The Silent Patient

by Alex Michaelides

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.

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.

Unexpressed emotions will never die. They are buried alive, and will come forth later, in uglier ways. —SIGMUND FREUD

All kinds of theories have been put forward about the origins of addiction. It could be genetic; it could be chemical; it could be psychological. But marijuana was doing something much more than soothing me: crucially, it altered the way I experienced my emotions; it cradled me and held me safe like a well-loved child. In other words, it contained me.

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.

“Trying to please someone unpredictable, someone emotionally unavailable, uncaring, unkind—trying to keep them happy, win their love—is this not an old story, Theo? A familiar story?”

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.

How terrifying that must be for a child, how traumatizing—how your sense of self-worth would implode, and the pain would be too great, too huge to feel, so you’d swallow it, repress it, bury it.

Over time you would lose contact with the origins of your trauma, dissociate the roots of its cause, and forget. But one day, all the hurt and anger would burst forth, like fire from a dragon’s belly—and you’d pick up a gun.