Book Review The Silent Patient

Introduction

For this week’s review, I’m diving into The Silent Patient by Alex Michaelides. It’s a psychological thriller that had been on my list for ages and all over book communities online. Before I even opened it, I had already seen it everywhere—almost like it was following me on every platform.

People on TikTok, Instagram, Twitter, Goodreads, and YouTube kept talking about it. The hype around Michaelides’ first book was massive. Many readers praised the story and called it incredible. Those glowing reviews made me want to grab a copy right away. But as always, where there’s praise, there’s also criticism.

Some said it was overrated or that the ending wasn’t strong. Because of that, I was nervous to start it.. Still, once I began reading, I was hooked. I couldn’t put it down.

Background of Characters & Setup in The Silent Patient

The Silent Patient by Alex Michaelides is a psychological thriller that follows the life of a famous artist, Alicia Berenson. One evening, she shoots her husband, Gabriel, in the face five times. After that, she never speaks again.

Alicia seemed to have a perfect life. She was married to a well-known fashion photographer and lived in a beautiful London home. But everything changes that one night. Her silence becomes her only voice.

The story is told by Theo Faber, a psychotherapist who becomes obsessed with Alicia’s case. He wants to understand why she killed her husband and why she refuses to speak. Theo takes a job at the mental hospital where Alicia is kept, hoping to make her talk and uncover the truth.

Michaelides has said in interviews that his own background in psychotherapy and his love for Greek tragedy inspired this story. Theo’s obsession with helping Alicia slowly becomes his downfall. The more he tries to reach her, the deeper he sinks into a web of secrets and lies.

Readers who enjoyed The Family Upstairs by Lisa Jewell will recognize a similar dark tone and layered storytelling that explores human emotion and guilt.

Story Overview of The Silent Patient

This novel is told through two different voices. The first is Theo Faber, the psychotherapist who dreams of working with Alicia Berenson, the woman accused of murdering her husband. Alicia was a painter, and her husband, Gabriel, was a fashion photographer.

Then, one night, the crime changed everything. There was a gun, blood everywhere, and Gabriel’s lifeless body. Alicia was found with her wrists slit, barely alive. Since that moment, she has lived in a secure psychiatric ward for women.

The second voice comes from Alicia’s diary. Her journal entries reveal her emotions and thoughts from the weeks leading up to the murder. The back-and-forth between Theo’s present-day investigation and Alicia’s past makes the story feel layered and suspenseful.

While Theo works at the institution, his own personal life unfolds. He’s married and loves his wife deeply, which adds another emotional layer. His need to save Alicia mirrors his desire to hold on to his own happiness.

For a deeper understanding of the book’s structure and symbols, readers can check out The Silent Patient Study Guide on LitCharts.

Narrative Style of The Silent Patient

The story uses shifting perspectives to build mystery. We move between Theo’s present point of view and Alicia’s diary from the past. This style keeps readers guessing and helps them feel closer to both characters.

Alicia’s diary entries give us her voice, even when she refuses to speak aloud. Her thoughts are painful and emotional, helping readers understand her silence. I found myself turning pages quickly, trying to piece the puzzle together before the big reveal.

The writing is clear, direct, and well-paced. Even when I doubted where the story was heading, the alternating perspectives pulled me back in. As a result, the rhythm of silence versus speech keeps tension alive until the shocking ending.

Reception & Awards

The Silent Patient became an instant hit. It won the Goodreads Choice Award for Best Mystery & Thriller (2019) and was nominated for Best Debut Novel the same year.

The book has received over 1.5 million ratings on Goodreads, with an average score above 4. It’s easy to see why it captured so much attention. Many readers praised its twist, strong pacing, and psychological depth. Even years later, it remains one of the most talked-about thrillers online.

Reviewer’s Rating & Impressions

When it comes to my personal rating, I’d give it three out of five stars. I enjoyed the journey, but it didn’t fully meet my expectations. The writing was smooth and easy to follow, but the emotional connection was missing at times.

Some parts felt intense and engaging, while others felt slow. The ending, though shocking, left me feeling uneasy rather than satisfied. It reminded me of Tender Is the Flesh by Agustina Bazterrica. Both stories reveal how far people can go when driven by obsession or pain.

Theo and Alicia are not easy to like. As the story goes on, I found myself disliking both of them. Their actions and choices made them frustrating but real. Even though I didn’t love them, I couldn’t stop reading because I wanted to see how it would end.

Without giving spoilers, I’ll say this: the final twist will surprise you. But you may not feel sympathy for the characters once you reach the end.

Strengths of the Novel The Silent Patient

The book’s greatest strength lies in its concept. A silent woman accused of murder, and a therapist desperate to make her speak—it’s a setup filled with suspense.

Michaelides uses his psychology background well, giving the story realism and emotional weight. The Greek tragedy influence adds meaning, showing how fate and obsession often lead to downfall.

The dual perspective, switching between Theo’s narration and Alicia’s diary, builds constant tension. This style keeps readers curious and makes the mystery stronger.

If you enjoy thrillers like Freida McFadden’s Never Lie, you’ll love how The Silent Patient mixes human psychology with slow, haunting suspense.

Overall Summary

When I finish a book, my rating depends on how much I’d recommend it. Typically, three stars usually means “good, but not great.” Four stars means “definitely worth reading,” and five stars means “amazing—don’t miss it.”

The Silent Patient falls in the middle. It’s worth reading for its unique twist and clever use of silence as a storytelling tool. The mystery is strong, and the psychological depth keeps you thinking.

What stops it from reaching a higher rating is the lack of emotional connection with the characters and a few slow moments in the middle. Nevertheless, it’s a gripping psychological thriller that deserves its place among modern mystery classics.

If you like dark, mind-bending stories with shocking endings, The Silent Patient will keep you turning pages until the very last one.