The Silent Patient
The Silent Patient is a 2019 psychological thriller novel written by British–Cypriot author Alex Michaelides. The debut novel was published by Celadon Books, a division of Macmillan Publishers, on 5 February 2019. The audiobook version, released on the same date, is narrated by Louise Brealey and Jack Hawkins. The story is narrated by an English psychotherapist, Theo Faber, dealing with a patient who turns mute after murdering her husband. Upon its release, the book debuted on The [New York Times Best Seller list|The New York Times Best Seller list] at No. 1. It later won the Goodreads Choice Award 2019 in the Mystery and Thriller category.
Writing
On writing his debut novel, author Michaelides, who is also a screenwriter, said, "I was feeling very disillusioned as a screenwriter. I kept seeing scripts being mangled in the production and this sense of frustration made me decide to sit down and finally write a novel." He revised the draft approximately 50 times before finalizing it. The Athenian tragedy Alcestis, by Euripides, served as an inspiration for the plot, while its narrative structure was influenced by Agatha Christie's writing.Michaelides decided to set his novel in a psychiatric unit as he had worked at one such facility for teenagers while he was a psychotherapy student.
Plot
The plot of the book focuses mainly on Theo Faber, a psychotherapist, and his patient Alicia Berenson. Michaelides describes Theo Faber's traumatic childhood in which Theo is exposed to a violent father and overall neglectful parents. In an attempt to fix and understand himself, Theo takes a degree in psychology and starts working as a therapist. Theo finds the love of his life in Kathy, an American actress who lives in London. Theo feels safe and his relationship means everything to him. While the plot unfolds, it becomes increasingly clear that Kathy is unfaithful. The book switches back and forth between narrating Theo's life story, focused especially on his relationship, and the therapy of Alicia Berenson.Alicia killed her husband six years previously by shooting him in the head five times. The couple seemed perfectly normal, content and happy before the incident. Alicia hasn't spoken a single word since and has thus been moved to a closed psychiatric facility, the Grove. Many therapists have attempted but failed to make her talk. It is evident that Alicia is perceptive to her surroundings, but the reason for her silence remains a mystery.
When Theo Faber applies for a job at the Grove and is accepted, he convinces his superior to let him become Alicia's therapist. Ever since the murder had hit the news, he has had a profound interest in her and her story. He finds her case captivating and wants to reveal the truth behind why Alicia suddenly killed her husband and hasn't talked since. Theo's therapy sessions don't show any results at first and Theo's superior contemplates putting an end to them because of the lack of results.
Nevertheless, Theo's fascination with his patient as well as his dedication to making her speak lead him to revelations about Alicia's past. Theo talks to Alicia's relatives, neighbours, and old friends. He discovers how Alicia feared her brother-in-law, what kind of friends she had, and how she used to paint all day long. Through his research, Theo reveals that Alicia had gone through tremendous, traumatic challenges as a child, having to handle the death of her mother, a violent father, and an ever-neglectful family. Theo believes that Alicia has developed a psychiatric disorder. In an attempt to let Alicia express herself and communicate, he collects her old art materials from her former best friend and provides Alicia with an art studio in the Grove.
Alicia paints a sophisticated painting of the Grove with her and Theo standing beside it. Theo's superior interprets the painting as a sign of progress and allows Theo to continue the therapy sessions.
When another patient at the clinic, who has had conflicts and a difficult relationship in the past with Alicia, writes the word "cunt" on Alicia's drawing, Alicia takes one of her pencils and stabs the other patient in the eye. The shocking act of violence risks putting an end to the therapy sessions because the other employees of the Grove reckon Alicia to be too dangerous to be in a room alone with Theo. Theo manages to convince them otherwise and, surprisingly, manages to get Alicia to talk.
Meanwhile the book depicts Theo's deteriorating relationship with Kathy. Theo witnesses Kathy and her new lover having sex in the woods. Theo grows increasingly unstable but doesn't want to give up the love of his life. He hasn't yet fathomed the magnitude of damage Kathy has brought to their relationship in her act of unfaithfulness. Theo feels abhorrence toward Kathy's new lover as well as myriad other negative feelings, which he has trouble handling.
At the Grove, the fact that Alicia has begun to talk equals an ineffable miracle and Theo receives big gestures of acknowledgement for reaching this kind of milestone. Alicia tells Theo her life story. She narrates, most importantly, the night of the murder and her motive, albeit she isn't telling the truth, or at least Theo and his colleagues interpret her story as an obvious lie. The following morning Alicia is found unconscious in her room, having overdosed, and it becomes obvious that someone at the Grove has injected her with a lethal painkiller. Local law enforcement commences an investigation, and an officer finds Alicia's diary.
The diary reveals Theo Faber is responsible for the murder of Alicia's husband. It is explained that Theo had stalked Kathy's lover with increased frequency, lingering in front of his house, driven by his hatred for him. He discovered soon that the man Kathy was having an affair with had a wife, and decided to inform her of her husband's unfaithfulness. Theo put on a mask and broke into their home. He told the wife, Alicia Berenson, about her husband's affair. After Theo left, Alicia lost herself in a psychotic episode, shocked by her husband Gabriel's behaviour. She took Gabriel's gun and shot him five times, driven by her overwhelming anger. Afterwards Alicia couldn't grasp that she had killed the love of her life and vowed to never speak again.
The book finishes with Theo's arrest and doesn't mention whether Alicia ever awakened from her coma. Nevertheless it is mentioned that Theo and Kathy's marriage continued after Kathy's lover Gabriel was murdered. Theo never confronted Kathy about the affair and they stayed together until Theo's arrest.