The Silent Patient

by Alex Michaelides

ALCESTIS IS THE HEROINE OF A GREEK MYTH. A love story of the saddest kind. Alcestis willingly sacrifices her life for that of her husband, Admetus, dying in his place when no one else will.

The real motivation was purely selfish. I was on a quest to help myself. I believe the same is true for most people who go into mental health. We are drawn to this profession because we are damaged—we study psychology to heal ourselves.

The development of our personalities doesn’t take place in isolation, but in relationship with others—we are shaped and completed by unseen, unremembered forces; namely, our parents.

Somehow grasping at vanishing snowflakes is like grasping at happiness: an act of possession that instantly gives way to nothing.

I don’t miss those druggy partyers who passed for friends during my twenties. I only ever saw them at night—they vanished at dawn, like vampires fleeing the light. When I met Gabriel, they faded away into nothing, and I didn’t even notice.

The psychoanalyst W. R. Bion came up with the term containment to describe a mother’s ability to manage her baby’s pain. Remember, babyhood is not a time of bliss; it’s one of terror. As babies we are trapped in a strange, alien world, unable to see properly, constantly surprised at our bodies, alarmed by hunger and wind and bowel movements, overwhelmed by our feelings. We are quite literally under attack. We need our mother to soothe our distress and make sense of our experience. As she does so, we slowly learn how to manage our physical and emotional states on our own. But our ability to contain ourselves directly depends on our mother’s ability to contain us—if she had never experienced containment by her own mother, how could she teach us what she did not know? Someone who has never learned to contain himself is plagued by anxious feelings for the rest of his life, feelings that Bion aptly titled nameless dread. Such a person endlessly seeks this unquenchable containment from external sources—he needs a drink or a joint to “take the edge off” this endless anxiety.

“Choosing a lover is a lot like choosing a therapist. We need to ask ourselves, is this someone who will be honest with me, listen to criticism, admit making mistakes, and not promise the impossible?”

“About love. About how we often mistake love for fireworks—for drama and dysfunction. But real love is very quiet, very still. It’s boring, if seen from the perspective of high drama. Love is deep and calm—and constant. I imagine you do give Kathy love—in the true sense of the word. Whether or not she is capable of giving it back to you is another question.”

one of the hardest things to admit is that we weren’t loved when we needed it most. It’s a terrible feeling, the pain of not being loved.”

love that doesn’t include honesty doesn’t deserve to be called love.”

Perhaps some of us are simply born evil, and despite our best efforts we remain that way.