Book Review- The Silent Patient by Alex Michaelides

“...we often mistake love for fireworks - for drama and dysfunction. But real love is very quiet, very still. It's boring, if seen from the perspective of high drama. Love is deep and calm - and constant." -Alex Michaelides, The Silent Patient

Can pain ever justify wrongdoing? What happens when a therapist needs therapy more than his patient? How far will someone go to avoid confronting their own guilt?

Picture of Alex Michaelides from his website, check it out! https://www.alexmichaelides.com/

Information about the Author

Alex Michaelides is a Cypriot-born author who obtained his M.A. in English Literature from Trinity College, Cambridge University and an M.A. in screenwriting from the American Film Institute in Los Angeles. He studied psychotherapy for three years and worked in mental health service for adolescents experiencing complex mental illness, which is said to be his inspiration for his books. The Silent Patient was his first novel and also his best-seller as it went viral on TikTok and other social media platforms. It was also on the New York Times best seller list and sold in over 49 countries. Michaelides currently lives in London.

Outside of his The Silent Patient career, he wrote the film The Devil You Know as well as The Con is On, each respectively hosting a wide list of A-list celebrities. But due to his short lived screenwriting career along with an encounter in a party, he decided to go into writing novels rather than films.

Summary

The Silent Patient by Alex Michaelides is a gripping psychological thriller about Alicia Berenson, a famous artist who was seemingly living an ordinary life-- until one evening she shot her husband Gabriel, in the face five times, and refused to speak another word. The title alludes to her silence, which is explored throughout the book using trauma and psychological repression.

The story is narrated by Theo Faber, a psychotherapist who became fascinated by Alicia's case, motives are brought to light later. Determined to uncover the measures that drove her into committing the murder, Theo takes a job at the psychiatric institution where Alicia was being held.

As Theo searches through Alicia's background, her journal, the people who knew her-- he discovers strange and mysterious hidden motives. The deeper he digs, the more eerie the case becomes, which leads to twists and turns that reader cannot see coming.

The novel dives into themes like hidden darkness, psychological trauma, silence, artistic expression, mental health and obsession, which is guaranteed to leave you eagerly flipping pages faster and faster to get to the ending.

Revenge

This novel is the epitome of "revenge is a dish best served cold", as revenge is a powerful unconscious force in The Silent Patient, consistently stirring the plot's climax. Rather than a linear story, Michaelides presents vengeance as a psychological and emotional impact that influences the characters decisions in multi-dimensional ways.

Alicia's act of shooting her husband is the most overt and violent action in this book, but her silence is her most profound act of revenge. By refusing to speak, Alicia punishes those around her-- family, friends, and therapists who are desperately seeking answers. This silence withholds her truth, making everybody overthink, guess and suffer in uncertainty. It is a way of keeping power when all else is lost, turning the people in her environment to prisoners of their own curiosity.

Alicia's silence can also be seen as resistance to the world that betrayed her. After a traumatic experience that shattered her life, speaking might feel like surrender or exposure. Her silence is a wall, a refusal to cooperate with a system or society that failed her. In this way, her muteness becomes an act of revenge against a cruel reality.

Theo Faber, the psychotherapist determined to break Alicia's silence, carries his own burden of trauma and unresolved pain feeding into a theme of revenge on a personal level. Theo's involvement with the case is not only professional, it is intertwined with his desire for retribution related to his past. He is motivated by guilt and a need to confront personal demons, which makes his pursuit of Alicia's psyche, include reasons other than helping her.

Perhaps the most tragic aspect of Theo's revenge is that it is partly directed inward. His guilt and self-loathing makes him self-destructive which shows how revenge can become a cycle of harm, not just toward others but also toward oneself.

Alicia's silence provokes obsession in others, especially Theo, which created a vicious cycle where revenge and retaliation become emotionally contagious. Each character's unresolved pain feeds the other's suffering, escalating the tension further.

The novel shows that revenge complicates the search for truth. While everyone is trying to figure out why Alicia killed her husband there remains: hidden motives, secret resentments, and silence. The effect of all these leads to clouded character perceptions, which distorts reality, making it harder for characters to find closure/healing.

Revenge hides deeper emotions-- shame, gear, grief. Both Alicia and Theo's actions reflect attempts to cope with unbearable pain by displacing it onto others through vendettas.

Cheating and Infidelity

At the heart of the story is Alicia's discovery that her husband, Gabriel is not the perfect husband as she believed. Her world becomes shattered when she learns he is having an affair, affecting her emotionally, psychologically, and morally.

The situation escalates when Alicia is forced into a surreal moral test: The Masked intruder man gives her husband (Gabriel) a choice, either he dies or Alicia does. Gabriel chooses to live, which results in Alicia feeling betrayed in the most devastating way.

This shows that infidelity is not only sexual betrayal, but moral failure and emotional abandonment. Alicia's silence and later killing of her husband are both rage and a response to a ground-breaking conflict.

Alicia built her emotional world around Gabriel's love and his cheating dismantled her sense of safety and identity. It drives her into psychological fragmentation: no speaking, no trust, and only self-expression through painting. Once this trust is broken, the fallout is not simply emotional, it's existential.

Theo, the psychotherapist and the narrator, also experiences a similar betrayal when he finds out his wife Kathy is also cheating on him. Unlike Alicia, he manifests his rage into obsessive, manipulative ways. He breaks into Alicia and Gabriel's home, he stalks them, and he is ultimately revealed to be the masked man that night who gave the unthinkable moral test.

Although Theo's response to infidelity is important because it mirrors Alicia's without her honest or emotional clarity. His hypocrisy is chilling as he is vehemently against cheating, while he commits emotional violations to others.

Were Theo's actions justified?

In my opinion, Theo Faber's actions in the Silent Patient are not justified although the novel does invite readers to understand how profound emotional betrayal and unresolved trauma can lead someone to commit psychologically twisted acts. While his motives are rooted in betrayal and obsession, his behavior crosses many ethical and legal lines-- making him not a hero but an unreliable and biased narrator.

Theo is not just a villain in this situation, he is portrayed as a wounded, emotionally fragile man who has suffered neglect, abuse, and, later romantic betrayal. His trauma of growing up with an emotionally absent mother and an abusive father leaves him with a low self-esteem and deep abandonment issues. When his wife Kathy cheats on him, these unresolved wounds are reactivated.

Theo begins to project his pain outward as he starts to see himself in Alicia, and he feels entitled to uncover her truth while obsessing over her story because it's parallel to his own. He commits multiple legal and moral wrongdoings to Alicia (who is innocent in this situation) which simply cannot be justified regardless if they stemmed from severe trauma.

1. Stalking: Theo watched Alicia and Gabriel for a while to gain extra information on them.

2. Breaking and Entering: He broke into Alicia and Gabriel's home.

3. Emotional terrorism: Wearing a mask to hide his identity, he held Gabriel at gunpoint and psychologically tormented both Alicia and Gabriel. This lead to Alicia feeling betrayed after realizing that her husband would rather her die than himself.

4. Indirectly Causing Murder: By staging "choose who dies" scenario, Theo pushed Alicia into a state of betrayal, which lead to her act of killing her husband.

5. Manipulating Therapy Patient: As her therapist he hid valuable information while violating ethical boundaries which could have exonerated her, he guided her towards self-exposure while hiding his own secrets.

6. Suppressing Truth: He withheld vital information during her recovery, not out of care but to protect himself.

Final thoughts

In the end, The Silent Patient reveals that silence can be more damning than words— and that truth, no matter how deeply buried, will always come back. Alicia's muteness is not just trauma, but resistance, a powerful act that exposes Theo as the catalyst that fractured her world. The final twist frames everything we past believed about guilt, trust and identity. It forces us to confront the uncomfortable truth that those who seek to heal are not always innocent— and those who remain silent may scream the loudest. Alex Michaelides leaves readers questioning the reliability of perception and the haunting ways in which love, betrayal and revenge intertwine. Overall I really enjoyed the philosophical thoughts that accompanied this book along with the unique plot, and I would love to read Michaelides other works.

Did you like this review? Do you have any similar or differing opinions? Be sure to let us know in the comment section, or tag us on Instagram @thereadingtableblog