The Silent Patient
Alex Michaelides
Contributed by Carey Speaks
Part 2

The second part begins with a record of Alicia’s life as expressed in her diary. Alicia’s diary describes how she suffers through an intense heat wave. Alicia, therefore, spends her days in open spaces and in cafes with air conditioning just to get away from the unbearable heat. Since they lack air conditioning in their home, Alicia decides to purchase a fan. Gabriel is adamant about the idea of having a fan because the noise from the device will prevent him from getting any sleep. He, however, sleeps through the fan’s whirring noise. In the subsequent days, Alicia moves around the house with the fan. She even uses it while she works. The author describes one of the paintings that she works on. She paints a portrait of Jesus on the cross. However, instead of having the face of Jesus on the portrait, she paints Gabriel’s face in its place. Since she is astonished by her unconscious decision to paint Gabriel on the cross, Alicia decides to have a breather and leaves the house.  

The diary describes Alicia as an outgoing character. It is while visiting the Camden Market that she finds a homeless man who appears to be suffering from mental illness. Alicia is sympathetic towards him as she wonders whether the man’s mother ever had a premonition that her son would end up being crazy. The theme of mental health is outlined when Alicia describes how her mother, Eva, had suffered mental illness and had consequently attempted to end both their lives by driving her car through a brick wall. Eva dies during this accident thereby leaving Alicia as the sole survivor. Alicia becomes melancholic as she remembers this incident. She fears that she too might have her mother’s madness especially after subconsciously painting Gabriel on the cross, “Is her madness in my blood?” (Michaelides, 55).

The diary also outlines the passionate love that existed between Alicia and her husband before she killed him. Gabriel is described as an encouraging husband who has nudged and supported Alicia through her love for painting. When Alicia gets home after one of their occasional dates, she asks Gabriel to pose for her so that she can paint him. Alicia is ecstatic when Gabriel agrees to this idea. In her diary, she remarks on how she is inseparable with her husband. She states that she will love him “until death do us part”- a phrase that she literary takes to heart as outlined by the author’s depiction of the cold-blooded murder of Gabriel in the first part of the novel. Out of guilt, Alicia tries to slit her wrists after killing her husband.

In addition, the second part of the novel talks about Theo’s therapy sessions with Alicia. She is heavily sedated by her doctor, Christian, to ensure that she does not experience violent outbursts. Nevertheless, Theo intended to lower Alicia’s dosage of her medication so that she can be more responsive to therapy. However, this approach fails to work after Alicia attacks Theo during her therapy session. Although Cristian and the Grove’s supervisor, Stephanie Clarke, see this attack as a consequence of reducing Alicia’s medication, Indira and Theo are optimistic and are of a view that the attack is a form of communication that Alicia is ready for therapy. Although Stephanie urges Professor Diomedes to have Alicia’s therapy discontinued, he refutes it. He intends to use the improvement of Alicia as a bargaining chip to the hospital’s Trust so that the Grove could not be closed down. Theo is happy as he leaves the Grove because the professor has overruled Stephanie’s suggestion of ending the therapy sessions with Alicia.

Theo goes home where he smokes marijuana in the absence of his wife. He then proceeds to use his wife’s laptop. He finds several implicating emails that prove that his wife has been having an affair. Sadly, he lacks somebody whom he can confide in about his wife’s affair. Exasperated by this he almost describes to Alicia how he wants to argue with his wife while they have a therapy session. This gives Theo the idea of using his anger with his wife to reach out to Alicia. He states that he sometimes hates his wife just as Alicia hated her spouse. This empathetic technique is, however, unfruitful. Instead of getting Alicia to talk, she angrily storms out of Theo’s office when he accuses her of killing Gabriel because she hated him.

Theo blames himself for Kathy’s promiscuity. He says that he was not good enough for Kathy. He questions her intent in their marriage as he wonders whether Kathy’s love was true or all but an act. Theo comes to the realization that he has no one else to turn to for support other than his therapist, Ruth. He decides to go and see her. When he arrives at her house, Ruth is accommodating and listens to him. Ruth tells Theo that his anguish is caused by his childhood feelings of abandonment. He had been trying to love Kathy who had been emotionally unavailable and unkind to him because he was afraid of being abandoned. Ruth tells Theo that he deserves somebody better than Kathy and that he should leave her. Sadly, Theo fails to confront his wife when he goes back home. Ironically, when Kathy finds Theo’s stash, she states that she barely knows Theo anymore because he smokes marijuana, yet she is having an affair. Theo chooses to ignore his wife’s promiscuity. He goes about his routines as though nothing happened. However, he starts to experience paranoia and constant suspicions on his wife. Theo snoops about his wife’s laptop in a bid to prove that she is still cheating.    

Later on, while talking to Elif at the Grove, Theo receives a phone call from Gabriel’s brother, Max Berenson. Max accepts to talk to Theo about Alicia’s case. The following day, when Theo visits him in his office, Max states that he had been adamant to talk to him the first time he called because he thought he was a journalist. Max reveals that he hated Alicia because she was mad. He claims that she had threatened to kill Gabriel several times. Moreover, Alicia had also attempted to kill herself soon after the death of her father. Just as Theo finishes talking to Max, his receptionist secretly advises Theo to talk to Alicia’s cousin, Paul, because he knew Alicia better. From the receptionist’s reaction, Theo realizes that she is afraid of Max.

The character of Alicia is further outlined in her journal. Alicia describes her fights with Gabriel that recur because she does not want her husband to keep a gun in the house. Some of these fights are described as violent. In the journal, Alicia also describes how she feared to have a child. Her childhood trauma made her feel like she was not fit to be a mother. She was afraid that she would turn out to be just like her mother, Eva. Alicia also states how there is no love lost between her and Max. At one time when Gabriel invites him for barbeque, Alicia tries to avoid going to the house because Max is there. Gabriel also notices that Alicia tries to dodge Max when she gets home. Max, however, finds her and Alicia is forced to confront him for sexually assaulting her during a party. It sickened her that she had not yet told Gabriel about Max’s inappropriate behavior. As she confronts him, Max pulls her and deeply kisses her. She struggles to pull away from his grasp and bites his tongue. Max yelps out and warns her about ever telling Gabriel about the incident. During the luncheon, there is tension between Alicia and Max. Nonetheless, the portion on Alicia’s diary ends in a positive mood. For her birthday, Gabriel takes her on a romantic picnic. Later, he asks Alicia to have a baby with him. This leaves her in an ecstatic disposition.

There is a twist in the plot when Theo calls Max and asks him about Gabriel’s estate. Theo realizes that Max could have been involved in Kathy’s misfortune because he wanted to inherit his brother’s estate. When Theo asks Max about the inheritance, he gets angry and hangs up the phone. Theo, therefore, visits Alicia’s cousin, Paul, who resides in Alicia’s childhood home in Cambridge with his mother. By understanding about Alicia’s past, Theo expects to find the answer to help her during therapy. While in Cambridge, Theo talks to both Paul Rose and his mother, Lydia. Paul states that he believes that Alicia was innocent because she was incapable of physically harming anyone. Lydia, on the other hand, is hostile and angry with Alicia for painting her in a grotesque portrait. Alicia hated her aunt for being autocratic and hardhearted. She states that she escaped her aunt’s house the first chance she got. Lydia’s aggression reminds Theo about his own abusive father that nearly drove him mad.

Theo makes a plan of visiting the art gallery so that he can see Alicia’s paintings. The relationship between Alicia and her father is described by the gallery owner, Jean-Felix. Although Theo thinks that Alicia experienced her first suicide attempt due to the grief from her father’s death, Jean-Felix states that she only felt responsible for his death. Alicia felt like she had abandoned her father when he needed her — that is, after the death of her mother. The relationship between Jean-Felix and Alicia is also outlined in this part. Having gone to the same art school, both characters have known each other for a long time. Jean-Felix had been in charge of exhibiting Alicia’s art. He admits that he visited Alicia on the day of Gabriel’s murder to find out the progress of her work because the exhibition was in six weeks’ time. In her diary, Alicia describes how Jean-Felix walked into her house uninvited, gets angry with him, and subsequently informs him that after the exhibit she would no longer work with him. Jean-Felix suggests to Theo that he should let Alicia paint while in the Grove so that she can communicate through her art. Theo observes a positive mood change in Alicia when she starts to paint. Sadly, the progress is short-lived. Elif, another patient, defaces one of Alicia’s paintings and drives her into fury. Alicia stabs Elif in the eye and gets confined in isolation. Consequently, Professor Diomedes ends Alicia’s therapy sessions with Theo. When Theo calls Alicia to inform her about Professor Diomedes’ decision, she hands him her diary. Theo expects that by reading her journal, he will get to learn more about Alicia.


The author begins this section with a symbolic description of Alicia’s diary, where her views on death are portrayed here. During an afternoon stroll, she picks up a dead bird from the ground and is sickened by its corpse. The novel further hints on the subject matter of death through the description of Alicia’s painting of Jesus. Her diabolical intent is hinted at by the fact that she has painted Gabriel on the cross instead. The character of Alicia is developed as outgoing, fun-loving, and humane. The diary also describes Alicia as being very similar to her mother; they both attempted to kill themselves together with the people that they love (Alicia had tried to kill herself right after murdering Gabriel). This subsequently gives the audience the perception that Alicia suffered from a similar mental condition as her mother, where her insatiable love for Gabriel makes Alicia cut her wrists after killing her husband. Only death would separate them.

The author also indicates how Theo had undergone therapy from Ruth. During the session with Alicia, he accepts that he is also not perfect — and ought to have been the one receiving therapy. To deal with his issues, the author states how Theo is addicted to cigarettes because they calm him. Moreover, he smokes marijuana in the absence of his wife. This, and the fact that he always hid while smoking, shows that he was ashamed of his addictive habits.

Kathy’s promiscuousness is a form of betrayal to her husband. Theo is left in a state of despair; his blissful marriage had been shuttered. Nonetheless, he admits that he would be forgiving to her, which shows that he loved her deeply and was not ready to lose her. During the visit to Ruth, Theo realizes that the pain he experienced — when he found out that Kathy had been cheating on him — had initially occurred in his childhood. Ruth, who represents a maternal character to Theo, describes this unresolved feeling as, “the pain of not being loved” (Michaelides, 90). When she advises him to end his marriage, Theo considers leaving Kathy. However, when he fails to confront his cheating wife, Theo shows the reader that his character is timid — while, at the same time, not wanting to be left in solitude. He is presented with a dilemma in which he must choose whether to forgive his wife or leave her. Sadly, Theo’s fear of abandonment overwhelms him, with jealousy and paranoia slowly taking hold and eventually getting the best of him — demonstrated by his constant checks of his wife’s phone and laptop. To indicate the extremities of his intentions, the author outlines how Theo plans on stalking his wife when she goes out.

The portrayal of Max in Alicia’s diary shows the contrast between Gabriel and his brother. Max is indecent and disrespectful, and abuses Alicia, and to the point of threatening and assaulting her. Max was jealous of his brother, to the point that he wanted to have his wife and his estate. Although Max had initially been described as kind and helpful, his inappropriate acts prove that he is controlling, diabolical and disrespectful. After the death of his brother, he kicks Alicia to the curb.

The role of Theo changes from that of a psychotherapist to that of a detective: “you sound more like a detective than a psychiatrist” (Michaelides, 128). He investigates Alicia’s relations to a great extent. Theo is “obsessed with investigating her crime” (“Hatchette Australia”), which is evidenced by the numerous personal questions he asks Max on his impromptu visit to Paul Rose in Cambridge. Nonetheless, the option of visiting Paul is a great alternative to finding out the root cause of Alicia’s mental illness. It, however, ends up being an unfruitful and regrettable visit for Theo — which subsequently leads him to the art gallery.

The visit to the art gallery is informative to Theo because it is where he gets to analyze Alicia’s paintings and decipher the hidden allusions in the art. For instance, the “Alcestis” analogy explains to the reader the reason why Alicia had remained silent after her husband’s murder. Seeing an opportunity, Jean-Felix gives Theo the idea of giving Alicia a brush and canvas so that she can communicate with him. The character of Jean-Felix is, however, portrayed as intrusive and obsessive. He goes to Alicia’s home without making an appointment, and where he even lets himself into the house. He also despised Gabriel because he was jealous that all of Alicia’s attention was focused on him. Gabriel fears that Jean-Felix’s obsessive behavior could be dangerous for both of them — and, thus, he warns Alicia to stay away from him.  

The similarity between Theo and Alicia is also shown in this part of the book. Theo had a traumatic childhood that became the catalyst for his mental illness. He escaped from his family to avoid his abusive and callous father. Theo ends up having to receive psychiatric care just to get over the impact of his abusive childhood — which is how Ruth has been helpful to him. The author also describes how Alicia was pleased that she had gotten away from her aunt’s house as soon as she could; yet, she felt sorry for Paul for having to remain in that household and remain a victim of Lydia’s heartless treatment. The fact that both Theo and Alicia are both haunted by childhood pasts makes them relatable to one other. By highlighting this, the author informs the audience that Theo was adept to aid Alicia in improving her mental health. Having gone through a tough childhood, he understood the impact that it also had on Alicia. The symbolic presentation of Alicia’s diary to Theo, as he informs her that the therapy has been terminated, creates suspense in the reader — and leaves the audience wondering what it will reveal.

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