The Silent Patient by Alex Michaelides - Review
TL;DR
4.1 Stars
Pros: Interesting main characters, Greek tragedy allusion, entertainment
Cons: Alicia's relationships, depiction of psychotherapy, bigotry
Spoilers in review? Yes
Opinions going in/why I picked it up:
There's kind of two reasons I picked this book up.
One: A good friend of mine HIGHLY recommended it to me. She and I have basically have opposite reading tastes so I was hesitant to read it -- so much so that, while I bought a copy from a thrift store, I put off actually reading it off for multiple years.
But then for a reading challenge I was doing (Orilium Academy Autumn Equinox 2025) I was require to spin a genre wheel and then read a book of whatever genre it landed on. I got 'Suspense' as my genre, googled 'Suspense books' because I wasn't even sure I owned any suspense books (I wanted to only read books off of my physical TBR) and The Silent Patient was the first book on the list.
I do not have a good track record with thrillers or mystery novels, so I also got the audiobook from the library to help me get through it. Additionally, I have two other friends who read thrillers regularly and had very 'meh' opinions on this book and so my expectations were very, very low.
Likes:
Overall, I did really like the book. My biggest complaint with most thrillers (and mysteries) is that we go so fast that by the time something "thrilling" happens I don't really care because the author never took the time and convinced me to give a fuck about the characters its happening to. I'm only ever going to be worried for a *person*, not a name on a piece of paper, so authors need to make me see their characters as people well before they start sprinting along their plot. (I have since seen much criticism that this book isn't even really a thriller, so maybe that's why I liked it LOL)
As such, I *really* liked how this book really let us sit with the characters and ruminate with them. Both Theo and Alicia has interesting thoughts, for the most part. (Again, some say this is boring monologue (and presumably not common in psychological thriller), but I'm gonna be honest -- I love a good villian monologue.)
Additionally, I have very little background in Greek mythology or tragedies -- we studied it in school a bit but I never cared much for it and that lack of interest has continued into adulthood. In this story, though, Alicia's story is kind of an allusion to/retelling of the story of Alcestis. I found the comparison fascinating. It was very heavy handed and I 100% get why those who are mythology buffs don't like that, but as someone who never got into mythology it is a nice change of pace when an author doesn't assume that I am familiar with Greek tragedies/myths/stories/etc. and all the symbolism associated.
Dislikes:
Alicia's relationships with others can almost be entirely boiled down to: Family (they abuse her), Men (they all lust after her), and Women (they don't get along). That and how she sees to always paint women nude (including herself), but never men -- even the one where she portrayed her husband as Jesus on the cross. Very much a woman written by a man.
The depiction of Psychotherapist and "therapy vs medication" argument is kind of wild. I'm no professional, but I've been in a psych-ward and uhhhhh. I have concerns about how this was portrayed. I lack the knowledge of the subject matter to properly articulate what my exact concerns are, but it did leave me with a bad taste in my mouth.
Additionally, the way some of the characters were spoken about in regards to the race, weight, etc. had me raising an eyebrow. I don't think I could point out many phrases that were explicitly awful (including Theo's description of Alicia's aunt, Lydia, who is fat and so there for must be described as disgusting and evil and bad >.>) Again, I struggle to articulate it, but it was something that stuck out to me in a negative way.
With the bigotry and the pyschotherapy points, you could argue that it is because Theo is telling the story and he is very much not a good person, but ehhhh. I don't think that the way the author wrote it would support that stance -- those lines dont appear to be evidence of Theo's or Alicia's flaws, but 'just the way things are'.
Rating Breakdown:
All in all, I would not necessarily argue that this is a technically *good* book, but I had fun -- which, to me, it important. I think I enjoyed this book because the story was dramatic and interesting and something new to me despite its many flaws.
I feel this review is not useful for others, but this blog is, first in foremost, for me. This is just the best I can do at the moment when it comes to explaining my opinions on the book immediately after reading it.
Characters: 9
Atmosphere: 7
Writing: 8
Plot: 9
Intrigue: 10
Logic: 6
Enjoyment: 9
Dialogue: 8
Total: 8.3/10 or 4.1 Stars












