Clarity visits Sarah Kane between 4:48 and 6am, staying for a brief time before abandoning her in the dark. She waits for her “happy hour”, longs for it, and forgets about it until it impresses itself upon her once again. Diagnosed with clinical depression, the British playwright was a figurehead of the ‘in-yer-face theatre’ movement of the 1990s. Already with a portfolio of four plays and one short film, her fifth and final piece was to be performed posthumously. Kane committed suicide in 1999, 4.48 Psychosis premiers at the Royal Court in 2000. This month, the Royal Opera returns to the Lyric Hammersmith to perform said productionthe only revival of its kind, as its composer Philip Venables is the first to have set music to a play by Kane.

She can’t breathe. Her face is pressed against the white, glossy floor. It is barren and clinical. Dispassionate. Opaque glass sinks into the back – a textured passage, glazing over light, sound, and air. Words stamp across the walls. Taunting. Comforting. The orchestra buzzes, a swarm of thoughts dancing, demanding that their occupant listens and acts accordingly. Six female bodies gulp. Voices shudder under the weight of the world, lengthy vibrato transforming into unintelligible noise. It is haunting, as though they are singing underwater.

Serial sevens count backwards from one hundred, incorrectly. A tape clicks as it slides into an audio recorder, wound too tightly on its reel. One woman whispers, her sadness played back through a large speaker. She joins others as they climb octaves and scatter across their self-destructive stream of consciousness. It is overwhelming. Steel chimes against steel, hammering in the claw-headed conversations between patient and psychiatrist. A drum rumbles. Feet are heavy, dragged by legs full of lead and hearts without hope. Hands creep across the collarbones, caressing cheeks and crawling over mouths. Static. Screaming. Singing.

Silence. There is a saw chewing defiantly on a block of wood. Then percussion. The membrane is stretched over its shell and struck with bare hands. Humour. Laughter. The shriek of a whistle drowns out nauseating adnouns – slander spat with self-loathing. Medical notes spring from the page and possess the performers, cycling rapidly from doctor to disorder. An organ blasts through biblical verse, adding to the chronic sense of otherworldliness. It is all consuming, terrifying. It is the story of a woman living in sanity and then existing beyond it.

A wall of sound envelops these spectres, poltergeists of Kane’s tortured spirit. They are hypnotic. They are unrelenting, dangerous, even. Swallowed by each other, in their grey habits until there is nothing left, save one, alone in the darkness. Here though, The End is just the beginning. This production goes further than intensity and above discomfort, but it is unique. Above all, it documents the experience of depression with bitter precision. Venables’ adaptation will stay with you while you turn out the lights and drift into sleep, making its home as a memory that the limbic system will refuse to forget.

4.48 Psychosis played at the Lyric Hammersmith until May 4

Photo: Stephen Cummiskey