Alex Michaelides On Writing "The Silent Patient," Uma Thurman's Advice & Plan B Optioning the Movie Rights

When Alex Michaelides (AFI Class of 2004) released his first novel “The Silent Patient” earlier this year, he not only had a taut and spellbinding psychological thriller on his hands, but also a hit novel that debuted at #1 on The New York Times Best Sellers List. Michaelides studied English literature at Cambridge University, received his MA in Screenwriting from AFI and credits Henry James, Hitchcock, Tennessee Williams and Billy Wilder as writing inspirations.


He decided to use his passion for Greek mythology and his real-life experience working at a psychiatric unit as the setting for “The Silent Patient,” which chronicles a woman’s sudden act of violence against her husband, followed by her mysterious silence ― and the therapist obsessed with unraveling her motive. This spring, Plan B acquired the movie rights to develop it as a feature film. In addition to writing novels, Michaelides has also worked as a screenwriter on films including THE CON IS ON and THE DEVIL YOU KNOW.


AFI spoke with him about the resilience it took to write his first novel, the advice Uma Thurman gave him on set and what he took away from his time spent at the AFI Conservatory.


AFI: What was your inspiration behind writing “The Silent Patient”?


AM: I think it was a combination for me of Greek mythology meets psychotherapy. I was inspired by Agatha Christie and Alfred Hitchcock’s classic thrillers and the Greek mythology I encountered in my early teens. It was inspired by the play by “Alcestis” by Euripides, where she dies to save her husband and, when they are reunited at the end of the play, she won’t speak to him and we don’t really know why she refuses to speak. That kind of refusal to concede haunted me.


Then I had to work out how to adapt it. I wanted to update it, but I didn’t know whether it should be a play or a film or a novel ultimately. It was only when I’d worked in a psychiatric unit for a couple of years that I suddenly had the idea to set it in that environment, and everything came together.


I knew I wanted it to be a thriller because I’ve always been obsessed with Hitchcock. I wanted to try and create something like that, so I imagined how he might be watching me over my shoulder as I wrote the novel.


AFI: I found it interesting how you managed to capture the zeitgeist of the Me Too movement in terms of your depiction of the “silenced woman.” Why do you think that concept has resonated so strongly with readers?


AM: When it went to auction for the movie rights, a lot of producers called from L.A. and they said it kind of chimed in well with the Me Too movement. Behind bars, with all of these men surrounding her, trying to control her, and I felt that a woman’s last recourse, when she has no other weapon, is silence. It felt very real to me, and I think that’s why it resonates with a lot of people in using silence as a weapon. It gives them the ability to retain their power.


AFI: Can you talk about that decision to use diary entries to give your character a voice and how you went about writing these?


AM: I knew that I wanted her to be threatening initially. But I knew that if we were going to care about this woman, we had to somehow get inside her head. And so it was a question of withholding access initially and slowly we get more diary entries as we get closer to her.


But in terms of the diary entries themselves, I felt really scared of that part and wasn’t sure I’d know how to interpret her, so I put it off. It was actually the very last thing that I wrote. I wrote the rest of the book. And then I spent a summer walking around a park near where I live in London, taking notes on my phone and essentially trying to get into her mindset and become this character for the diary entries. And then I cut it all up and inserted it. It was a really interesting process.


AFI: What were the challenges of being a first-time novelist? Did you feel the pressure or was it liberating to be writing a novel where you have so much space to explore the interiority of characters, as opposed to a screenplay?


AM: There are two aspects here. One was professionally I felt as a writer on films that it was quite painful for me because everything that could go wrong usually does go wrong in production. I wanted to have a creative project were nothing could go wrong, apart from my own mistakes.


And the other side of it was a friend of mine who’s a critic read it and said that, “films are about contraction whereas novels are about expansion.” By that he means, in a film you have to keep it going full-speed while with a book you can really slow down and get into the character’s head. Discovering that was incredibly liberating, and now I feel much more like a novelist than a dramatist because I think I’m better at entering someone’s head than at staging a scene. I think they’re very different skills.


AFI: What was it like transitioning from writing screenplays to penning a novel like “The Silent Patient”?


AM: It’s interesting because all writers are influenced by film whether they want to admit it or not. I think that AFI particularly had a big influence on me. I was very lucky when I was at AFI and had a really incredible teacher named Allen Estrin who was all about motivation, intention and goal and constantly having to think about that as the DNA of every scene. I think about him and the way that he drummed that into us every day, even now. So that obviously effected me as a novelist — this kind of filmic need to have a constant forward movement.


Before I started writing “The Silent Patient,” I felt like my writing career had not gone very well and it had been quite difficult, and I had a kind of whispering voice in my head telling me to write a novel. So I thought that before I gave up writing altogether, I was going to write the novel that I’d always wanted to write — a detective story, a Hitchcock thriller.


AFI: Was there anything you learned at AFI that helped you in the process of completing your first novel? 


AM: I was fortunate to have Estrin, who was a really good teacher, and I miss that writing group even now. I learned how to structure a story and I got a really good grounding at the Conservatory. I don’t think I could have written the book without it actually, so I owe the AFI a lot. It also just made me feel like a creative person who was worth something. At the time, it was a real validation.


AFI: I heard you were actually in the middle of writing “The Silent Patient” when you were on the set of THE CON IS ON, and you shared the idea with actress Uma Thurman. Did she have any good advice that you applied to your process?


AM: Yes, she had some really good advice. I told her about the character of Alicia, and she said to me, “what does she do?” And I said, “I don’t know.” And Uma said, “She should be a painter because then if she doesn’t speak, that’s her way of getting the unconscious onto the page, and we can communicate through her paintings.” And I thought that was a really brilliant idea, so I went back and rewrote a lot of the book after she gave me that advice.


AFI: Your novel is the first publication from Celadon Books, a new boutique division of Macmillan. Can you talk about how you got your script into the hands of your agent and then your editor Ryan Doherty at Celadon?


AM: Actually this is really interesting because it goes back to my former teacher, Allen Estrin. On my first day, he told us not to go out to parties or to network. He said to just write a really good screenplay and then leave it in a parking lot, and it’ll get made. And that made me laugh so much, but I also thought about that with all of the emphasis on getting an agent. And I didn’t have an agent when I wrote the book. I had actually been dropped by my last agent.


And I didn’t even think about having an agent until I felt that the book was ready for someone to read. So I made it as good as I could and then I went online and found an agency that I thought looked good that accepted unsolicited submissions, and I emailed them the first three chapters. And the next day, an agent asked for the whole book. And then the next week, he asked me to meet him. And a week after that, “The Silent Patient” went to auction in the UK. And then Celadon heard about it from the scouts and called us in London to preempt the sale. It sounds like a fairytale because nothing in my career has ever happened quite like that. It was a dream come true.


AFI: After Celadon came onboard, what was the editing process like?

AM: Ryan Doherty is my editor and he comes from film — he used to work at Sony, so we get along really well. I’d revised it so much because I felt like it was my last shot. I kept printing it out and going over it and making corrections. I did that for about a year, and the corrections didn’t seem to be getting any less so I thought I was going crazy. But eventually they did pretty much stop, so I knew that it was time to get an agent.


When I worked with Ryan, there weren’t many edits to do because I’d already done most of them. But he did say the previous ending didn’t work because it was too rushed, and he made some suggestions. So he ended up fixing the ending for me and had me rewrite it. It was really a wonderful experience working with him.


AFI: With a novel that features a forensic psychotherapist so strongly, how did your experience working at a psychiatric unit influence the novel?


AM: I studied therapy at two different places in the UK, but I didn’t graduate. I ultimately decided I was a writer and not a therapist. I also worked for two years in a psychiatric unit for teenagers as part of my training and then it kind of took over my life. I only left because it got shut down due to all of the budget cuts after the financial crisis.


I didn’t use any of the people from that unit as inspiration for the novel, but I did recognize that I needed an iconic, enclosed location. And I thought, “I know about psychiatric units. I can write about that convincingly, and I can use the emotions I had while I was there.” I didn’t know anything about detectives, but I did know about psychotherapists, so I thought of making the hero into one. A lot of it was about using my own life experience in the writing, which I hadn’t ever done before.


AFI: Can you talk about Plan B optioning the rights to “The Silent Patient” to adapt it into a film and if you’re attached to write the screenplay?


AM: Yes, I’m adapting it, and it’s in development right now. There was a real irony to producers I’d been trying to meet unsuccessfully for the past 20 years suddenly calling me. It was a really lovely moment when that happened. And Plan B makes great movies.


Ultimately, I think it’s important to be flexible. When I was a young writer, I wasn’t flexible. So now I tend to be very adaptable, and I don’t have any ego about taking “The Silent Patient” apart and putting it together in a completely different way for a different medium. Producer Jeremy Kleiner at Plan B is amazing, and I think I will learn a lot from working with him.


AFI: What project are you currently working on?


AM: I’m currently writing my next book so I’ve been doing that for the past few months, and I hope to be done with it by the end of the year. It’s about a series of murders at Cambridge and a Greek Tragedy Professor who is suspected of murdering his students. So, again, it’s about an iconic, enclosed location that I know something about since I went to school there. It’s been really fun. I got an apartment in Paris for the summer, and I just wrote every day.


AFI: For any AFI Fellows and/or alumni interested in writing novels, what were the greatest hurdles for you, and do you have any advice for how to go about breaking in?


AM: The moment you said that, I immediately thought of the Stephen King quote: “writing a novel is like crossing The Atlantic in a bucket.” I think it’s true because it goes on so long and you can’t see land for the longest time, so you just have to trust and keep going. When you’re writing a novel, you really have to cut yourself some slack and be kind to yourself, so you can keep going until you finish.


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