Although Sarah Kane’s 4.48 Psychosis is a play familiar to most people in touch with the world of theatre, Paula Garfield has directed a first: the only production of 4.48 Psychosis to be performed in British Sign Language and spoken word.

Deafinitely Theatre was created with the mission of opening up live performance to the deaf community, allowing actors as well as audiences with this disability to access the wonderful world of theatre without limitations. Their last play – Mike Bartlett’s Contractions – won the 2018 Off West-End Award for Best Production, and so this one had a lot to live up to. 4.48 Psychosis is a theatrical representation of clinical depression. The number refers to the time in the morning when Sarah Kane frequently awoke. The language is disjointed and confused, withholding full clarity and devoid of a sense of clear narrative.

The overwhelming feel of this production is of disconnection as well as a constant striving to communicate, but never being fully understood. This came in part from the glass wall covering the stage like a transparent curtain. We can always see the actors behind, but from far away, it is as though they are trapped in a cage or cell. This feels like the physical representation of the deaf person’s experience: receiving everything at a distance, with everything translated into sign – never getting a discussion first-hand, and inevitably losing something along the way. When the doctor asks questions to his patient, they can only communicate through a mediator speaking both out loud and in sign. This created a feeling of disparity. What was already a frustrated conversation (ironically one about self-harm, often misconstrued as simply a cry for help) becomes near-impossible.

Part of this alienation effect seemed to be in the portrayal of the doctors, who are stereotypical rule-following and straight-laced medics, void of compassion or genuine empathy and understanding. For me, this was the failing of this production. The doctors become too much like caricatures, taking away from what could have been a more moving and believable portrayal. However, in defence of this presentation, it definitely adds to the play as an experience of the patient, who might well have seen the doctors in this stale and more inhuman way, standing in opposition to them as opposed to cooperating with them.

In all, Deafinitely Theatre have taken a modern classic and adapted it superbly. Seeing the play for the first time, one could easily be led to believe that this is the way it was always intended to be performed. A triumph.


4.48 Psychosis is playing at the New Diorama theatre until 13th October. For more information and tickets, see here