“I was disconnected from my emotions, like a hand severed from a wrist”: Trauma, Plasticity, Unprecedented Identities and Coolness in Alex Michaelides’ ‘The Silent Patient’ – S. Kirubakaran


The last few decades have seen an increase in the research on human memory. Human brain is an extremely complicated and a unique device among the living beings. The topics covered are Plasticity, Unprecedented Identities and Coolness in correspondence to trauma, which are depicted in Alex Michaelides’ novel ‘The Silent Patient’. The characters in the novel go through various psychological conditions. Literature is an important field of introspection on memory studies. A fiction is an amalgamation of realities and possibilities. The articulation of absence in a fiction makes it a cognitive medium, for the interplay of Memory Studies and Medical Humanities. A rigid understanding of remembering and forgetting is achieved through a critical study.

Keywords: Literature, Memory Studies, plasticity, remembering, forgetting

Trauma is the emotional and psychological response to a disturbing event. Alex Michaelides’ novel, The Silent Patient, abducts the encounter between a trauma victim Alicia Berenson and her psychotherapist Theo Faber. He is convinced that he could successfully treat Alicia, does not speak after her traumatic experiences. The forensic psychotherapist employs all his psychotherapeutic expertise, and makes her speak. Gabriel, Alicia’s husband is murdered six years before Theo Faber starts to treat her. 

Alicia’s trauma lasts for a long period of time. According to research, “Trauma is commonly understood as some terrible event(s) a person undergoes that can cause continual residual psychological suffering” (Casper & Wertheimer, 2016, p. 82). Alicia remains silent, for a long period of time owing to her traumatic experiences. Other than Theo Faber, all psychotherapists consider her mad. This research paper aims to assess the invocation of Trauma, inducing Neuroplasticity, Unprecedented Identities and Coolness as proposed by Catherine Malabou. Her philosophical framework, helps in the textual location of a traumatized subject by looking at the ontology of the wound. It offers a poststructuralist understanding of mental trauma, in opposition to the classical understanding of trauma and mental injuries. 

Neuroplasticity is the quality of the nervous system, to modify its activities in accordance to the immediate environment. Plasticity makes us resistant to injuries. It makes us, extend our creative and recreative faculties. The subject’s identity before and after the accident, has not any relationship always. This condition is observed as, “It is entirely possible that there will be no relation between the identity that comes before a lesion or trauma and the identity that comes after, that, once again, the new identity will be unprecedented” (Malabou, 2012a, p. 19). Cerebral lesions affect neural operations, which leads to the alteration of a subject’s identity. This alteration could happen in such a way that, the subject could not even recover its former identity

The change of personality is evident with Alicia. The contradiction of her own personality, pre and post traumatic happenings, is well captured in the novel. Alicia can be seen embodying a different personality, which is clearly unprecedented. It is observed as, “when connections change, personality, too, can change” (LeDoux, 2003). The prominent incident in connection with Alicia’s change of personality is linked with her husband Gabriel’s murder. Her emotions run wild in Theo Faber’s sessions. She has a murderous rage to kill Theo Faber. She behaves in a very aggressive way with her fellow patients, in contradiction to her earlier personality of remaining a soft and kind person. 

The difference between traumatic memory and narrative memory is represented as: The traumatic memory recurs involuntarily against the wishes of the rememberer, in contrast to our studied efforts to remember what we have forgotten or dreaming reverie. In traumatic memory, the past defines and determines the present actions and thinking of the rememberer, whereas in normal remembering the needs of the present determine what is called up associationally from the past (Leed, 2000, p. 87).

Alicia used to write in a diary, before killing her husband Gabriel. This act is seen as her earlier ability to textually narrate her memory in a notebook. After the traumatic murder episode, she completely forgoes writing in her diary. She cannot voice out her narrative memory both textually and orally, post her lesion. So, the traumatic memory leads her to depression. 

The unprecedented appearance of a new identity is potentially the difference between the Freudian hypothesis of plasticity and Malabou’s hypothesis of plasticity. The contemporary understanding of neurology and brain wounds elucidates that psychic life cannot resist destruction always.  So, the psyche is impacted by a negative plasticity condition, which forefronts the appearance of a new identity. According to research, “This negative plastic power consists in the transformation of the patient’s previous personality and in the emergence of a new individual proceeding from the explosion of the former identity” (Johnston & Malabou, 2013). The unprecedented new identity of Alicia puts the Freudian definition of plasticity at stake. Therefore, a complete return to an earlier state after mental diseases cannot happen. Alicia draws a self-portrait of Alcestis, a princess in Greek mythology. Theo Faber takes this as Alicia’s willingness to speak of her traumatic memory. He clearly understands that a complete return of Alicia, to her earlier state is impossible. This understanding of her Plastic Self, helps him to take Alicia out of her depression. 

Encephalopathy leads to the distortion of old identity, but the psyche still survives to breath with new traits. This survival is neither redemption nor resurrection. Rather, it leads itself to the manifestation of an escape from life. The subject finds it very difficult to emote with others. Alicia undergoes this catastrophe. She is completely absent from her life, insulting herself without talking to others. Her life is not the same, after the loss of her earlier identity. 

Change in personality traits, is an important aspect after a traumatic lesion. Alicia’s old self, took weeks and months before starting to sketch a new picture. Post the trauma, modification is seen in her creative faculty. Her portrait after Gabriel’s murder, is completed within a few days. The change of identity, after the lesion is clearly spotted. Her primitive self of consuming enormous time to draw a portrait is replaced by a quick completion. It is represented in the novel as, “Now, however, she drastically altered her creative process, completing this painting within a few days of her husband’s murder” (Michaelides, 2019, p. 10).

The further plasticity clash between contemporary psychopathology and the conventional psychoanalytic models, has its breaking point in regression. It is observed as a person’s return to his previous state. While the Freudian hypothesis insists on regression, contemporary neuroscience excludes it. Alicia’s behaviour cannot be considered simply as a return to her previous state. Her changes do not regain anything familiar. She has not returned to her primitive psyche. This affirms the importance of mapping Literature with Malabou’s hypothesis. According to Malabou (2012b):

The nature of the changes in personality caused by brain damage excludes the possibility of interpreting them as forms of regression. Indeed, these changes do not allow patients to return to a previous state, to seek refuge in a past of any kind, or to find even the most precarious relief in the labyrinth of their psychic history. When a psyche is shredded, it corresponds to the birth of a new, unrecognizable person. Such phenomena demand new forms of treatment that would no longer be based on the investigation of the past, the exploration of memory, or the reactivation of traces (p. 48).

Theo Faber points out the lapses in Freudian understanding of plasticity and memory. He says, “It means I think Freud was wrong about a couple of things. I don’t believe a therapist can ever really be a blank state, as he intended” (Michaelides, 2019, p. 99). This proves his understanding of the mind that, all thinking is biased in some way or the other. He finds out Alicia’s bias towards painting. This makes him, emote her smile after the lesion. 

Accidents and sudden shocks lead to Decisive Psychic Repercussions, which incarnate themselves as changes in personality. Theo Faber understands Alicia’s rage and anger as a means to communicate with him. He calls it as a powerful mode of communication. 

The unprecedented identity of Alicia leads her further to Postlesional Plasticity. The formation of a new identity is through destruction, with loss as its ally. Theo Faber clearly acknowledges her bothering. He has successfully treated Alicia, because, he spots the destructive plasticity phenomenon in her. It is pointed when the alteration of character happens. This condition takes birth, only when there is no escape left. It has put herself in void, unable emote her feelings. So, she takes the embodiment of being silent completely.

Theo Faber himself is healed by psychological science, in his early life. In Theo Faber’s case, a most fundamental level of cognitive crisis is spotted. He has a traumatic relationship with his father. Theo decides to move away from him. He has always been traumatized in his father’s presence. When he is at his university, he realizes that, a new being is born out of himself. Further, the identity of this new being is something, which he cannot realize. This phenomenon is observed as, “What destructive plasticity invites us to consider is the suffering caused by an absence of suffering, in the emergence of a new form of being, a stranger to the one before” (Malabou, 2012b, p. 18).

In severe cerebral pathological cases, Destructive Plasticity, creates a new identity with the loss of an old one. All of the transformations have its source in destruction. Being a survivor of trauma, Theo Faber fails to emotionally connect, both within himself and the external world. Here, a new identity is created within himself. He is unable to establish a connection to his original subject. An identity without childhood is created. According to Malabou (2012b), “Plasticity is only evoked when there is a change in the volume or form of neuronal connections that impacts the construction of personality” (p. 3). A flaw in the neuronal activities of Theo Faber is visible.

Emotion and cognition are directly proportional to each other, as it affects the decision-making process. Without an affect, reason and cognition cannot co-exist. Cognitive processes like language, memory and reasoning are attached to the subject’s emotive quality. Malabou’s definition of coolness is mapped with Theo Faber’s unemotive quality. It is the subject’s inability to be affected by bothering events. This detachment from stimuli is a severe psychological disaster. Theo Faber is exactly affected by this issue, as his ability to emote goes away. He cannot empathize with people around him, and to an extent with his very own self. In his session with the psychotherapist Ruth, he confesses his painful memories and suicidal thoughts. He admits that his psychotherapist sheds tears after hearing about his past. But he does not weep, as he cannot relieve the original moment of his trauma. Even though he feels like crying, he is unable to perform it as the wound in his mind is so fresh. His inability to mourn for his own self, also indicates a failure of phallic performance. Thus, masculinity crisis comes into action along with cognitive crisis.   

Theo Faber’s cognitive crisis of empathy acts at two levels. It includes both medical quality and social quality. His unaffected mentality, makes him detached from everything. He acknowledges that, even though he mouthed his painful distressed memories, he is unable to feel anything.  Malabou calls this condition of being unable to be wounded, the new wounded, offering a new definition for mental wound. Theo Faber finds a new person being born out of himself. This further leads to a form of his absence. This phenomenon is spotted as, 

“We must find a way to think a mutation that engages both form and being, a new form that is literally a form of being. Again, the radical metamorphosis I am trying to think here is well and truly the fabrication of a new person, a novel form of life, without anything in common with a preceding form” (Malabou, 2012c, pp. 17–18).

The Plastic nature of a psyche is a never-ending process. It can mutate into anything and everything, given the nature of the destruction that strikes. When Alicia’s psyche is unable to find the right balance between remaining the same, and the ability to change, Theo Faber’s new treatment methods came to help. He found that her silence in itself is a manifestation of her trauma. As she cannot digest her trauma, and come to terms with it, she is struck. His understanding of plasticity helps her to narrate her trauma and confess her guilt. Making entanglements of memory, trauma, plasticity and articulation of absence, Alex Michaelides’ novel weaves a psychologically dense plot. As intense psychological conditions and situations are compiled, exploring them through memory studies becomes valuable. Thus, the appearance of unprecedented identities is surfaced out, as the novel makes way for the collusion of realities and possibilities.  It clearly captures trauma, plasticity and the articulation of absence in it: “I was disconnected from my emotions, like a hand severed from a wrist” (Michaelides, 2019, p. 20).


Casper, M. J., & Wertheimer, E. (Eds.). (2016). Critical trauma studies: Understanding violence, conflict and memory in everyday life. New York University Press.

Johnston, A., & Malabou, C. (2013). Self and emotional life: Philosophy, psychoanalysis, and neuroscience. Columbia University Press.

LeDoux, J. (2003). Synaptic self: How our brains become who we are. Penguin Books.

Leed, E. (2000). Fateful memories: Industrialized war and traumatic neuroses. Journal of Contemporary History, 35(1), 87. https://doi.org/10.1177/002200940003500108.

Malabou, C. (2012a). The new wounded: From neurosis to brain damage (S. Miller, Trans.; 1st ed.). Fordham University Press.

Malabou, C. (2012b). The ontology of the accident: An essay on destructive plasticity (C. Shread, Trans.; 1st ed.). Polity.

Michaelides, A. (2019). The silent patient (1st ed.). Orion.

S. Kirubakaran is a Freelance English Tutor and an Aspiring Research Scholar. He has completed his Master’s Degree in English Language and Literature from Bharathidasan University, Tiruchirappalli. He is a University Rank holder, both in his UG and PG. His research interests include Memory Studies, Medical Humanities, Cultural Studies and New Historicism. He hails from the city of Thanjavur, Tamil Nadu. Email: kirubasharvan@hotmail.com