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The Silent Patient Book Club Questions

The Silent Patient by Alex Michaelides is one of the best thriller books of recent years, and with so many twists and turns and a charming unreliable narrator, it also makes for the perfect book club pick! If your club has picked it for your next meeting, never fear! We’ve got a summary, themes, and The Silent Patient book club questions to help ensure your discussion is a success!

About The Silent Patient

The protagonist of The Silent Patient is Theo Faber, a criminal psychotherapist who helps patients after they’ve committed a crime and tries to set them on a better path through therapy. At the start of the novel Theo is excited because he’s just landed a new job at The Grove, a prestigious private in-patient facility where some of the most complex criminals are house–including Alicia Berenson. She made the papers for murdering her husband, and then refusing the utter a single word in her defense–or any other words at all, for that matter.

Because of this, she’s declared psychologically imcompetent and is now a resident at The Grove, where she continues to refuse to talk to anyone about anything. Theo can’t help but think that maybe he can get through to her, if he’s just given a chance. And he is given that chance–but both Theo and Alicia have secrets, and when those secrets collide, they’re bound to become deadly.

Themes: truth, trust, sanity, boundaries, silencing voices

The Silent Patient Book Club Questions

Did you trust Theo at any point during this book? Why did you initially believe that he wanted to work with Alicia?

Who did you trust in this book, if anyone? Why or why not?

What did you think about the dual timelines? Did you gravitate to one story over the other?

Who did you initially suspect killed Alicia’s husband? Did you find Alicia to be a sympathetic character?

Discuss Alecestis, and the significance of her inclusion in the narrative. How does Alicia use artwork to make sense of her life, both before and after her husband’s murder?

Discuss the setting of The Grove. Did you think it was a positive place for some of the patients, or a prison? How did the setting influence the mood of the entire book?

Compare and contrast Theo with his coworkers. Do you think he was a good therapist, his preoccupation with Alicia notwithstanding?

Did you think Theo, despite his past, had any healthy relationships?

Communication is important in this book–discuss how the characters communicate, whether it’s through the things they say, write, draw, or don’t say.

This book is, in many ways, about the importance of boundaries and the consequences of what happens when people on both sides cross boundaries. Discuss how Theo’s relationship with Alicia compares and contrasts with Theo’s relationship with his own therapist, Ruth.

Did you figure out the twist before it was revealed? How did you feel when you knew the truth?

 Do you think Theo was driven by a genuine desire to help other people? Or were his motivations never completely pure?

Discuss what Alicia meant by saying that both her husband and her father killed her. 

Did Alicia ever feel like a fully developed character to you, or was she only ever seen as someone that other people (men) wanted to influence or control?

Do you consider Theo a hero, villain, or anti-hero? Knowing his entire story, do you feel sympathetic towards him?

What did you think about the ending? Where do you envision the characters ending up?

Would you consider this book a psychological thriller, or a deep dive into character?

Considering the power imbalance between therapists and patients, do you think the repsonibiity is on the therapist to maintain professional boundaries, or is that the responsibility of both parties involved. Is the patient ever “at fault”?

How do you feel about unreliable narrators in general?

Would you read another book written by Alex Michaelides? Why or why not?

Find Your Next Book Club Read

If you enjoyed this guide and are looking for more great book club selections, check out our best book club picks of 2020! Then sign up for TBR: Tailored Book Recommendations! TBR is a personalized book recommendation service that send you books you’ll love to read.

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