Book Review: The Silent Patient by Alex Michaelides

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The following review is unsponsored. These are my feelings about the book and its contents, not the author themselves. This review may include profanity. This review will begin with a brief summary, followed by some vocabulary words I learned along the way, and finish with direct quotes and/or answers to book club questions (if available from the author). This book review will also include a link to my Amazon affiliate list which, if you choose to purchase from said list, will earn me a small commission at no extra cost to you! For updates on what I'm currently reading, follow my Goodreads! To find out what else I plan to read this year, check out my TBR list 2024 for some inspiration and conversation.

Rating system:

⭐️ = Did not finish/I hate it
⭐️⭐️ = I did not like it
⭐️⭐️⭐️= I like it
⭐️⭐️⭐️⭐️ = I would recommend this
⭐️⭐️⭐️⭐️⭐️= my soul has healed, I'm enlightened, I can be anyone and do anything!
 

The Silent Patient by Alex Michaelides

⭐️⭐️⭐️⭐️

Winner for Best Mystery & Thriller (2019), Nominee for Best Debut Novel (2019)
Kindle Unlimited ✅ Amazon 

Summary:

This book is written from two perspectives: Theo Fader and Alicia Berenson. Theo is Alicia’s psychotherapist years after she brutally murdered her husband and remains as a silent patient at Grove Hospital. By investigating her past, we often wonder throughout the book if we can understand her present. Is Alicia a vicious, evil killer? Is she innocent? Is she a victim of something much greater? Theo searches for answers in any way that he can, even if it is frowned upon by his peers. Throughout each chapter we yearn to understand Alicia. The perspectives of her family and friends could help, but it could blur other lines too. This psychological thriller provides character development, Greek mythology, and consistently plants seeds of destruction. 


Vocabulary Words: (New to me!)

Prurient (adj.)

Having or encouraging an excessive interest in sexual matters

Sherry (n.)

A fortified wine originally and mainly from southern Spain, often drunk as an aperitif.

 

**This section may contain spoilers**

 

Quotes & Reflections

"Love that doesn’t include honesty doesn’t deserve to be called love."


“The development of our personalities doesn’t take place in isolation, but in relationship with others – we are shaped and completed by unseen, unremembered forces; namely, our parents”

 We are born, and the rest is drag!

“Like therapy, music is about a relationship, entirely dependent on the teacher you choose.”

As a music major, this spoke volumes. A bad teacher in your early years will change the whole trajectory of your life! Imagine being young, with no knowledge of what music is capable of and here goes some teacher telling you were just “not a musical person”? WHAT DOES THAT EVEN MEAN???


“I felt a small flicker of pride – a son congratulated by his father.”

Knowing that Theo has daddy issues (along with many other issues I’m sure), this thought coming to him in reaction to Diomedes was interesting to me. Does he respect Diomedes? What was that relationship truly like between them? He continues by admitting needed to justify his reasoning for making Diomedes proud…and then we don’t really get closure of their relationship after everything shuts down.


“Was she crazy? Is that why she did it? Why she strapped me into the passenger seat of her yellow Mini and sped us toward that redbrick wall?”

The main connection to Alicia Berenson’s silence and trauma is to her fatherly “sentencing her to death”, but her mother was LITERALLY doing that. If she thinks her illnesses are a direct route to her mother, I don’t see how the father’s comment sealed the deal more than the car crash itself? Both of them are terrible!


“I fought a sudden desire to hold her, take her in my arms, kiss her, reassure her, promise her she was safe”

It was at this point I knew…he f*cked up. It really made me want to believe the other psychiatrist Christian Wells; yes, I do think he is a piece of sh*t too!

Discussion Questions:

  1. The story begins with the revelation Alicia murdered her husband. Why do you think the author made this admission?

I honestly think it is the easiest way to believe it. We have no other evidence to deny that, so then it begs the participation in discovering the following events. It’s genius! Along the way you second guess, maybe even triple quadruple guess yourself about what really was going on. It is the beauty of a psychological thriller.

 

2. Alicia’s diary plays a key role in the book. What purpose do you think it serves? And does your perception of Alicia change the more you read?

If we never see her perspective, we would never know her experiences with all these people that held relevance in her life. It was almost as if everyone in her life perceived her completely opposite of what she was feeling. For example:

Max was in love with her. Alicia thought he was a creepy weirdo.

Jean-Felix was an intrusive friend. Alicia was afraid of him.

Gabriel chose himself to live over her. Alicia thought he was her world.

Don’t get me wrong, Max was a piece of shit, Jean-Felix had no boundaries, and Gabriel is a cheating shitbag BUT that does not change the fact that nobody ever really understood her besides well…maybe her cousin?

3. Alicia’s silence is related to the Greek myth of Alcestis. How do you feel about the story of the myth? Why do you think Alicia is silent?

I LOVED the reference! It made me think deeper about how Alicia really expresses herself creatively…and also how smart and well put together she really is despite everyone painting her as a crazy person. Yes, she probably suffered from a disorder, but she was capable of being understood. Especially in this world, it is not uncommon for a woman to be harassed/stalked and be labeled as “the girl who cried wolf”. It is not uncommon for a woman’s abuse to be swept under the rug. I thought her silence was a euphemism for that fact in some way. Her silence could have also been fear, confusion, self hatred…. She knew what she had to do to get her story told the right way.

4. Theo’s motives to work with Alicia are complicated. Do you think he wanted to help her? 

Theo admittedly had his own issues. Childhood traumas plus his cheating wife. You’re telling me this man watched his wife get fucked in the bushes several times without saying a word to her?! No arguments about ANYTHING????? No, I don’t think he was trying to help her. He should have been a patient there with her! 

5. Both Alicia and Theo had difficult childhoods. Early on, Theo says no one is born evil. That who we become depends on the environment into which we are born. By the end of the novel he appears to change his mind, saying that perhaps some of us are born evil, and, despite therapy, we remain that way. Which do you think is true?

I think he was right the first time; I fully agree we are a product of our environments. A lot of us could be humbled into poverty by outstanding circumstances in the blink of an eye. One traumatic point in childhood could make you the next serial killer…I would never assume an innocent baby with no understanding of life beyond the womb could just be considered evil. Somebody did something to them, or something happened. 

6. Weather plays a large role in the book, such as the heat wave during the summer. What purpose do you think the description of the weather serves in the novel?

In all honesty I did not really notice the weather until the final chapter where he was catching the snowflakes! Maybe I missed something I was supposed to understand…

7. Do you think the world of a psychiatric unit was convincingly portrayed? How do you feel about Diomedes and the other psychiatrists?

Clearly everybody represents a different type of person to come across in that career field. I was super shocked by Yuri, but thoroughly impressed with the reveal! Indira was gentle and motherly, Christian was a cocky criminal (as opposed to Yuri being the humble criminal), and Diomedes just seemed like a regular dude trying to survive against the odds, and maybe even had his own screws loose. Everyone seemed to understand each other’s roles in the workplace which made it easy for someone like Theo to come and fit like a puzzle piece.

8. We never enter Kathy’s mind in the book. Do you have any sympathy for her?

Not really, why yo freaky ass in the park?!?! I would like some answers to this for real. Her point of view would have made me mad anyways.

9. What do you think happens at the end of the book? The last line is ambiguous.

I wish I had deeper things to say about it, but unfortunately, I was left at the end looking silly. “What does that even mean?!” was actually the first thing I said! 

I can maybe assume he accepted his fate? I don’t know….is there going to be a second book?!

10. It’s a psychological thriller with a twist. The author has said he was influenced by Agatha Christie. Did you feel this was simply a detective story or are there any other influences you can spot?

I did not see it as a detective story because the connections of Greek mythology as well as genuine advice throughout made me think a lot deeper. This book raises great questions and could make a lot of conversations interesting. As a fan of Freida McFadden, James Patterson, Dean Koontz, and Stephen King, I thought it was a great thriller! …it had the character plot I yearned for. The only reason I did not give it five stars is because the ending threw me off a little. The book I read before I had terrible plot holes and lack of character development so coming to this afterwards, I had high expectations. 

It is soft on the blood and gory stuff, which I appreciate, and many others could too. I would recommend this book to someone who wants to get into psych thrillers without an overwhelming amount of plot twisting. Immediately after I would recommend The Housemaid by Freida McFadden. From Alex Michaelides, I have added Fury to my TBR list for 2024

Have you read this book? Do you plan on it? Let us know in the comments, let's talk about it.

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xoxo,

Schae

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