The Struggles of Living with Psychosis in Sarah Kane's 4.48 Psychosis

Sarah Kane is one of the most important names when it comes to In-Yer-Face theatre. Before everything about her and 4.48 Psychosis it would be appropriate to explain what In-Yer-Face theatre is. Basically, for the first time this term was used by Aleks Sierz, British theatre critic. Sierz uses this term to describe work by young playwrights who present vulgar, shocking, and confrontational material on stage as a means of involving and affecting their audiences (Sierz). Using shocking methods like sex, violence, rape, nudity etc. on the stage was not what the audience got used to in those times. Most probably this is the reason why that period known as Nasty 90’s. In-Yer-Face theatre is for disturb the audience, not imply the message but more like showing it with neon colours so there will be no way to not see or understand it and of course it’s about doing it by violating personal space and crossing the boundaries. It considered as a direct reply from the artists to their own socio-political and socio-cultural background in Margaret Thatcher’s term as prime minister. In his website, Aleks Sierz says ‘In the 1990s, a revolution took place in British theatre. Out went all those boring politically correct plays with tiny casts portraying self-pitying victims; overthrown were all those pale imitations of European directors’ theatre (Sierz).’ about this because like Vlad Nemirovich-Danchenko said to Konstantin Stanislavski ‘New plays attract audiences everywhere because they discover in them new answers to the problems of living. (Benedetti 24)’.

Knowing her biography may be helpful to understand and analyse her plays. She was born on 3 February 1971. Her parents raised her as a Christian and then she became Evangelical. She struggled with her faith and rejected it completely. She studied drama at Bristol University and went on to take an MA course in play writing at the University of Birmingham, led by the playwright David Edgar. Shortly after she finished MA, she wrote Blasted (Sierz 91). In the last years of her life she struggled serious depressions and died in 1999; two days after taking an overdose of prescription drugs, she hanged herself by her shoelaces in a bathroom at London's King's College Hospital. The coroner, Selina Lynch, said Ms Kane had killed herself while 'the balance of her mind was disturbed' (Quinn).

About the title of the play, many different opinions can be considered; in her book, Don't Want to Be This: The Elusive Sarah Kane, Annabelle Singer says ‘the early morning hours when Kane wrote, when she felt the most sane, though these were also the hours when she appeared the most insane to others (Singer 161)’, and at the introduction part of Sarah Kane: Complete Plays David Greig says ‘4.48 Kane often woke when in her depressed state (Greig) and as the other opinion, statistically early morning hours like 4.48 are the time most suicides take place. Analysing the examples in the play, it can be said that this time has changeable meanings. For the first time it’s mentioned as ‘At 4.48 / when depression visits / I shall hang myself / to the sound of my lover's breathing (4.48 Psychosis 4).’ The sign of suicide is coming later, like ‘After 4.48 / I shall not speak again (4.48 Psychosis 20)’, ‘At 4.48 / I shall sleep (4.48 Psychosis 23).’ and lastly, maybe the obvious one is ‘the happy hour / when clarity visits (4.48 Psychosis 30).’ Normally, 4.48 symbolises the time of transformation, when the night evolves into the day, the twilight, just like the spirit of the play. 4:48 was the symbol of all the inability to sleep, the state of sleep and waking, discomfort and the spiritual suffer that Kane experienced. As mentioned earlier, the meaning is changing but the negativity of it stays remain within the play.

4.48 Psychosis is considered as suicide note of Sarah Kane which is quite understandable for the reader. Unlike her earlier plays 4.48 Psychosis does not include physical violence, it includes mostly psychological violence. In 2000, after the premiere, like most of critics, Michael Billington writes that ‘Judging 4.48 Psychosis is difficult. How on earth do you award aesthetic points to a 75-minute suicide note? (Billington)’ She achieves to create an organic form from her own experiences and discomforts and she manages to form it poetically. Her death gives life to the play rather than her life.

Depression is the main part of the play; anger, pain and darkness are almost touchable in every line. As her friend and colleague Mark Ravenhill says, ‘she fell out of love with life and drawn constantly to thoughts of suicide (Ravenhill, Obituary: Sarah Kane)’. Her ideas about herself, life, God, faith, doctors, love, her questions, desperation, and fears are all given in the play and most importantly, the normality of death. While death is a frightening phenomenon for most people, Sarah Kane points out how usual this is for her at that time in her life.

Nothing can extinguish my anger.

And nothing can restore my faith.

This is not a world in which I wish to live (4.48 Psychosis 7).

Surrounded by the desperation and the lack of will to live, Sarah Kane presents her state of mind and underlines for the reader that this is not a cry for help. On the contrary, she clears the air about that. So determined about her future, she puts her cards on the table

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 (4.48 Psychosis 7).

Again as her friend and colleague Mark Ravenhill says ‘Kane's work wasn't just some outpouring of the soul. It was immensely crafted. (Ravenhill).’ Considering Sarah Kane's experiences in that period and the play’s themes as depression, suicidal thoughts, self-destruction, pain etc., it can’t be wrong to say it’s difficult to separate the play from the reality of Kane's personal life because everything is vague, except from the pain of life and to wish to die. However doing this cleverly and magnificently can’t be easy. Reading it as a poem gives the feelings of beauty and the artistic feature of the pain. Not try to make it divine or artificial but accepting and reflecting it as it is. As mentioned earlier, depression is the main part of the play; on the other hand, ‘Kane managed to interlay the play with many forms of love and their value – unconditional love, unrequited, painful love, lost love, love never found, betrayed love and reciprocal love (Chramosilová)’, but as it seems all of them are connecting to something gloomy.

Many things are ambiguous in the play. The play has no apparent dialogues of dramatic personages, the play rather offers an impression of views and the voices gallop (Čermák, Chrz and Zábrodská). There are no character or gender specifications, performance information, no stage direction and it’s written as a poem. It’s not clear who is talking but something is definitely understandable that this play includes self-struggling unlike Sarah Kane’s other plays. From most of the monologues it can be said there is a patient, the setting is not clear but, from the dialogues, it can be a doctor’s office. Dialogue parts are creating ‘the doctor’, and he/she has various conversations with the patient. It may explain with the word psychosis. Psychosis is mental illness of a severe kind which can make people lose contact with reality (Colins Cobuild English Dictionary). Alienation from reality might be the part of her life and Kane reflects it as a mirror. Also the names of the medicines in the play and the effects of them can be related with this subject. ‘Lofepramine and Citalopram discontinued after patient got pissed off with side effect and lack of obvious improvement. Discontinuation symptoms: Dizziness and confusion. Patient kept falling over, fainting and walking out in front of cars. …Venlafaxine, 75mg, increased to 150mg, then 225mg. Dizziness, low blood pressure, headaches. No other reaction. Discontinued. (4.48 Psychosis 17)’

Sarah Kane's death is often associated with Sylvia Plath. Sylvia Plath was dealing with depression and disillusioned from her crumbled marriage, burdened financially, struggling to care for two young children, and affected by the medication she was taking, Plath took many sleeping pills and allowed herself to be consumed by the fumes from the gas oven. She had left a note asking that her doctor be called, and indicating his name and number. As a result, many people assume that she was expecting to be found and revived again, as she had been at 20, especially because the children’s nurse was to be at the house early in the morning. However, she was pronounced dead on arrival at the hospital that morning of April 11, 1963 (Bloom). The main reason of it is what James C. Kaufman explained as Sylvia Plath effect, ‘Female poets were found to be significantly more likely to suffer from mental illness than female fiction writers or male writers of any type. …This early finding has been dubbed “the Sylvia Plath effect,” (Kaufman).’ This concept matches madness with authentic creation. According to this theory, Plath's suicide affected many women poets and writers who followed her. Sarah Kane was one of the representatives of this concept including women writers such as Virginia Woolf, Charlotte Perkins Gilman or Nilgün Marmara. Especially, Sylvia Plath’s The Bell Jar can be related to these writers and poets. In the Bell Jar, the main character Esther Greenwood says ‘'I can't sleep…' 'I can't read.' I raised my voice. 'I can't eat.' (Plath)’, as Sarah Kane says in the 4.48 Psychosis ‘I can't make decisions / I can't eat / I can't sleep / I can't think / I cannot overcome my loneliness, my fear, my disgust / I am fat / I cannot write / I cannot love (4.48 Psychosis 4).’ According to these examples, it wouldn’t be wrong to say that Sarah Kane was influenced by Sylvia Plath.

The reason why Sarah Kane is so hard to digest is related with her life and of course her plays. To have to fight not just with the disease but also with the society and the necessities to live, even if she didn’t really want to live, all of them are tiring and damaging the soul which is so obvious in the following line. ‘Watching me, judging me, smelling the crippling failure oozing from my skin, my desperation clawing and all-consuming panic drenching me as I gape in horror at the world and wonder why everyone is smiling and looking at me with secret knowledge of my aching shame. (4.48 Psychosis 6)’ Kane is very talented to reflect her experiences and feelings. Living with serious depression and writing at the same time are creating this sort of a play. In the play, there are many contradictions that not mentioned in this paper but somehow all of them are defeated by despair except from the last line. Kane says ‘please open the curtains (4.48 Psychosis 35)’ at the end of the play which invites the actors to open the window shutters and let the light and the sounds of the street in; an ending that suggests the possibility of a reconciliation with the outside world and turns the whole play into a complex meditation on mortality (Carazo). Normally in her plays, Sarah Kane coverts every idea, theme and feeling into a carnage, but at the end of 4.48 Psychosis, maybe she was doing a favour by creating a little hope for herself and for the reader.