The Silent Patient, by Alex Michaelides, is a fabulously twisty thriller that sent chills running down my spine and had me muttering more than one ‘Phwoar!’.
Convicted of the murder of her photographer husband, famous painter Alicia Berenson spends her days locked up in a high security psychiatric hospital. Nobody knows why she killed her husband and Alicia isn’t giving away anything. She’s been silent since she was arrested.
Enter Theo Faber, a new psychotherapist at the hospital who is determined to bring back Alicia’s voice by getting to the bottom of why she did what she did.
As his unorthodox investigation and treatment continues he becomes more than a little obsessed with his silent patient.
I absolutely loved this story. I’d put it in the same category as Ghosted, by Rosie Walsh and, of course the usual Gone Girl and The Girl on the Train.
Though set in present-day England, the hospital setting is wonderfully gothic, with crumbling buildings and a failing staff. The head professor of the hospital is mad as a cut snake with an office to match:
Professor Diomede’s office was located in the most decrepit part of the hospital. There were cobwebs in the corners and only a couple of the lights in the corridor were working.
The attitude to the patients is incredibly gothic as well, with staff seemingly viewing them as experiments rather than real people. Theo Faber is almost grotesque as he tries to ‘conceal [his] excitement’ at being allowed access to the famously mysterious murderess, Alicia Berenson. His attitudes to psychotherapy don’t seem particularly modern either, with his conviction that all adult behaviours can be traced back to trauma in childhood.
My overwhelming feeling at the start of The Silent Patient was grief that such vulnerable people were left at the mercy of such apparently twisted protectors. This feeling didn’t quite dissipate, but my opinion of the patients certainly shifted a little as the story progressed.
It did make me laugh, in a black comedy kind of way, at the pscyhologist to patient ratio: Alicia is literally Theo’s only patient and he sees her maybe once per day at the most. I’m sure plenty of medical professionals would love to have anywhere near such a ratio in 2019.
The telling of the story shifts between Theo himself – in first person – and Alicia Berenson, via diary entries prior to the killing.
The writing is fabulous and the handling of the complex story was brilliant. I slowly pieced together the puzzle and thought I’d solved what I thought was the mystery, only to have the rug pulled out from under me right at the end.
I highly recommend this to you if you’re a lover of psychological thrillers.
Disclosure: I received this book from the publisher for the purpose of review. This post contains affiliate links.