The Silent Patient
Alex Michaelides
Contributed by Carey Speaks
Part 1

In the first part, the author introduces an artistic couple. Gabriel is a renowned photographer, while his wife Alicia is an upcoming painter. Although the couple has been married for seven years, the narrator astonishes the audience by outlining how Gabriel is gruesomely killed by his wife, Alicia. During the incident, she is found in the house with her wrists cut. After the failed suicide attempt, Alicia is arraigned in court for her husband’s murder. While the litigation is still ongoing, she paints her most infamous painting, the Alcestis — with the narrator describing the title as a Greek heroine who sacrificed her life for her spouse. Although the author cites the inappropriateness of this analogy in Alicia’s situation, he acknowledges that the subsequent sections of the book will shed more light on the similarity between Alicia’s predicament and that of Alcestis.

Alicia’s trial becomes a popular broadcast on the airwaves. Due to the bad publicity made through the media, numerous people define her as a merciless murderer who deserves to be punished. However, the narrator states that it is unfair that Alicia should be proven guilty even before she has been tried in court. During the litigations, Alicia’s defense presents the judge with her history of mental health so that she could avoid a long-year sentence. Her lawyers avail a forensic psychotherapist who admits that Alicia had previously indicated that she had mental health issues. In accordance with Professor Diomedes’s expert opinion that Alicia was not of sound mind, the court decides to be lenient with her. She is to be admitted at the Grove, a psychiatric hospital run by Professor Diomedes. It is in this section of the novel that Theo, the narrator, explains how he would later meet with Alicia. He applies for a job at the Grove with the intention of treating Alicia.

The author outlines how Theo becomes a forensic psychotherapist. Since Theo had been raised by an abusive father, he had suffered a psychotic disorder. Theo describes how this abuse affected his mental health, which in turn limited his social interactions. He admits that he had at one time attempted to commit suicide. This made him seek out a psychotherapist to treat his mental illness. Theo’s mental recovery had, thus, encouraged him to study psychology so that he would help other people who also had psychotic disorders. Just as his treatment had intervened to save him, Theo seeks to help Alicia get better. Hence, his character can be described as supportive.

On his first day at the Grove, Theo walks into a group therapy session attended by the staff and the patients there. It is at this meeting that Theo sees Alicia and describes the waned state that she is in — thin, and having lost her beautiful features. Moreover, she is heavily sedated and can barely comprehend what is happening around her. Seeing how lost Alicia has become, Theo vows to make her his patient so that he can treat her. “There was no time to waste: Alicia was lost. She was missing. And I intended to find her” (Michaelides, 29).

Theo, therefore, goes to see Professor Diomedes to request that he be allowed to have therapy sessions with Alicia. From Theo’s dialogue with the professor, it is evident that Professor Diomedes has abandoned all hope of helping Alicia. He describes her as an uncooperative and unreceptive patient that can be difficult to work with. Nonetheless, Theo remains determined that he can make a positive impact on her mental health. Professor Diomedes gives Theo the green light to start the therapy sessions with Alicia. She attends her first therapy session with Theo but remains silent throughout. Theo acknowledges that the task of proving himself to Diomedes and helping Alicia will be tough.

In a zeal of preparing a better plan on how to handle Alicia’s case, Theo acquires her file. Alicia’s patient file defines her as isolated, ill-tempered, and self-harming. To better understand his patient, Theo intends to decipher the hidden meanings of her paintings and enquire about the type of childhood that Alicia had. Sadly, as Theo reaches out to Alicia’s relatives, none of them are receptive to his inquiries. Alicia’s aunt, Lydia Rose, hangs up the phone while her brother-in-law, Max, is unavailable. Theo gives up on this approach and decides to go home. However, as he leaves the Grove, he meets Alicia’s nurse, Yuri, whom he expects will reveal any vital information about Alicia since he had taken care of the protagonist for six years.

However, from Yuri’s response, it is evident that he, too, has lost hope of reaching out to Alicia, discourages Theo from making an effort with her. Yuri assumes that Theo is only keen on helping Alicia because he is attracted to her. Yuri instead urges Theo to go home to his wife, Kathy — someone who has a sweet charismatic disposition that the author describes in depth. The marriage of Theo to Kathy is described as blissful. The author outlines how the couple met and how they had come to fall in love. This section of the novel ends with a comparison of the characters of Kathy and Alicia. The contrast between the two characters is described by the narrator. Kathy makes him think of love while Alicia only makes him think of despair, “It’s hard to imagine two women more different than Kathy and Alicia. Kathy makes me think of light, warmth, color, and laughter. When I think of Alicia, I think only of depth, of darkness, of sadness” (Michaelides, 51).


In the first part of the novel, the author highlights how our society is quick to judge wrongdoers without giving them a second chance. The author describes the helpless state that Alicia is in. All but one character, Theo, have deserted Alicia. The author’s depiction of Alicia’s situation can be described as disheartening. Not only has her next of kin given up on her, but also the specialists at the psychiatric hospital that have the duty of looking after her. There is, however, hope for Alicia. The character of Theo shows the audience of the novel that even social outcasts, such as Alicia, are still redemptive. As much as the murder of Gabriel represents the character of Alicia as a cold-blooded killer, the narrator is of a different view. For instance, even though the people that visit the art exhibit to see Alicia’s painting despise her, the narrator is sympathetic.

The first part also highlights the theme of mental health. The Grove is described as a mental hospital with several patients, such as the main character. Alicia is locked away in the facility so that she can get treatment instead of serving a life sentence (Ochse, 2019). Theo is a psychotherapist who applies for the job at the Grove with the intention of assisting Alicia. He “has waited a long time for the opportunity to work with Alicia” (“Good Reads”). Since he is familiar with the struggle for mental well-being, Theo expects that Alicia will benefit from his expertise. Moreover, he understood how traumatic childhood experiences could have precarious implications for the victims in the future. Alicia was orphaned at an early age while Theo was raised by an abusive father. Their childhood experiences make both characters fear being abandoned by the people that they love. Theo appreciated that he was in a better position to treat Alicia since they had both been driven to extremities by their abandonment issues. Theo attempts suicide while Alicia murders her husband because they were both afraid of facing the rejection of their loved ones. Theo’s experience, therefore, makes it easy for him to be empathetic of Alicia’s situation.

This section of the book also shows the audience that it is still possible to assist somebody without expecting anything in return. Although Yuri expected that Theo only wanted to help Alicia because he was attracted to her, the author disapproves this by showing the intense love between Theo and his wife, Kathy. The description of Theo’s marriage to Kathy also indicates the contrast between Alicia and Kathy. The former has a dark and sad personality, while the latter has a loveable and kind character that Theo has come to appreciate. The close relationship between Theo and Kathy, therefore, demonstrates that Theo did not want to help Alicia simply because he felt attracted to her.

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