4.48 Psychosis is the last play written by Sarah Kane, finished in 1999 and first performed in 2000. The play, much like Crave, has no setting and there are no characters. Instead, it is a series of dialogues with a jumble of words and quotes that could present several mindsets with the themes of depression, suicide and maybe vanishing from existence. The play is possibly Kane possibly presenting the viewer a subjective view of depression; its title came from the time (4:48 A.M.) when allegedly she awoke in her depressive state. She never saw the play, ending her life just as she finished it. The play was brought to life by Kane's brother and past collaborators.
The premiere left the audience and critics questioning it and trying to connect it to the reality of Kane's death. Some believe it to be her suicide note, a cry of pain, or that it was written to be posthumous.
Since there is no direction, productions vary; some have multiple characters, or may just be a solo monologue. There is an opeatic adaptation written by Philip Venables, which was well-received by critics as well as Kane's brother.
This play contains examples of the following tropes:
- Arc Words:
- "4.48", supposedly the time that those with depression wake up, and supposedly a time Sarah herself kept waking up at. 4.48 is variously referred to as something that gives her clarity and grief.
- A countdown of numbers appears; those in mental health will realise that the numbers are Serial sevens which are used by doctors to test mental function counting down from 100 using the number 7.
- "Hatch opens. Stark white." It's the closest thing to happiness, a scene change, or even concrete imagery, and seems to denote hope, or more of the undying pain the lead(s) are in.
- Armour Piercing Response: The typical anti-suicide rejoinder of "But you have people who love you" is turned into a scathing question of "do you have people who love you", either asked aloud by a lead, a character, or in monologue, and possibly from a doctor or bystander to the lead.
- Does This Remind You of Anything?: The lead "character", such as the role could be, is a writer that was of working class background, whose work has received critical pillory and has attempted suicide before, much like Kane herself. Critics and close friends alike believe this play was a suicide note due to these personal touches.
- Halfway though the play the lead claims that they are responsible for all the genocides of the 20th century, thinking about this theme in Kane's work is a honest retrospect of the plays Blasted and Cleansed showing the relationship of the writer and the cruelty of human nature. Of note is that the lead explicitly mentions sucking out eyes, much like the brutal soldier of Blasted; another factor is that the backlash against Blasted deeply affected Sarah.
- Also like Crave this play reuses pieces of pre-Blasted monologues.
- Don't You Dare Pity Me!: When an doctor enters the character feels that they are beyond saving and loathes the way the doctors treat them like a child.
- Downer Ending: The lead dies and fades from existence while reciting (or even due to) the fragmented last lines.
- Dr. Jerk:
- The narration/lead/monologues depict the doctors to varying degrees as all dispassionate, inept, unable to respond to the bitter diatribes with nothing more than basic platitudes, open questions, or standard-issue reassurances that do nothing against the lead's description of a deep, unending, complex pain.
- The narration/script singles out one such doctor, who apparently has put in more effort than the others, but in the end is dismissed as just as, if not worse, than the others; the narration/script/characters/monologue consider the doctor's attempt to gain the trust of the patient invasive, and in the wake of being unable to pull the patient/lead out of their depression, a villain; the narration/script seethes that at least the other doctors didn't give them false hope or stayed their distance.
- The "I Love You" Stigma: The lead confesses their love to the Doctor. It fails, as the doctor is first shocked, then admits they can't return it (being professional); however, as the lead is dying, they realize the accepted of this truth.
- Improv: The play has no stage directions or characters so the director has the freedom to do what they wish.
- The Insomniac: The character can't sleep, regularly waking up and wanting nothing more than to sleep forever.
- Loving a Shadow: The narration/lead laments that they are forever doomed to never truly love or know their true love; it is ambiguous as to if this is a real person, an idea/concept that will never live up to reality, or even the doctor that interacts the most with the lead/one of the characters in the narrative.
- Minimalism: Most productions focus on this element in the play, the original production had a mirror on the wall with the floor covered in featureless wallpaper, a few chairs and a table.
- The Nameless: There is no names or characters which has left director's the difficulty of what to do.
- No Cure for Evil: The character spends the later half of the play feeling like they truly are evil due to depicting (or even feeling that their existence caused) the Holocaust and the Bosnian War, meaning that people will celebrate their death.
- Prelude to Suicide: The play is presented as one and clearly it was for the writer.
- Self-Harm: The lead continually slashes her wrists or guzzles lethal amounts of pills only to be rescued each time; in the aftermath, the doctors question them about it in a condescending and/or dispassionate way. One passage is a long, clinical record of each suicide and/or self-harm attempt.
- Suicide by Pills: The play has a list of the medication Sarah was possibly given, however she finds the pills numbing and is unable to be creative. However the character feeling the same instead tries to overdose, then succeeds. Of note is that Sarah survived at least one overdose attempt.
- Therapy Backfire: One of the doctors tries to save the person, but it's clear that their therapy fails at each turn first off because the lead is in love with them and then finals Dr has a small breakdown but it's clear that the lead is too angry to forgive this.
- Too Upset to Create: The lead is a writer, but depression has forced any attempts of writing to fail.
- Tragic Dream: The lead tells of a dream they have that they will commit suicide in front their loved one, however it's clear at the end the lover is non existent.
