Twenty-five years since it was first staged, the playwright Sarah Kane’s final play returns to the Royal Court’s Jerwood Theatre Upstairs. Labelled Kane’s “suicide note” by critics (the play was first performed the year after Kane took her own life), 4.48 Psychosis enters into the mind of an unnamed woman struggling with suicidal thoughts, derealisation and poor patient care – horrors made all the more intense by a theatre that sits 80.
First performed before sertraline, Prozac and venlafaxine became part of casual conversation, it is no surprise that the play disturbed viewers. A quarter of a century on, it is still disturbing. And it should be. Kane convincingly portrayed the desperation and urgency of suicidal thoughts. The unnamed woman is played by three actors – all of whom were part of the original cast – at times speaking in unison, finishing each other’s sentences or contradicting one another. The monologues, though, cannot be taken for delirious ramblings – the play’s protagonist is highly intelligent and self-aware, eliciting laughs from the audience.
Her erratic moods are only intensified by Nigel Edwards’ lighting design: the blue and purple washes, low golden lights, the white and greys of TV static cast over the actors after the main character starts taking her antidepressants. The set designer, Jeremy Herbert, gives the audience an alternative perspective through which to watch: a six-panelled mirror, suspended from the ceiling at an angle. You can choose to see the story unfold in front of you, as you would real life, or watch a distorted reflection of it.
“Hatch opens,” say the actors on numerous occasions. But what do they mean? A moment of clarity and relief amid the anguish? A hatch into Kane’s mind in the last few months before she took her own life? Either way, 4.48 Psychosis is a remarkably frank dissection of a mind at war with itself.
4.48 Psychosis
Royal Court, London WC2. Until 5 July 2025
[See also: Thom Yorke’s Hamlet is brilliantly rendered sacrilege]
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This article appears in the 25 Jun 2025 issue of the New Statesman, State of Emergency