The Silent Patient

The Silent Patient (2019) is a contemporary psychological thriller from author Alex Michaelides. It tells the story of Alicia, who killed her husband, Gabriel, six years earlier—and hasn’t spoken since. The bulk of the novel takes place in the present-day, narrated by Theo Faber, a forensic psychoanalyst who recently began working with Alicia at The Grove, the psychiatric hospital where she resides following Gabriel’s murder. The novel uses the epistolary technique, interspersing Theo’s narrative with excerpts from Alicia’s old diary, a written narrative from the past that recounts the weeks running up to Gabriel’s murder. These two narratives ultimately intersect in a plot twist that reveals that Theo and Alicia have a shared past that is far more personal than the simple doctor-patient relationship first presented.

Alex Michaelides is Cypriot American author and screenwriter. He resides in London, where The Silent Patient is set. Upon publication, the novel went to the top of the New York Times bestseller list. This study guide refers to the Astramare Ltd Edition version, published in 2019.

Content Warning: The source material and guide feature depictions of emotional and physical abuse, substance use, sexual violence, mental illness, suicidal ideation, death by suicide, and death.