The Silent Patient Book Summary

Alicia Berenson’s life is seemingly perfect. A famous painter married to an in-demand fashion photographer, she lives in a grand house with big windows overlooking a park in one of London’s most desirable areas. One evening her husband Gabriel returns home late from a fashion shoot, and Alicia shoots him five times in the face, and then never speaks another word.

In this post, we will provide an in-depth summary of this book and also share all the necessary information about the book. Spoilers ahead, watch out, and take care.

The Silent Patient Book Overview

The Silient Patient is a psychological thriller by Alex Michaelides about a dedicated psychotherapist trying to help his patient recover after she refuses to speak following the murder of her husband.
Alicia is the woman who killed her husband in cold blood. She is a talented painter who apparently snapped that fateful night. She has a history of mental health problems following her mother’s suicide.
Theo is the psychotherapist tasked with treating Alicia. He was exceptionally drawn to Alicia’s case following the news of her murdering her husband. Many believe Alicia is a lost cause, but this only inspires Theo even more to get her to speak, which she eventually does.

But from there, things become even more complicated. Theo and Alicia’s patient-therapist relationship continues to blur as Theo tries to find answers about the murder and Alicia herself.

The Silent Patient Book Details

  • Publisher ‏ : ‎ Page Publishing, Inc. (September 11, 2017)
  • Language ‏ : ‎ English
  • Paperback ‏ : ‎ 62 pages
  • ISBN-10 ‏ : ‎ 1640826033
  • ISBN-13 ‏ : ‎ 978-1640826038
  • Item Weight ‏ : ‎ 3.35 ounces
  • Dimensions ‏ : ‎ 5.98 x 0.13 x 9.02 inches

The Silent Patient Spoilers & Full Book Summary

Max Berenson

Theo arranges a meeting with Max Berenson, Alicia’s lawyer and brother-in-law. Max is initially friendly, as they talk about Gabriel, but becomes incredibly cold when Theo brings up Alicia. Max says she is crazy and is wholly responsible for his brother’s death.

As Theo goes to leave, Tanya, who is Max’s receptionist and wife, tells Theo to talk to Alicia’s cousin Paul. He knew her better than anyone. As Max comes back out, Tanya rushes back to him. Theo suspects she’s afraid of Max.
In Alicia’s diary, she writes about Gabriel wanting to invite Max over for a barbecue, which she initially protests but ultimately agrees to.

The night of the barbecue, Alicia confronts Max when they are alone, saying she is going to tell Gabriel that he assaulted her the last time they saw each other. Max says he doesn’t remember, but then proceeds to grab Alicia and forcibly kiss her. She bites his tongue.

Theo calls Max again, asking about details of Alicia’s attempted suicide that Max had mentioned in passing. Max claims he doesn’t remember the treating doctor, as it was kept under wraps. Theo also finds out that Max was the beneficiary of Gabriel’s will, not Alicia. Max hangs up angrily.
Later that day, Diomedes confronts Theo, saying he knows he has been calling Alicia’s relations. Max called Diomedes, claiming Theo’s questioning was a form of harassment, and Theo promises that he won’t do anything like that again.

After work, Theo takes the train to go visit Alicia’s cousin, Paul Rose. The house is incredibly dilapidated, and Paul reeks of whiskey. After he talks to Paul briefly, Alicia’s aunt Lydia calls Theo into her room, where she berates Alicia viciously. Theo leaves, saddened by Paul’s living conditions.

Alicia Berenson

Alicia Berenson was married to Gabriel Berenson. They were both artists: Gabriel was a well-known photographer and Alicia was a painter. Alicia murdered Gabriel, and on the night of his death, Alicia was found with a gun on the floor and Gabriel bound to a chair with wire.
Alicia hasn’t spoken since the murder. She never admitted or denied her guilt; instead, she painted. After only a few days on house arrest, Alicia completed an entire painting, something that normally would’ve taken her weeks. It was a self-portrait titled .

Alicia’s self-portrait was of herself painting, in the nude, days after the murder. The portrait, under much controversy, was exhibited in public.
During Alicia’s trial, Lazarus Diomedes, a professor of forensic psychiatry, testified that Alicia’s silence was evidence she was mad, and her defense claimed diminished responsibility. This was accepted by the judge and jury, and Alicia was admitted to the Grove, a secure forensic unit, under Diomedes’s care and supervision.

Theo Faber

The narrator is named Theo Faber. He felt especially drawn to help Alicia, as he is also a forensic psychotherapist. When a position opened up at the Grove six years later, he promptly applied and got the job.
Theo was told by his previous supervisor that working at the Grove was career suicide. The supervisor had heard the Grove could close down within the year, and had lingering suspicions about Diomedes and his treatment methods.

The Grove

On his first day, Theo meets with Yuri, the head psychiatric nurse; Stephanie, the manager of the Grove; Indira, a therapist who had interviewed Theo for the job; Professor Diomedes; and Christian, another therapist and former colleague of Theo.

Theo has a meeting with Diomedes and asks about Alicia. Diomedes explains that he handled Alicia personally, but she never even looked at him, let alone spoke to him. Theo asks if he can try, and Diomedes agrees, though doubtful he can accomplish much.

Theo meets with Alicia, and talks about how he has been a fan of her work. She doesn’t respond or even acknowledge him. He thinks back to what Ruth, his old therapist, would have done. He feels sorry for Alicia, and he decides to just sit in silence with her.

Theo decides to go through Alicia’s contacts. The first is her aunt, Lydia Rose. The second is her lawyer, Max Berenson, the brother of Gabriel. Lydia hangs up almost immediately once Theo identifies himself, and Max is supposedly out of town. Not a great start.

Theo’s Wife

Kathy, Theo’s wife, was his first experience of love. She brought him out of his introverted self, and turned him into an adventurous man he had never been before. Theo’s previous encounters with partners had never been satisfying – with Kathy, he knew immediately it was love.
Theo feels so incredibly lucky to be with Kathy, and to be completely loved. He can’t think of any two more different women than Kathy, who is an actress, and Alicia. With Alicia, all he can think about is silence.

The Accident

The narrator, now Alicia Berenson, is reflecting in her diary about the summer of her mother’s death, when she was only five years old.
Alicia was strapped into the passenger seat, and her mother drove them straight into a brick wall. Alicia is not sure if it was suicide or attempted murder, but she is saddened by all the pain people have to deal with.

Trouble at Work

Theo asks Diomedes to lower Alicia’s medication, so he can try to reach her. Diomedes informs him that Christian is in charge of her dosage. Christian and Theo used to work together at Broadmoor, but Diomedes picks up on tension between them. Diomedes eventually agrees to ask Christian about it.
Christian enters the nurses’ room as Theo and Indira are enjoying tea. He is immediately hostile towards Theo, aggressively questioning why he came on board when the Grove seems destined to fail. He also brings up that he knows Theo had a problem with Alicia’s dosage.

In Theo’s first session with Alicia after her dosage has been reduced, he can tell she is already more alert and present. But suddenly, Alicia attacks Theo. After a short struggle, Theo is able to alert other nurses and they eventually restrain and sedate Alicia.

Theo has his injuries tended to by Yuri, and then he is called into a meeting with Diomedes, Christian, Indira, and Stephanie. Theo explains to everyone that Alicia attacked, but claims this is her way of trying to communicate.
Christian thinks Theo is being crazy, and Stephanie believes he should stop treating her for his own safety. But Theo still wants to treat her, and Indira agrees that her attack is a sign of progress. Diomedes gives Theo six weeks to get results.

Smoking and Cheating

Theo arrives home to find Kathy, who is an actress, not home yet from rehearsals. He decides to risk it and roll himself a joint. Theo had been smoking weed since his first year of college, where he grew to love the intoxicating high and comfort he got from it, but Kathy doesn’t approve.
Theo gets too stoned and accidentally knocks over Kathy’s laptop on the way to the couch. When he picks it up, he sees explicit, sexual emails being sent between Kathy and someone named BADBOY22. He becomes sick to his stomach.


A few days later, Theo still hasn’t confronted Kathy. He walks around London aimlessly, until he notices he is only a few doors down from his old therapist Ruth. He knocks on her door, and she lets him in.
Theo sits down and tells Ruth everything, about how he started smoking marijuana secretly again and how he stumbled upon Kathy’s affair. Ruth listens intently, just like she always did, but Theo can’t answer what went wrong between him and Kathy.

Ruth tentatively explains to him that perhaps Theo might be replaying his childhood relationship with his father, trying to please someone who doesn’t love him, with Kathy. She tells him he has to leave Kathy, and Theo agrees.
Theo returns home, and Kathy confronts him immediately about the weed he left out on the counter. Unsure of what to say, Theo suggests they just go to bed, and does not bring up her affair. He decides the next morning that Ruth was wrong.


Theo visits the gallery that had shown Alicia’s art, and meets her old friend Jean-Felix Martin, the owner of the gallery. Theo asks about Jean-Felix and Alicia’s relationship, and suggests that Gabriel might have been jealous of it. Jean-Felix responds defensively.
Theo continues to question Jean-Felix, which he continues to deflect until deciding to show Alicia’s artwork to Theo. These include her self-portrait . He suggests that if Theo wants to get her to talk, he should have her paint again.


Theo decides to read the play . In it, a man is condemned to die, but will be spared if he can convince someone else to take his place in Hades. Alcestis, his wife, volunteers. For her sacrifice, she is spared, but returns from Hades unable, or unwilling, to speak.
Theo talks with Diomedes about the play. He doesn’t understand why Alcestis would stop talking, and Diomedes tells him she doesn’t talk because she is angry. She is angry about the betrayal of her husband. Theo connects that back to Alicia and Gabriel.

Theo, with Diomedes’s permission, takes Alicia out of group art therapy, and asks if she wants to paint by herself in private. She doesn’t say anything, but lets out a small smile.
With Yuri’s help, Theo gets a room set up for Alicia to paint by herself. She immediately gets to work and over the course of a few days, she paints a photo-realistic image of the Grove, burning to the ground.


Theo meets Barbie, Alicia’s old next-door neighbor, who comes to visit her at the Grove. They meet again that night, but Theo finds it difficult to keep Barbie focused on Alicia, as she constantly falls into monologues about herself.
Barbie eventually tells Theo that Alicia came to her one night before the murder and told her she was afraid of someone watching her. Barbie pulls up photo evidence of this mystery man, but all Theo can identify is a grey blob behind a tree.

The Fight

The next day, Theo comes into the Grove hearing screams. Rushing to the noise, he sees Elif, another patient, with a paintbrush impaled into her eye socket. Alicia is being restrained, but she is unmoving and emotionless.
Theo investigates Alicia’s studio and finds that her painting had been defaced. He asks Elif what had happened, and she says Alicia didn’t attack because of the painting, but because she was taunting Alicia about Theo, and how he was in love with her.
After the incident, Theo is no longer allowed to meet with Alicia. But in their farewell meeting together, although she is in a drugged haze, she hands him her diary.

The Diary

In her diary, Alicia notices a man outside of her house, staring directly at her. She becomes unsettled, and goes down to her studio to paint. When she comes back up twenty minutes later, he is gone. When this keeps occurring, and Alicia tells Gabriel, he only half believes her.
Per Gabriel’s request, Alicia goes to see Dr. West, who’s a friend of his that she also saw after her father’s suicide. Dr. West suspects she is having a psychotic episode similar to the one she had after her father’s death, but Alicia swears this time is different.

Alicia believes Max is the man following her, but when she questions him about it, it’s clear from his reaction that it isn’t him. The next day, Alicia hears a noise outside, followed by someone entering the house. She writes she is terrified.

Dr. Christian West

After absorbing what Alicia had written in her diary, Theo realizes that Christian’s last name is West, and he was the one treating Alicia secretly. When Theo confronts him, Christian admits it, saying he was a friend of Gabriel, but could lose his job and license if Theo tells anyone.
Theo asks Christian about Alicia’s mental state before the murder, and Christian explains she was always paranoid, delusional, and psychotic, but it got worse after her father’s death. Christian doesn’t believe the man watching her is real.

Theo secretly meets with Alicia, and gives her diary back. He asks her more questions, but she remains silent. He leaves, telling her he is still going to investigate what happened to her, and that he is on her side.
Theo also secretly follows Kathy as she goes on a walk. She meets a man, whom she kisses passionately. Theo follows them into the woods where they have sex. Theo overhears everything, and he begins thinking he should kill that man.

The Past

Theo meets with Paul, and asks him why he lied about the last time he saw Alicia. In their first meeting Paul had said they hadn’t seen each other in years, but in Alicia’s diary they met just a few weeks before the murder.
Paul confesses, and is about to tell him something that Alicia did the night after her mother’s car accident, but decides he wants to show Theo instead. They go back to Paul’s house and climb onto the roof.
Paul explains that the night after Alicia’s mom died, Paul and Alicia hid on the roof and overheard Alicia’s father say he wished Alicia had died instead. Theo realizes this was the source of Alicia’s trauma, and this would be how he could reach her.

Theo speaks with Alicia, telling her what he learned from Paul. He says what her father did to her was equivalent to psychological murder. Suddenly, Alicia speaks. After the session, Theo tells Diomedes, and they agree he should continue seeing Alicia.
The next day, Alicia tells Theo that she couldn’t speak the days after Gabriel died, even if she tried. When she did eventually regain her voice, she found it pointless to speak.

The Murder

At the next day’s session, Alicia begins with the day of Gabriel’s death. She was painting, and she saw the reflection of the man in her studio. He was wearing a black mask and had a knife. He led her back into the house.
Alicia reached for a gun, but the intruder had already gotten it. Gabriel called, and told Alicia he’d be getting home late that night, which the intruder overheard. He tied Alicia to a chair with picture wire, and waited until Gabriel got home. When Gabriel arrived, the intruder knocked him out with the gun. He then tied Gabriel to the chair, shot him six times in the face, and left without saying a word.

Theo concludes the session, and knows that Alicia was lying about that entire story. There were many discrepancies between her story and what the police found, and Theo goes to tell Diomedes, who agrees with him.
Theo follows Kathy once again on her walk, and sees her meet with her lover. When they split up, Theo follows the man home, and learns he is also married. He wants to kill him, but thinks he needs a more clever plan of revenge.


Theo comes into the Grove the next day to find out from Yuri that Alicia has overdosed. She is alive, but in a medically induced coma. Alone in the room with Alicia, Theo notices a tiny mark on her wrist, and knows that she was injected with morphine.

Theo is called into a meeting with Diomedes and Stephanie. Theo informs them of the injection point, as well as Alicia’s diary. He also reveals that Christian saw Alicia as a patient before the murder. The police are called in.
Theo talks about when he was following his wife’s lover. He took note of the man’s wife, whom he wanted to talk with. He watched her for a couple days outside her home, and eventually entered unannounced. He says this was the first time he met Alicia Berenson.

Alicia’s Voice

In Alicia’s diary, she writes that she recognized Theo as her intruder when he came into the hospital. That is why she attacked him during their first meeting. When she lied about what happened to Gabriel, she knew that Theo knew she recognized him. She writes this after Theo drugged her.
Alicia writes that Theo tied her to a chair the night of Gabriel’s murder, and eventually did the same to Gabriel, having them sit back-to-back. He told Gabriel he had to choose who died, him or Alicia. As Theo counted down, Gabriel said he wanted to live.

Theo shot into the ceiling, making Gabriel think that he had shot Alicia. Alicia remained silent as Theo left. She untied herself, and shot Gabriel in the head. She writes that Gabriel killed her that night, and she just pulled a trigger.


Theo and Indira are clearing out Alicia’s room, as she is unlikely to recover. Theo thinks about that night, and how he never thought Alicia would kill Gabriel after he left. He wanted her to see the truth just as he did with Kathy, and to stop the lies. But he wouldn’t have done it if he had known about Alicia’s mental state.
When Indira leaves the room, Theo searches through everything, trying to find Alicia’s diary. He can’t find it anywhere.

The Aftermath

Theo has moved back into his parents’ house with Kathy. Kathy has become increasingly withdrawn and depressed, but still remains quiet about her affair with Gabriel. Theo finds it ironic he did all of that to Alicia to keep Kathy, yet he has still lost her.
That night, the doorbell rings and it’s the chief inspector in charge of Alicia’s case. The inspector tells Theo that Jean-Felix came to collect Alicia’s artwork, and found Alicia’s diary inside the painting of the burning Grove. The Inspector begins to read it aloud to Theo.
Theo feels relieved he is caught, and relaxes as the inspector reads Alicia’s writing about Theo drugging her.

The Silent Patient Book Reviews

Wow, I’m still reeling from that ending! A mindblowing, to-die for twist!

A fast read that kept me intrigued from beginning to end, although the shocker came at the end. Wait……wait……what just happened? This was how I felt as a read the last few chapters!

Holly Via Goodreads

THE SILENT PATIENT is a deep, dark tale of murder, love and revenge. This is a contemporary story steeped in a deliciously gothic tone. At the beginning of the book, we have a vicious murder, a frightening asylum setting for the criminally insane, and a suspect who refuses to speak. When Theo steps in to save the day as psychotherapist to the silent Alice, well….you are in for a twisted treat, so I can’t divulge anymore!

Jewels Via Goodreads

I thought I had ordered the Silent Patient. Someone maybe being clever used this title to sell their book, what a disappointment.
It is inspiring. But it is written in no set timeliness and goes back and forth, prepare like notes or a first copy. This book was not ready for print I wouldn’t think

Barbara Via Amazon

About the Author

Alex Michaelides was born and raised in Cyprus. He has an M.A. in English literature from Trinity College, Cambridge University, and an M.A. in screenwriting from the American Film Institute in Los Angeles. The Silent Patient was his first novel and was the biggest-selling debut in the world in 2019. It spent more than a year on the New York Times bestseller list and sold in a record-breaking forty-nine countries. Alex lives in London.


We hope you enjoyed this book summary which we have shared. If you enjoyed this book summary, make sure to purchase the book! Doing so will allow you get a firsthand experience of the book.

Leave a Comment