Philip Venables gives the distress in Sarah Kane’s 4.48 Psychosis six overlapping voices. Reviewing its London revival, Clive Paget describes a musical form that can hold competing thoughts together, while sometimes deciding too firmly how they should feel.
Kane’s final play confronts the clinical depression she experienced. Venables sets its 24 disjointed sections almost entirely, moving between poetic abstraction and bitter exchanges between a patient and a psychologist. Depression, isolation and the difficult choices surrounding medication run through the work. Six identically dressed singers may, in Ted Huffman’s staging, represent fragments of one personality.
Music makes repetition and simultaneous voices possible in ways ordinary dialogue cannot. Paget hears fierce orchestral passages, moments of quiet beauty and the unsettling familiarity of waiting-room background music. Patient-doctor exchanges become projected words paired with percussion. The clinical encounter acquires rhythm, friction and occasional humour alongside its anguish.
Paget’s reservation concerns the freedom left to the audience. A tightly controlled chorus can prescribe the emotional temperature, narrowing the possible readings of Kane’s text even as it makes the experience harrowing. His review raises a question about representing mental distress: how much can an artwork make an inner experience palpable before its interpretation starts to crowd out ours? This is criticism of a particular staging, not a clinical account of depression.