4:48 Psychosis

Theatre, Drama
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4:48 Psychosis
Photograph: Andre Vasquez Lucy Heffernan in 4:48 Psychosis

Sarah Kane's confronting final play, about the darkness of depression, comes to the Old FItz

The first thing you need to know about 4:48 Psychosis is that it focuses narrowly and completely on major depression and suicidal ideation. It isn't uplifting and it may be difficult to watch if these issues are sensitive for you.

4:48 Psychosis is British playwright Sarah Kane’s final work, and it’s become entrenched in its own morbid mythology – Kane died by suicide shortly after submitting the play to her agent along with a note saying writing it had killed her. When it premiered in London a year later, critics found it understandably difficult to review. “How do you judge a 75-minute suicide note?” asked longtime British critic Michael Billington.

At the Old Fitz, directed by Anthony Skuse, the play is now an hour long, but it is still a difficult one to judge. It’s informed directly by Kane’s major depression (she often woke at 4:48am when depressed) and her sense of disconnection from the world and from feeling. There’s no denying the honest heft of the script – it feels too real to be fiction. 

The play is more of a tone poem meditating on depression than it is a structured dramatic work. There are no assigned lines or characters; there are no stage directions; there is no set location. Each director and company has an enormous amount of license to interpret the play and shape it as best suited for its audience.

Here, Skuse has divided the loose-structured play among three distinct parts. Three women – played by Lucy Heffernan, Ella Prince, and Zoe Trilsbach-Harrison – share the stage. They are the same woman. Sometimes Trilsbach-Harrison is the woman’s many doctors, or even perhaps just one doctor (it’s ambiguous) but what’s clear is that we are to regard the women as a unit, a multi-faceted approach to an individual, suffering.

The women are bored. They don’t want to die but they can’t bear to live. They love someone they have never met, and feel deprived of love; they feel unloved, unknown, and alone. The banal grotesqueries and deeper traumas of life are equally unbearable. We know that this is how the woman feels because she tells us repeatedly how she feels. We must bear witness to her experience. We have no choice – there’s nowhere else to look. Sometimes the language slips into cliché and simplicity, but how many ways do we truly have to express “I am sad” outside those we’ve heard a million times over? Sometimes common phrases are the best way to be communally precise.

Much of the play’s life rests on the shoulders of lighting designer Alexander Berlage. Jeremy Allen’s set design creates a landscape of nowhere (mirrors reflect our faces and fleeting, illusory versions of each woman), and it’s the way Berlage shapes shadows that directs our moods and our focus. Spotlights break through the darkness to illuminate the face of each woman when it’s their time to speak, but they are always partially obscured by the dark; harsher lights flicker and die out, rising and falling with the text.

Benjamin Freeman’s gloomy soundscape and Skuse’s sense of tension and timing support and enhance the lighting; as a whole, the result is both ominous and repetitive.

There’s a dull affect to the whole production which seems apropos for a show about depression, but also, uneasily, can make us bored. And how can we be bored by what seems like it’s the painful end to a life? What does it mean that we can’t easily sit with someone else’s discomfort for an hour?

Heffernan, Prince, and Trilsbach-Harrison give studied, wrung-out performances as the woman in pain. Heffernan’s performance places emphasis on the bodily manifestation of depression; as the play opens, she slowly and with effort tries to lift her body from the floor, dress, and be upright. Prince is more coiled and intense; she bites out her despair – Heffernan and Trilsbach-Harrison are allowed sardonic gallows humour but Prince screams her frustration, anger, and turmoil directly at us. 

Trilsbach-Harrison is the most outwardly composed, frequently shifting into the role of medical professionals. Over and over again, we see those professionals fail our woman, and her death seems like a foregone conclusion. From the beginning, Heffernan and Prince are barefoot; when Trilsbach-Harrison removes her shoes and curls into herself on the ground, it’s a small, but final break: that last boundary crossed, that last lifeline lost.

4:48 Psychosis is not supposed to be an easy watch. Expect to feel uneasy. Expect to look uncomfortable ideas, and nakedly honest pain, right in the face. Don’t expect a reprieve. Sometimes, in life, we just don’t get one.

By: Cassie Tongue

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