4.48 Psychosis – Royal Court

‘At 4.48 when depression visits, I shall hang myself to my lover’s breathing’.

Sarah Kane’s 4.48 Psychosis contains many lines like the one above that simply go through you.

The play is a beautiful and terrifying exploration of the pain, anguish, despair, boredom and paralysis that accompany someone thinking of killing themselves. The work has an obvious resonance because it is Kane’s last before her own suicide, but the quality of the writing is such that it would be wrong to say that this is why the play is so impactful. Kane mixes honest, brutal statements with poetic, even biblical passages; lucid descriptions of a prescription with strange lists of numbers and staccato strings of words ‘flicker, punch, slash, dab, wring, press, burn, slash’. It is a startling piece of writing, whose originality lends it an almost prophetic feel.

‘A room of expressionless faces staring blankly at my pain, so devoid of meaning there must be evil intent’.

Director James Macdonald and designer Jeremy Herbert have done serious and dedicated work in tackling Kane’s text. Herbert’s set has a simple white floor, two chairs and a table. Suspended above it is a huge panel composed of several mirrors which reflect the stage out to the audience. It is a strong device,and utilises his staging effectively to produce some excellent images, with the cast able to lie on the floor and still play to the audience.

A particular strength of the staging is its use of sound and projection along with the set. This allows the stage to be transformed into a doctor’s office, bathed in heavy static or the flickering blue light of a television. And then, in an instant, harsher lights come up and the illusion collapses. This supports the text well, allowing the actors to slip between the dreamlike sequences and more conventional dialogue in a way that conveys the punctured sense of reality Kane is trying to describe. Sound and light designers Nigel Edwards and Paul Arditti deserve great credit.

Finally, the cast is excellent. Each of them finds a slightly different voice to each other which allows different shades of Kane’s text to emerge. Jo McInnes is perhaps the most outwardly ‘feeling’ of the three, giving us outbursts of rage as well as some of the text’s most tender moments. By contrast, Daniel Evans is the sharpest, most cutting of the three. He delivers one of the most powerful sections of text (‘drowning in a sea of logic, this monstrous state of palsy’) stretched out on the table, his head painfully suspended off of its edge. Madeleine Potter finds a voice that expresses all of Kane’s exhaustion and hopelessness. And, miraculously, between them they find a surprising amount of playfulness. This is a text that makes its audience laugh because it is so truthful, and the actors do well to find this playfulness as well as the overriding darkness. This is a phenomenal production, and you should get a ticket where you can.

The final image of the play responds to its last line, ‘please open the curtains’. Potter and McInnes carefully opened the windows to the Royal Court’s upstairs theatre, throwing light into the room and the gentle sound of the traffic outside Sloane Square. It was so beautiful I almost did not want to clap them when they returned for their bows.

Playing until 5th July, https://royalcourttheatre.com/whats-on/4-48-psychosis-4/

Reviewer: Ralph Jeffreys

Reviewed: 18th June 2025
North West End UK Rating: 5