“4.48 Psychosis” at Royal Court Theatre Upstairs
Jeremy Malies in West London
23 June 2025
Is there a narrative to this essay on suicide? Does absence of narrative matter? Is it one character as a sole protagonist whose alter egos are being dissected? Sarah Kane didn’t even choose to tell us how many actors she envisaged speaking the lines of 4.48 Psychosis. The production at Royal Court Theatre Upstairs isn’t just a revival, it’s a replication 25 years to the month of the premiere at the same venue and with the same director and cast. Kane had committed suicide 15 months earlier (February 1999) at the age of 28 so the emotional charge during the opening run must have been immense.
Photo credit: Marc Brenner.
James Macdonald, whose Waiting for Godot divided opinion recently, is reunited with Daniel Evans, Madeleine Potter, and Jo McInnes. It’s McInnes who is surely presented as the focus here, but Macdonald is in no way prescriptive. You could see one of the other two actors as the driving force if you wished or you could choose to see the piece as a fragmented prose poem with no real narrative. There are no character names; none of the lines are attributed in any way but simply follow each other.
The topics covered include rejection by loved ones, unrequited romantic passion, low self-esteem, self-loathing from body dysphoria, opioid pain medication and its side effects, hallucinations, and general despair. But there are plenty of laugh-out-loud moments: “I dreamt that I went to the doctors, and she gave me eight minutes to live. I’d been sitting in the fucking waiting room for half an hour.”
The set by Jeremy Herbert uses an artfully designed angled mirror that tricks us into thinking there might be a second group of actors suspended on a diorama and thus more split personalities. I certainly bought into this for a moment or so. As McInnes reeled off the pharmacopoeia she is taking, I caught myself in the mirror both visually and in the realization that I too am on one of her medications.
The lighting design by Nigel Edwards is all refracted warm orange and yellow hues. It reaches a climax when a despairing and sleep-deprived McInnes lets in what looks like natural light, nominally at 4:48 in the morning which is the time that Kane would often wake from fitful medication-induced sleep. “An instant of clarity before eternal night.” It should be mentioned that Herbert and Edwards were creatives on the original too.
Amid all the gloom, you sense the mordant wit that endeared Kane to her peers who still treasure and protect her legacy. When she relaxed, she could be riotously funny: “Have you made any plans?” “Take an overdose, slash my wrists then hang myself.” “All those things together?” “It couldn’t possibly be misconstrued as a cry for help.”
Macdonald shows restraint in every aspect; he knows this is a text-driven piece that could be easily overpowered. Look at the play script as I’m doing now, and some of the speeches fall across the page diagonally like concrete poetry. There are the signature calligrams that we see in Kane’s play Crave which had a revival at the Chichester Festival Theatre as the country came out of Covid.
But Ben Walden is given freedom with his projection design. He punctuates phases in the speeches with the random dot flickers that older audience members would have associated with analogue television. I took it as underlining the white noise in the head of McInnes as she disintegrates into a stupor. There is a low-resolution projected loop recording of cars in a town centre that is suggestive of the Nineties.
“Madness is scorched from the bisected soul” was a line that resonated with me as I watched Evans in writhing contorted postures on the floor as he excelled when mirroring the pain of the McInnes character. I say “character” but more accurately the word should be “iteration”. And yes, this is indeed Daniel Evans, the current co-artistic director of the Royal Shakespeare Company. There are brief sequences when Evans and Potter truly are other characters. The play becomes dialogue as McInnes goes in and out of clinics and is questioned by medics.
Would it be churlish to criticize a literary suicide note? I like to think I should have done so if I had not been entranced. There was a bated-breath tone of reverence at the performance I attended but none of this struck me as out of place. This was a simulacrum not a revival and was always going to be an edgy high-wire act. But the creative team are realists and there is nothing that smacks of the redemptive in how they handle the play’s discussion of love. Macdonald, the Royal Court, and the RSC create and sustain a frighteningly intense world.
This is a co-production with the RSC and transfers to The Other Place, Stratford-upon-Avon, beginning on 10 July.
