Alicia Berenson, the titular silent patient of Alex Michaelides’s novel The Silent Patient, never speaks; for six years after the murder of her beloved husband Gabriel (which she may or may not have committed), Alicia is entirely mute, communicating only through the occasional painting or act of violence. For a therapist like narrator Theo Faber, Alicia’s lack of communication is an almost impossible challenge to solve—without speech, how can therapy, which Theo calls the “the talking cure,” ever work? More than that, as someone who himself had been healed through talking about past traumas, Theo sees silence as the ultimate barrier to mental peace and safety.
But fascinatingly, Alicia’s own trajectory through therapy complicates this simple dichotomy. Alicia is an artist, and her artwork often communicates her contradictory feelings just as clearly as any speech would; as her gallerist and friend Jean-Felix puts it, Alicia’s “refusal to comment” is her real message. And when Alicia does finally speak, with a voice “like a creaking gate,” the story she tells Theo is quickly revealed to be a lie. Indeed, by the end of the novel, Theo feels that “the talking cure itself” has failed—and the book’s readers have come to be suspicious of all speech, from Alicia’s falsified therapy monologue to the very words on the page in front of them. For even as The Silent Patient affirms the value of therapy, it also emphasizes that silence can be its own form of communication—and that there are some forms of pain that can never be fully captured by language.
Silence vs. “The Talking Cure” ThemeTracker
Silence vs. “The Talking Cure” Quotes in The Silent Patient
There was a heavy snowstorm that night. My mother went to bed and I pretended to sleep, then I snuck out to the garden and stood under the falling snow. I held my hands outstretched, catching snowflakes, watching them vanish on my fingertips. It felt joyous and frustrating and spoke to some truth I couldn’t express; my vocabulary was too limited, my words too loose a net in which to catch it. Somehow grasping at vanishing snowflakes is like grasping at happiness: an act of possession that instantly gives way to nothing. It reminded me that there was a world outside this house: a world of vastness and unimaginable beauty; a world that, for now, remained out of my reach. That memory has repeatedly returned to me over the years.
God hadn’t abandoned me during my childhood when I had felt so alone and so scared—He had been keeping Kathy hidden up his sleeve, waiting to produce her, like a deft magician.
I felt such humility and gratitude for every second we spent together. I was aware how lucky, how incredibly fortunate I was to have such love, how rare it was, and how others weren’t so lucky. Most of my patients weren’t loved. Alicia Berenson wasn’t.
It’s hard to imagine two women more different than Kathy and Alicia. Kathy makes me think of light, warmth, color, and laughter. When I think of Alicia, I think only of depth, of darkness, of sadness.
Of silence.
Then I walked home, back up the hill, slowly, step by step. It seemed much steeper now. It took forever in the sweltering heat. For some reason I couldn’t stop thinking about the homeless man. Apart from pity, there was another feeling, unnamable somehow—a kind of fear. I pictured him as a baby in his mother’s arms. Did she ever imagine her baby would end up crazy, dirty and stinking, huddled on the pavement, muttering obscenities? […]
Tears collected in my eyes as I walked up the hill. I wasn’t crying for my mother—or myself—or even that poor homeless man. I was crying for all of us. There’s so much pain everywhere, and we just close our eyes to it. The truth is we’re all scared. We’re terrified of each other. I’m terrified of myself— and of my mother in me. Is her madness in my blood? Is it? Am I going to—
No. Stop. Stop—
I’m not writing about that. I’m not.
As we sat there in silence, my head started to throb at the temples. The beginnings of a headache. A telltale symptom. I thought of Ruth, who used to say, “In order to be a good therapist, you must be receptive to your patients’ feelings—but you must not hold on to them—they are not yours—they do not belong to you.” In other words, this thump, thump, thumping in my head wasn’t my pain; it belonged to Alicia. And this sudden wave of sadness—this desire to die, die, die—did not belong to me either. It was hers, all hers. I sat there, feeling it for her, my head pounding, my stomach churning, for what seemed like hours. Eventually, the fifty minutes were up.
Idiot, I thought to myself. You idiot. What was I doing? I pushed her too far, too hard, too soon. It was horribly unprofessional, not to mention totally fucking inept. It revealed far more about my state of mind than hers.
But that’s what Alicia did for you. Her silence was like a mirror—reflecting yourself back at you.
And it was often an ugly sight.
She was right. I have been groping for the right words to express that murky feeling of betrayal inside, the horrible hollow ache, and to hear Ruth say it—“the pain of not being loved”—I saw how it pervaded my entire consciousness and was at once the story of my past, present, and future. This wasn’t just about Kathy; it was about my father, and my childhood feelings of abandonment; my grief for everything I never had and, in my heart, still believed I never would have. Ruth was saying that was why I chose Kathy. What better way for me to prove that my father was correct—that I’m worthless and unlovable—than by pursuing someone who will never love me?
I buried my head in my hands. “So all this was inevitable? That’s what you’re saying—I set myself up for this?”
It was just as beautiful and mysterious as I remembered it. Alicia naked in the studio, in front of a blank canvas, painting with a blood red paint brush. I studied Alicia’s expression. Again it defied interpretation. I frowned.
“She’s impossible to read.”
“That’s the point—it is a refusal to comment. It’s a painting about silence.”
“I’m not sure I understand what you mean.”
“Well, at the heart of all art lies a mystery. Alicia’s silence is her secret—her mystery, in the religious sense. That’s why she named it Alcestis. Have you read it? By Euripides.” [Jean-Felix] gave me a curious look. “Read it. Then you’ll understand.
Christian gave me a doubtful look. “Be careful, mate.”
“Thanks for the warning. But it’s rather unnecessary.”
“I’m just saying. Borderlines are seductive. That’s what’s going on here. I don’t think you fully get that.”
“She’s not going to seduce me, Christian.”
He laughed. “I think she already has. You’re giving her just what she wants.”
“I’m giving her what she needs. There’s a difference.”
“How do you know what she needs? You’re overidentifying with her. It’s obvious. She’s the patient, you know—not you.”
Gabriel keeps asking me how I’m doing—if I’m okay. I can tell he’s worried, despite me insisting I’m fine. My acting doesn’t seem to be convincing him anymore. I need to try harder. I pretend to be focused on work all day, whereas in fact work couldn’t be further from my mind. I’ve lost any connection with it, any impetus to finish the paintings. As I write this, I can’t honestly say I think I’ll paint again. Not until all this is behind me, anyway.
“What do you want to talk about?” I asked.
“I don’t know. Nothing. I just want to talk.”
So we talked. We talked about Lydia and Paul, and about her mother, and the summer she died. We talked about Alicia’s childhood—and mine. I told her about my father, and growing up in that house; she seemed curious to know as much as possible about my past and what had shaped me and made me who I am.
I remember thinking, There’s no going back now. We were crashing through every last boundary between therapist and patient. Soon it would be impossible to tell who was who.
Even worse than the shock or repulsion, or possibly even fear, in Ruth’s eyes as I told her this would be the look of sadness, disappointment, and self-reproach. Because not only had I let her down, I knew she would be thinking she had let me down—and not just me, but the talking cure itself. For no therapist ever had a better shot at it than Ruth—she had years to work with someone who was damaged, yes, but so young, just a boy, and so willing to change, to get better, to heal. Yet, despite hundreds of hours of psychotherapy, talking and listening and analyzing, she was unable to save his soul. Perhaps I was wrong. Perhaps some of us are simply born evil, and despite our best efforts we remain that way.