots Gabriel five times and then never speaks another word.


Forensic psychotherapist Theo Faber is convinced he can successfully treat Alicia, where all others have failed. Obsessed with investigating her crime, his discoveries suggest Alicia’s silence goes far deeper than he first thought.

And if she speaks, would he want to hear the truth?

I think that the premise of The Silent Patient is a brilliant one.  The reader is presented with a woman who, according to the evidence, tied her husband to a chair and shot him in the face five times.  Since then, she hasn’t spoken a word, leading to a conclusion of diminished responsibility in court, and confinement in a hospital for treatment.  Throughout the trial and her time at The Grove, she refuses to speak, and she is largely given up as a lost cause, receiving medication, but little direct therapy.

Theo Faber is a forensic psychotherapist, and upon hearing about Alicia’s case, he is desperate to work with her.  This raised questions for me, particularly what was driving him in his desire to work this case in particular.  He gives up a role with good future prospects in order to work at The Grove, despite it being considered for closure at the time.  It’s a risk for Theo, and I was curious as to his motives.  Is it merely the professional challenge of working a difficult yet high-profile case, or is it hubris, in that he thinks that he can succeed where others have failed?  Is it Alicia herself?  Theo’s actions raised questions for me, and added an additional element of mystery to that of Alicia and her husband’s murder.

As Theo begins to work with Alicia, he shows a flagrant disregard for the rules, seeking out the family and friends of Alicia in order to understand her better.  While this seems sensible when trying to get Alicia to communicate, it’s unconventional for a psychotherapist and more in keeping with a police investigation.  Needless to say, it lands Theo in some bother, although his actions can at least be explained in that he has a mere six weeks to succeed in Alicia’s therapy (given the ongoing review of The Grove), and he does uncover a lot of information that is relevant to Alicia’s treatment.

I loved the excerpts from Alicia’s diary which are dotted throughout the novel.  These detail Alicia’s comings and goings in the days leading up to her husband’s murder, and reveal more about her character which, given her silence, is essential in understanding more about her.  Whether she is guilty of murder or not remains unclear, however – Michaelides successfully draws out the mystery until the denouement, leaving the reader none the wiser as to Alicia’s innocence or guilt, and I thought that this was very cleverly done.

The Silent Patient is a quick read, and one that will have you hooked as you try to work out what happened.  I thought that the ending was brilliant, and this is a novel that I wouldn’t hesitate to recommend to others.   

The Silent Patient is published by Orion, and is available in hardback and digital formats.  the paperback will be released in December.


    1. It’s so good! I think it’s all too often the case that a book with lots of hype around it proves to be a bit meh, but that certainly wasn’t the case here!

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