Sarah Kane’s 4.48 Psychosis: ‘It’s not for everyone. But I feel very alive when I watch it’

I t’s the final play Sarah Kane wrote before she killed herself at the age of 28. A crafted work of art and a philosophical inquiry into suicide , 4.48 Psychosis is like a bolt of lightning in its purity and intensity. At the same time, it’s hard to get away from the idea it’s a suicide note.

That’s not the only reason it’s so challenging to put on. It has no named characters and no stage directions. Instead, Kane, who died in 1999, gives us a fragmented text out of which different voices seem to rise and recede, something like the shifting speakers of the TS Eliot poem The Waste Land.

The germ of the idea for Tom Creed ’s bold new staging, which stars Marty Rea , came to him while watching a student production of 4.48 Psychosis at the Lir. Eight actors shared the text in a large ensemble production, with video, moving sets, blood and cutting.

It was the first time Creed had sat with the play since directing it in 2005.

“I found myself thinking about the play again and thinking back to the work that I’d done on it 20 years previously, and I just had a hunch to come back to it again.”

The first time he put it on with three actors, “because I couldn’t come up with a better idea,” he says drily. There’s good precedent for that approach: a note Kane left with the draft that said, “Remember: victim, perpetrator, bystander”, informed the use of three actors in the first London production.

Subsequently that became something of a performance tradition. Other productions have used a single performer with a doctor, including a French production with Isabelle Huppert.

Creed traces the approach back to a particularly 1990s strain of theatre, and works such as Martin Crimp’s Attempts on Her Life, “the idea of a fragmented self being presented by multiple actors.”

This time around, though, another understanding of the play was revealed. “This is an expression of one consciousness,” Creed says. “We should hear it from one person, and we should only be looking at one person on the stage.”

The empty space Kane leaves around the text, he wondered, might not be a postmodern invitation to fill the stage with video, scenography and action at all. “What if we took it seriously that the idea of this play is just a text,” he says, “then what we did was just present a text?

“When you have just one person onstage speaking it, it’s a conversation with a doctor and a conversation with a lover and a conversation with an audience and a conversation with critics and a conversation with public opinion, all at once. That’s very like psychotic states, which are characterised by the busyness of your thinking.”

That pared-back approach has made most of the rehearsal process extremely technical, involving close reading, “working on the particular emphasis of a word, or why a word is there rather than another, how it sets up the line to follow, what it means to have a line break. Our approach has been strict. It’s about boiling the play down, trying to honour the precision of the writing. Every decision is important.”

One crucial early decision was to cast a man. Creed had Rea in mind: a performer around his own age, and someone he knew had an affinity with poetry after seeing recordings Rea made during the pandemic. Casting him was a way of pulling the play away from Kane’s experience, away from the temptation to read every detail as autobiographical.

A slipperiness around gender is already embedded in the text, Creed believes. On the first page the speaker calls themselves “the broken hermaphrodite who trusted hermself alone”, using an invented, almost Joycean nonbinary pronoun; elsewhere the gender of the lover seems to shift, or to encompass both male and female.

The director is careful not to speculate about how Kane might identify today, but he regards aspects of the plays as having become more legible with time. Cleansed, for instance, can now be seen as a trans play in a way that wouldn’t have been possible in its own day.

“That conversation was not really being heard in the 1990s,” Creed says. “It just wasn’t.”

Questions of gender outside the binary were more often treated as the stuff of crass jokes or sensationalism.

The decision to cast a man also seems to do something else: it brings the play sharply into the present, connecting it with conversations around the crisis in male suicide. Was that on his mind? “Absolutely,” he says. At the time the project was taking shape Creed was collaborating with the visual artist Cecily Brennan, who was making work about men with psychosis. Much of that work informed his conversations with Rea.

As the production evolved, they also sought out psychiatrists. They talked a lot about critical psychiatry, in particular the enormous power psychiatrists have to define what is wrong with someone, medicate them or even certify them against their will. Critical psychiatry asks where that authority comes from and whether the problem is always inside the person.

Not so long ago homosexuality was treated as an illness; before that, even writing with your left hand was something to be corrected.

“Sometimes the problem isn’t the inside of someone’s head,” Creed says. “The problem is in the outside world.”

That opened up a way of approaching Kane’s play not as an expression of mental illness but as someone asking a genuine, if profoundly difficult, question: can someone be allowed to choose not to live?

“I remember being in London at the time, in the mid-1990s, and everyone was talking about Sarah Kane. The way the media covered her, the way they talked about her, it was so extraordinary. So punitive.”

Her first play, Blasted, boldly drew a connection between the cruelty of an ordinary British man and the atrocities unfolding in Bosnia. Kane was making a point reminiscent of Hannah Arendt’s about the banality of evil, but many critics instead dismissed her work as an exercise in cheap shock tactics.

The response was often intensely hostile: people seemed scandalised by the play, as though Kane had deliberately set out to cause harm. In reality, her depiction of violence was less an attempt to provoke for its own sake than a lament for the brutality and ugliness she saw in the world around her. (A famous story goes that when a soldier first saw Guernica, he asked Picasso, “Did you do that?”, and the artist replied, “No, you did.”)

The headline on the Daily Mail’s review of Blasted called it a “disgusting feast of filth”. Kane named the torturer in Cleansed, her next play, after Jack Tinker, the journalist who wrote the review. “It’s literary tradition to get your own back on a critic,” Creed says. “It shows her as someone with a sense of humour. People forget: there are really funny bits.”

Marty Rea agrees that it’s easily forgotten. When people hear he’s doing 4.48 Psychosis, their response is always the same, he says: “Are you okay?” They think of Blasted and Cleansed; they expect a procession of mutilations and rapes.

“But I keep finding myself saying to people, I think it’s beautiful. I think her poetry is really beautiful. Yes, it’s grim, but Keats is grim. Shakespeare is grim. I think she’s a romantic, which sometimes feels like such a basic thing to be.”

Creed adds: “This is a person who wrote a play in which a sunflower bursts out of the floor.”

Kane’s characters have a void inside them, and they know that only love can fill it. So they chase after love, and at the same time they know it’s not enough. “Still, it’s the only solution, and that involves living in a paradox.”

Rea says hope is the killer. “It hurts. The desire to be seen and heard is so stark in the text: ‘Validate me, witness me, see me, love me.’ It’s the idea that, yes, I’m going to die, but before I do I’m going to put this thing out into the world in the hope that I can be seen and heard. I’m always reminded of Waiting for Godot, where the boy goes, ‘What am I to say to Godot?’ ‘Tell him you saw us. You did see us, didn’t you?’”

Beckett keeps coming up, not just in the language but in the silences. There’s a lot of white space in 4.48 Psychosis. “Writers speak about the terror of sitting in front of the blank page,” Rea says. “The fear of having to fill it and not being able to.”

Thinking about how to approach this white space, Rea was reminded of Beckett’s guidance to actors on how to deal with his silences: act as if you are in a boat with a hole in it and the water is coming in and the boat is slowly sinking. When you speak, you’re bailing water out of the boat. When you’re silent, you’re still, and the water is coming in.

“We’re not doing anything definitive,” Creed says. “We’re just staging an encounter with the text and transmitting something of that encounter to people who choose to come and see it.

“It’s not for everyone,” he cautions. “But I feel very alive when I watch it. I’m glad that we’re in a world where it’s possible for people to come to a small room and experience this.

“It’s a dispatch from the frontline of human experience. Somebody wrote this. They wanted to communicate that experience to you.”

4.48 Psychosis is at Project Arts Centre, as part of Dublin Theatre Festival , from Wednesday, October 7th, until Saturday, October 17th, with a preview on Tuesday, October 6th; it then runs at the Mick Lally Theatre, Galway, from Wednesday, November 4th, until Saturday, November 7th

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