The Silent Patient by Alex Michaelides***

6 March 2022 | ,

Reading date: 01 February – 05 March 2022

The Silent Patient is a good thriller, which should be right up my street. It is smart, well-narrated and features a lot of talking therapy, complete with transference and counter-transference. But I did not love it. Something about it was too neat. It reminded me more of Girl on a Train than The Less Dead. Perhaps I am not drawn to this type of flawed main character, or perhaps some interiority was missing. I also did not completely buy the characters of Ruth (the supervising analysis) and Kathy (the wife). these were either not fully drawn despite their importance in the story, or not consistent.

I would recommend the novel: it is clever and interesting and the setting is fabulous. There are also some quite insightful parts (see below). But I would not re-read it.

Here are some insights on therapy:

babyhood is not a time of bliss; it’s one of terror.


But our ability to contain ourselves directly depends on our mother’s ability to contain us—if she had never experienced containment by her own mother, how could she teach us what she did not know? Someone who has never learned to contain himself is plagued by anxious feelings for the rest of his life, feelings that Bion aptly titled nameless dread. Such a person endlessly seeks this unquenchable containment from external sources—he needs a drink or a joint to “take the edge off” this endless anxiety.


Like therapy, music is about a relationship, entirely dependent on the teacher you choose.

And on love:

intimacy requires the repeated experience of being responded to


“Choosing a lover is a lot like choosing a therapist. We need to ask ourselves, is this someone who will be honest with me, listen to criticism, admit making mistakes, and not promise the impossible?”


how we often mistake love for fireworks—for drama and dysfunction. But real love is very quiet, very still. It’s boring, if seen from the perspective of high drama. Love is deep and calm—and constant.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Silent patient