Sarah Kane struggled with severe depression for many years
and was admitted to a psychiatric hospital twice during her short life. Kane
was a prolific writer in her adult life, writing six plays before her death in
1999. 4:48 Psychosis was written shortly before her death in 1999, during a
period of deep depression. The play is Kane’s shortest and most fragmented
piece of work, she has disposed of plot and character and there was no
indication of how many actors were to be in the play. It has been suggested
that the play was a suicide note, and this leads readers to listen out for
cries of help, but friends of Kane have said the reader is then distracted from
the “explosive theatricality, the lyricism, the emotional power, and the black
humour contained within the play”. Obviously because of the circumstances
surrounding Kane at the time of writing this play it is hard to read the play
outside of biography. It is believed
that the title of the play derives from the time at which Kane frequently woke
in her depressed state – 4:48 in the morning.
Kane has been described as an independent spirit who wasn’t
afraid to stick up for her rights, she cared about people and injustices in the
world, something that reflected in her plays. I found this to be true in the
case of 4:48, there are moments within the script where I felt that Kane is
trying to highlight the negative side of the health system that is meant to care
for the mentally ill. In the scenes where the Doctor and Patient are conversing
there is always the sense that the patient is trying to make the Doctor slip up,
therefore removing the “facade” that the Doctor is there to make the patient
better.
D- “It’s not your fault. You’re ill.”
P-“I don’t think so.”
D-“No?”
P-“No, I’m depressed.
Depression is anger”.
This interaction
shows that the Patient is countering the Doctor’s diagnosis of being ill and
the patient states that they are not ill but are dealing with strong,
uncontrollable emotions. There is a running theme of the Doctor telling the
patient that it is not their fault, and the patient will always agree. The
patient knows that they are not to blame for being ill but the repetitiveness
of that statement leads them to start to think it is their fault because it is
said so often. This could perhaps be a way of Kane showing the injustice that
is placed on a patient’s shoulder as they have to listen time and time again to
a doctor say it is not their fault as if that is somehow going to make them
better. The character in 4:48 appears to be rather outspoken and isn’t afraid
to say it’s not their fault, they take it further by suggesting that the drugs
they are given don’t do anything to make them better. In fact it will only
hinder: “I won’t be able to think, I won’t be able to work”. In one of my lines
the patient lists the things the doctors should do if they are trying to heal
her and she suggests a chemical lobotomy. As soon as I had read that line I
thought of the end of “One Flew Over the cuckoo’s Nest” when McMurphy has had a
lobotomy. I spent the entirety of the film wondering if he was in fact
suffering with a mental illness and then it seems as if the lobotomy is not a
treatment as it is supposedly described as, but a further cause of mental
illness. It is the lobotomy that ends McMurphy, not his supposed problems that lead
to him being institutionalised in the first place. This one line seemed to sum
up the injustice of the treatments that were supposed to help patients in
institutes but didn’t seem to be as effective as they were made out to be. Kane
showed this again when listing off the countless drug prescriptions that were
meant to help and the list of reactions caused by each new drug that the
patient has taken. One instance is when the patient takes Venlafaxine, they
suffer with dizziness, low blood pressure and headaches and all the doctors say
is “No other reaction” as if those other reactions are simple problems that are
nothing to worry about. This passage of text in the script is just a series of
medical terms used by the doctors, who are paying no attention to the negative
effects each new drug has on a patient, as they reduce it to a simple “no other
reaction” – another injustice.
The style of 4:48 and Sarah Kane’s other works is known as “in-yer-face”
theatre, which is a theatre of experience, experimentation and shock tactics,
all of these elements can be found in 4:48. Kane’s play is recognisable as
in-yer-face with its unusual aspects such as the structure and language, it
creates discomfort for the audience and gets “in-their-faces” by invading their
personal space. In-yer-face theatre took off in the 90s (when Kane was writing)
and became the dominant style of new writing. Some of Kane’s other in-yer-face
contemporaries include Mark Ravenhill (Shopping and Fucking) and Anthony
Neilson (Penetrator). During the early 90s it was thought that new writing was
in a state of crisis but in-yer-face theatre begun to make theatre newsworthy
again and the playwrights of in-yer-face theatre were speaking to audiences of
their own generation.
