The Silent Patient: a spoiler-free synopsis

emilie reads
4 min readAug 14, 2021

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Title: A Silent Patient

Author: Alex Michaelides

Publisher: Celadon Books

Pages: 325

My rating: ⭐⭐⭐

Who will like it? People into Freudian psychology and mental illnesses, who are looking for a shorter cerebral read. Don’t dwell on this too much, but I wouldn’t recommend both The Murder of Roger Ackroyd and A Silent Patient at the same time.

Okay, honestly, I did not go into it thinking it was a detective novel. I was expecting a thriller. It tells the story of an artist, Alicia Berenson, who is married to a fashion photographer, Gabriel. One day, when her husband returns long after dark from a photoshoot, Alicia shoots him five times in the face, and then never speaks again, just as in the Athenian tragedy Alcestis, where a woman, sent to her death by her husband, returns from Hades speechless for the rest of her life. The only communication Alicia provides is through paiting a self-portrait, titled “Alcesitis”. Enter Freudian psychologist, Theo Faber, fascinated by this case, attempting to uncover the inner workings of Alicia’s mind.

This book leaves a hefty series of casual clues for reasons behind the murder. There aren’t more than a handful of characters to keep track of, and the clues slide together unquestionably in the end.

Every time I read a detective novel, I try to put on my thinking cap (not Sherlock Holme’s deerstalker) and race against the clock to beat the detective and solve the murder. Have I succeeded before? Nope. But this book might be the first one where the world stayed mostly on its feet; I wasn’t so shocked, so much that the world flipped upside down. I remember my jaw dropping while reading And Then There Were None and also when watching “Knives Out”. Every time I fail, I’m struck by how stupid and blind I was. How did I not even suspect that? Was this incompetency a reflection of my sharpness or intelligence quotient at all?

Maybe partly. But really, not following as tightly when it comes to detective fiction boils down to your lack of experience. If someone has devoured all of Agatha Christie’s 73 or more novels, then I doubt another detective novel will make them feel like they just got struck by a thunderbolt. At least that’s how I feel when I read Michaelides’ book this time. I was surprised I have seen this twist done before, with my quite limited experience with detective novels.

But viewing this book from a different lens, I still think it met some basic expectations I had. Detective novels tell us how complicated creatures we all are as human beings, and reading The Silent Patient, every character I encountered felt mentally ill on some level. Our narrator himself, Theo Faber, admitted that, “I mean, of course I wanted to help people. But that was a secondary aim — particularly at the time I started training. The real motivation was purely selfish. I was on a quest to help myself. I believe the same is true for most people who go into mental health. We are drawn to this profession because we are damaged — we study psychology to heal ourselves. Whether we are prepared to admit this or not is another question.”

In a sense, all of us are crazy.

Although the significance of childhood trauma is certainly influential to personalities and psychology, pure psychoanalysis is rarely used in psychotherapy nowadays. Freudian psychology does create a nice baseline for a mysterious murder, because everything is based off of the unconscious mind, how psychosexual development stages influenced us, and how people’s memories haunt their presence. All murderers are arguably mentally ill. A person needs to consciously and proactively cross a moral line to kill someone, a line that most if not all of us would never be willing to cross.

When I read Alicia Berenson’s diaries, I saw flashbacks to “The Yellow Wallpaper” by Charlotte Perkins Gilman, a short story about a wife descending into madness while confined in a nursery of her house, because of how her doctor husband never truly is aware of her needs. Alicia writes similarly, “Thank God I have this diary to write in. It’s keeping me sane. There’s no one else I can talk to. No one I can trust.” Parallels can be clearly drawn.

The structure of the plot, the pacing, and the descriptions are all done well, but the writing felt a little bit cheap for some reason (this may be because I was reading on a Kindle for the first time), but it’s a thriller so we keep things short, sweet, and we keep things moving.

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