Michaelides (who holds a master’s degree in psychotherapy) uses the novel to critique the therapeutic relationship. Theo claims to want to help Alicia, but he violates every boundary in the book. He lies, manipulates, and ultimately uses her for his own psychological closure. The novel asks: Is therapy about curing the patient, or about the therapist curing themselves?
Michaelides, who has a background in Greek mythology, weaves the myth of Alcestis into the fabric of the plot. Like Alcestis, who returns from the dead and remains silent, Alicia’s quietude feels ancient and heavy with meaning. The Silent Patient