The Silent Patient: a cold, calculating psychological thriller

The Silent Patient book review

What is this about?: Theo Faber wants to answer the riddle that is Alicia Berenson and why she murdered her husband. And then refused to speak.

What else is this about?: What happens when another book out-twists what at any other time would be a magnificent twist? You be grateful for excellent characterisation, and an atmospheric cold and calculating thriller.


Promising to be the debut novel of the season The Silent Patientis 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 is, as lots of write-ups have been touting, an impressive debut.

However, I think it is more impressive for the characterisation and cold and calculating atmosphere the writer created, with a twist in the end that adds to the goodness that is already there.

So what is The Silent Patient about?

Alicia Berenson killed her husband Gabriel and then refused to talk about it or defend herself. She was sentenced to a psychiatric hospital and for Theo Faber, she is fascinating, as is her case. She becomes the unicorn for him, for if he can get her to talk, then he becomes … famous. Infamous? He just wants to be the person who solves the riddle of Alicia Berenson.

The interesting thing here, is that Alicia does have her voice –– through the addition of a journal entries, given to her by Gabriel. There we learn about them from her POV, about her fears and her love for him.

Other than the journal entries, Alicia is a construct of everyone else in the book — her doctors around her, her family members, and her husband’s family members. So it’s hard to believe the things they say. However,  is Alicia to be believed?

The book is also about love 

We learn about Alicia and her relationship with Gabriel and we learn about Theo and his wife — whose name I can’t remember as I write this — which makes sense because it’s not about them per say, but it is about what Theo considers love and what he perceives as their relationship. His wife is there to be an object for him to love, to rescue him from his past.

Theo is at the centre of this story as much as Alicia is. We learn about his past, his own problems that consumed him and how much he wants his marriage to work — and to understand what happened to Alicia and Gabriel’s relationship.

But again, it becomes obvious that we are learning things that are one-sided and you’ll begin to wonder at the purpose of this.

So all of this isn’t going to make much sense in a review

Because there’s a twist that resets the narrative in what is a startling way. And then resets it again. So, there’s a lot packed into this debut.

I did appreciate that Theo and his obsessions as well as his desire for love — and Alicia’s —  weaved a story together that created an atmosphere where I wasn’t sure what to believe — something this author is excellent at playing with.

The Silent Patient is a well-written, tension filled novel with characters that will mess with your head, and an ending that will make you rethink everything you just read.


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