Barnes & NobleThe Silent Patient by Alex Michaelides

A thriller about power, not madness

The Silent Patient was my first real experience with an unreliable narrator in a thriller, and it left a lasting impression. I was immediately invested in uncovering why Alicia Berenson killed her husband—not just the act itself, but the psychology behind it. As a therapist, I found myself especially drawn to the therapeutic process and the methods used to try to draw Alicia out of her silence. What makes this novel so effective is how thoroughly it pulls the reader into that search for meaning. I was convinced the answer lay in Alicia’s mind—her trauma, her mental health, her past. When the truth was revealed, I closed the book in genuine disbelief. The realization that Alicia was not “crazy,” that she truly was being watched and stalked, reframed everything that came before it in a deeply unsettling way. The novel becomes particularly chilling when viewed through a professional lens. The abuse of power, manipulation, and ethical violations embedded in the story linger well beyond the final page. While I don’t believe this level of exploitation is the norm in therapeutic spaces, the idea that it can happen—and does happen—gave me a lasting sense of unease. Despite the heaviness of the themes, this was a fast-paced read for me. The urgency of wanting answers kept me turning pages quickly. Other readers may not experience the same emotional weight, especially without the professional connection I felt, but the tension and payoff are undeniable. Oddly enough, I found the experience comforting in the way good thrillers often are. I take comfort in being unsettled, and this is a book I would absolutely reread—if only to sit in that discomfort again.