Theatre 3900

Monday 25 March 2013

Sarah Kane's "4.48 Psychosis" -Mark Gibson

    Sarah Kane was born in 1971 in Essex on February 3rd. She came from a linage of writers as both her parents were journalists. Her family was very religious, a faith she claimed to until she was 17. She studied drama at Bristol University where she graduated with first class honors in 1992. Afterwards she did her MA at Birmingham University. She struggled with manic depression for many years, needing hospitalization at one point. During hospitalization she attempted suicide via an overdose of sleeping pills. She was unsuccessful but attempted suicide a few days later where she achieved her goal a few days later and died by hanging on the 20th of February of 1999.
     As a playwright her plays dealt with themes of death, sex, violence and mental illness. Her plays are characterized by an increasing poetic intensity, and a rich affirmation of love in all its forms. Her use of sharp violence gives a powerful image that fragments the narrative in order to convey the experience of life torn up by its roots.
     Before her premature end, Kane led a promising career and became acknowledged as a major force in British theatre and one of the key figures in the so-called In-yer-face theatre. This type of theatre grips the audience in a way that is perhaps uncomfortable but gets the point across. Her first plays were not accepted in society as well as they are now due to the intense violence and grim imagery. Not until her fourth play Crave, which she wrote under a pseudonym of Marie Kelvedon in order to keep the critics from bias created by the shocking and brutal violence of her previous plays. 
     She produced six works in her lifetime Blasted, Phaedra’s Love, Skin, Cleansed, Crave and 4.48 Psychosis. . Blasted was produced in 1995 at the Royal Court Theatre, London. Pheadra’s Love was produced in 1996 at the Gate Theatre, London. Skin was an eleven minute film with a script written by Kane. In 1998 Cleansed was produced at the Royal Court Theatre in London. Crave was produced at the Traverse Theatre in Edinburgh. Her last play was produced at the Royal Court Theatre in London a year after her death.



      4.48 Psychosis deals with a patient in a psychiatric ward who is suffering from severe depression. The script goes between dialogues between the patient and the doctors and an inner monologue the patient has with herself. The main subject of the play is that of severe clinical depression and the patient being diagnosed with pathological grief. This play does not adhere to conventional theatrical form and so many adaptations have been made since its inception in 1999. The wording of the text varies as well between naturalistic and highly abstract or poetic. These techniques were very effective in portraying the mind of the patient as she slowly slips into psychotic breakdown.
     The story touches upon several subjects that plague a psychiatric ward including pathological lying, self injury, suicidal thoughts and the emotional struggles of patients dealing with psychosis. A part of the script goes through a doctor’s notes on the patient depicting the progress of the patient and the use of medications. First is the diagnosis of pathological grief and then the barrage of psychiatric medications used as treatments. Unfortunately not every drug is a miracle.
     4.48 Psychosis is also about a relationship between the doctor and patient and the difficulties that ensue. Professional relationships can be the most taxing of relationships as both parties have to avoid attachment to each other, called transposition, and keep everything within the context of the doctor patient relationship. Many times complications can arise through emotional attachment and the doctor has to come up with a decision to transfer the patient for their benefit. This however can be seen as cruel by the patient or as the doctor abandoning them. In the case with the patient in 4.48 Psychosis, sometimes doctors say too much to their patients, general feelings come out that are taken personally and the hurt can never really be healed. A bit ironic when the person who is supposed to do the healing is the one that ends up hurting you.
     In the end though it is too much for her, and through an extravagant amount of medication she dies in her own poetry. Some initially felt like that this play was a suicide note to Sarah Kane’s own death. Wether or not this last work of Kane’s was her personal statement to the world or simply another work of genius is still up to debate.


1. How was the use of poetry effective in the writing of this play?

2. Did the format of the writing have any affect on the flow of the script?

3. Is there significance behind only being sane for an hour and twelve minutes in a day?

4. The doctor kept bringing up that the patient had lots of friends. How is this significant?

5. The Doctor/patient relationship can often be a strained relationship, how could the thought of betrayal impact patients?

6. What kind of effect do you think doctors’ repeated questions have on the patient?

7. What is the significance of 4:48AM?

8. The patient keeps referring to a woman who is her unknown love, someone she has never met. Is it possible this has significance, or is simply the ravings of an insane person?

9. There is a section that depicts the medical notes of the doctor. Is this indicative of actual patient care in today’s society?

10. It is common amongst severely depressed persons to have the view that to feel pain is better to feel nothing at all, or that physical pain is more easily dealt with than physical pain. How is this apparent throughout the play and does it have any grounds to be true?

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