Review: 4.48 Psychosis (NSK Theatre)

Polarizing play takes to the Toronto stage

4.48 Psychosis  by Sarah Kane (Native Earth Performing Arts, 2018) is a 75 minute ode to suicidality. The protagonist, her lover, and her psychiatrist rarely engage in dialogue, with most of the narrative unfolding in the form of voluminous poetic monologues. There is no plot per se, but rather a deep exploration of the inner life of someone on the brink of death.

British playwright Sarah Kane wrote five plays during her short life, and 4.48 Psychosis is her requiem. Kane (1971-1999) was a disciple of In-Yer-Face theatre, a genre that strives to be shocking, aggressive, and uncomfortable.

The protagonist describes what it is like to be severely depressed, anxious and at times delusional. The lover describes what it is like to be in love with someone who is extremely mentally ill and at high risk of death by suicide. The psychiatrist is the only person with whom the protagonist engages in dialogue. There was no character development in the traditional sense.

I have seen one other play from the In-Yer-Face school: Radiant Vermin by Philip Ridley. The use of shock value is the only feature these plays have in common. I had a very different reaction to 4.48 Psychosis. In my view, the script lacked coherence and direction. The monologues were peppered with metaphors that my companion and I found incomprehensible, culminating in a mystifying reference to chickens dancing. Chickens had never been mentioned before.

Insofar as shock value was exploited, it appeared arbitrary and added little value from my perspective. The most notable example was when the protagonist, seated in a bathtub during the wee hours of the morning, began to scream, “I gassed the Jews, I bombed the Arab, I f*** little children.” The point of these incendiary statements was unfathomable.

I got the distinct impression that the performers, while committed to the piece, were struggling with the material just as much as we were. While each performer appeared to have a grasp of their character’s situation, it did not feel as though each line of the rambling script was infused with meaning.

The set was divided into three sections that remained constant throughout the piece. The protagonist and lover’s bedroom was on the left. The lover’s speeches were delivered from this location. On the right was a room at a psychiatric facility where encounters with the psychiatrist took place. At centre stage stood the bathtub.

Costume design was similarity straightforward, consisting of black pants and loose white shirts, with the psychiatrist wearing a lab coat.

The lighting design stood out, but unfortunately did not add to my experience. Each time the psychiatrist administered a test that involved counting backwards by 7s, a bright pulsing light beamed directly into the audiences eyes. If you have any sort of photosensitivity, it is not possible to see this scene, and about 60 seconds of what follows.

Suffice it to say, this was not my cup of tea. When the play was first mounted in 2000, reception was mixed, with some critics feeling as I do about the script, and others deeming it destined to become an integral part of the canon in this genre. It is entirely possible that an audience member might find themselves in the latter camp, although I was in the former.


    • 4.48 Psychosis played until March 10, 2018 at Aki Studios (250-585 Dundas Street East, Toronto, ON)
    • Shows ran from Friday to Saturday, at 8pm, with an additional matinee on Saturday at 3pm
    • Ticket prices ranged from $22 (Students, Seniors, Arts Workers) to $25 (General Admission).
    • Tickets are available online, by phone at 416-531-1402 or by email at