Book Review : The Silent Patient by Alex Michaelides

The Silent Patient (Amazon Affiliate Link)

Author : Alex Michaelides
Published By : Celadon Books
Year Published : February 5, 2019
Genre / Tags : Mystery, Psychological Thriller, Contemporary
Formats : Hardcover, Paperback, eBook, Audiobook
# of Pages : 336 pages (Hardcover)


The Silent Patient is a shocking psychological thriller of a woman’s act of violence against her husband―and of the therapist obsessed with uncovering her motive.

Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word.

Alicia’s refusal to talk, or give any kind of explanation, turns a domestic tragedy into something far grander, a mystery that captures the public imagination and casts Alicia into notoriety. The price of her art skyrockets, and she, the silent patient, is hidden away from the tabloids and spotlight at the Grove, a secure forensic unit in North London.

Theo Faber is a criminal psychotherapist who has waited a long time for the opportunity to work with Alicia. His determination to get her to talk and unravel the mystery of why she shot her husband takes him down a twisting path into his own motivations―a search for the truth that threatens to consume him….


The Silent Patient has a fantastic premise and a writing style that is simple yet enthralling and easy to get into. I was very quickly immersed into the storyline after just a few pages in and interested to see how it would all unfold.

When weak points started to emerge by the quarter to halfway point, the prevailing mystery already had its hooks in me. This resulted in a dogged determination to see how it would all end and what the larger truth is among a flurry of suspicious-seeming characters and situations.

Our story follows two characters. The main narrative voice is Theo, a criminal psychologist and therapist. He reads as young and not entirely convincing for much of the book. His personal relationships are strained and frankly, he does not come off as a character who could convince the powers that be that he is stable and thoughtful enough to fulfill his obligations. I had to suspend some disbelief to process that and had mixed feelings for the character overall. He is well-realized but there are definitely some noticeable weak points in the portrayal of him as well-versed in criminology and psychology.

The patients and doctors and the ways they relate could also be alarming, I often felt like the patients were almost like projects and sometimes treated inhumanely. Multiple doctors speak sweepingly about some mental illnesses in a way that seemed questionable. But for full disclosure- I don’t have a background in the fields on display here. Just as a casual observer, something didn’t sit consistently right about the portrayal(s) here.

Now for the next main character, Alicia. In short, she killed her husband (this is revealed almost instantly into the novel) and has since become mute. She is a conundrum to all who try to communicate with her. The motive behind her actions is murky and leads down an ominous path where each question leads to even more questions, down a rabbit hole of possibilities. We learn of her story when Theo goes full-on detective mode to investigate the events leading up to that fateful night. He meets people she knew, each one inspiring uncertainty. The truth about what happened to Alicia and her husband is at the heart of the story and I found it to be quite a captivating question.

Along the way we find out the gist of all the relationships involved and events that led to the murder, layer by layer. There are also numerous journal entries that were written by a much more lucid Alicia in years prior. These go far in shedding light upon her psyche and hint toward a more nuanced explanation for everything.

So without further ado, here were my thoughts on the ending. Still aiming to be spoiler-free but you may want to stop reading here if you don’t want any inkling of how it ends. I just think that when it comes to suspense/thrillers/mysteries, knowing whether the ending is satisfying or not is so important since the whole point of books in these genre(s) are often wrapped up within that payoff.

In my opinion most questions were answered and the big whodunnit reveal, while not a gasp-worthy surprise (and I kind of guessed it early on but only as a passive thought) was probably the best way to end this story. For how much info was given on all the suspects, any other solution might have been far less interesting. Also of note is that the ending does supply some re-read potential, which is rare. A second read of The Silent Patient would probably be quite different and make me think more analytically about everything that occurred.

I’ve given this book 4 stars on Goodreads but would place it on the lower end of 4. In comparison to other books in similar genres that I’ve read this year, it places below The Turn of the Key by Ruth Ware and Big Little Lies by Liane Moriarty but above Pretty Girls by Karin Slaughter. Expected a more jaw-dropping experience given the hype and widespread popularity of this title.

Overall Rating – 7.7/10

Why You Should Try It – An interesting and effectively mysterious premise. Lots of clues along the way that serve to expand the story toward several possibilities. A quick, brisk read- as such it can be a good starter book in this genre. I enjoyed the ending and it offers re-read value.

Why You Might Not Like It – I’m sure the ending will be hit-or-miss for many people. I’ve noticed that some avid readers of mysteries and thrillers have more critical thoughts. The approach to mental health and criminal psychology is not as sophisticated as it could be.

The Silent Patient recently won first place in the Mystery/Thriller category of the Goodreads Choice Awards 2019. There was/is a lot of hype behind this title so I’d eagerly wanted to read it for a while now. Have read The Silent Patient or want to? Have any other mystery/psychological thriller recommendations from this year? Thanks so much for checking out my review. I’m currently read The Wife Between Us and look forward to reviewing it soon too. Hope you have a great mid-week/weekend. ~ Kitty


14 thoughts on “Book Review : The Silent Patient by Alex Michaelides

  1. I have been hearing so much about this book- it is one of Barnes and Nobles books of the year. But I never thought for a second to pick it up. When I read your review I was quite shocked. I had no idea it was such a non-literary type read… although I will admit the cover did kind of freak me out!

    Liked by 2 people

      1. Oh my god THAT cover… like it is on a special table and I have to slow key walk by it when it isnt really busy. Or if a customer has a lot of books to check out and I dont notice it? Damn thing makes me jump hella high. 🤣

        Liked by 1 person

  2. This honestly wasn’t the fast paced thriller I expected when I picked it up. The hype was HUGE around it and everyone kept blowing it up so I was expecting to get something completely different. That said, while I actually struggled with it at the start, the last 30-40% really had me racing through the pages. I actually had the twist figured out but I passed it off as being too insane to be right, but haha I was right and it had me screaming! 😂 I think the twist/ending was actually what made this a four star read for me! Fantastic review, Kitty 😍

    Liked by 1 person

    1. It definitely has some polarizing opinions, I am surprised honestly by the sheer volume of reviews and widespread attention given to The Silent Patient since there are several thrillers to choose from in 2019. I’m glad the twist enthralled you! Had a similar feeling of thinking maybe that will happen, but it might be too much or too far-fetched- and being surprised when it did, lol. Thanks for your thoughts and hope you find some great variety of thrillers in 2020 too.


  3. I absolutely loved the way you wrote this review. I’m not always a in a thriller mood but on the odd occasion I love them. I’ve been wanting to read this book because of the hype and you’ve just helped me put it towards the top of my TBR list. I’m a fan of Moriatry’s Big Little Lies but I’m keen to also try Turn the Key before the end of the year as well 😊 awesome post Kitty! Jen

    Liked by 1 person

    1. Thanks so much Jen!! 😀 I hope you like The Turn of the Key, it’s probably my favorite thriller of 2019. The Silent Patient has a lot going for it too though if you end up finding the scenario appealing. Much agreed on Big Little Lies, it was a fantastic read.


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