‘How shall I speak again?’ Deafinitely Theatre’s 4.48 Psychosis

Jim Fish, Brian Duffy, Matt Kyle and Adam Bassett in 4.48 Psychosis. Photo credit: Becky Bailey

Waiting at the bar in the New Diorama Theatre before seeing Deafinitely Theatre’s production of 4.48 Psychosis I am presented with the first difficulty I will have reviewing this play. There is a hubbub in the bar as the crowd of theatre-goers arrives, but a near-silent hubbub, as the majority of people here are speaking in British Sign Language (BSL). I realise, stupidly and certainly belatedly, that this is the first time I have been in a majority-BSL-speaking space and that I am, for want of a better word, foreign here. How do I, as a hearing person with no BSL knowledge go about reviewing a play which has been made by and for the deaf community? What is my role in this space? How does my ‘Sarah Kane expertise’ interact with my absolute ignorance about the language and community of this production?

I don’t have the answers to these questions. What I am presenting here is not so much a review as an account of some aspects of the play that I found interesting, and what I have tentatively learned. 4.48 Psychosis is still at New Diorama for another week, and I would encourage readers who are interested to catch it before it closes.

4.48 Psychosis is a notoriously difficult play to stage. The playtext is fragmented and free-wheeling, and none of the speech is assigned. It could be performed by any number of actors, on any kind of set. Written as it was in the weeks preceding Sarah Kane’s suicide, each production involves making a decision as to how far the staging and assignation of speech should reflect a psychiatric setting. In Deafinitely Theatre’s production director Paula Garfield has split the text over four actors, two deaf BSL-speaking actors who play ‘patients’ (Adam Bassett and Brian Duffy), and two hearing BSL-speaking actors who play doctors (Jim Fish and Matt Kyle). The play takes place behind a Perspex screen, on a plain, clinical-style set with lime green doors on either side.

Difficulties in communication define the psychiatric experience in this production. The doctors’ obtuse and patronising attitudes are compounded by their stilted signing, which is so different in expressive quality from that of the patients. Standing on the opposite side of the stage from the patients, white coat on and clipboard in hand, one has the sense of an unbreachable gulf between hearing medical establishment and the eloquent BSL-speaking patients.

There is a point in the playtext of 4.48 Psychosis in which the medical voice breaks his or her professional distance. Drawn out by the obstinate silence of the patient, the doctor breaks down momentarily and admits their own difficulties with their work:

‘Most of my clients want to kill me. When I walk out of here at the end of the day I need to go home to my lover and relax. I need my friends to be really together.


I fucking hate this job and I need my friends to be sane.


I’m sorry.’

In most productions I have seen this moment marks the possibility of connection between doctor and patient, a glimpse at a relationship which can be honest, even if it is antagonistic. Garfield presents a bleaker vision. The ‘I’m sorry’ is spoken with disdain, and the doctor turns away, leaving Duffy to sign his response to his back. The issue here isn’t ‘access’ – the play is set in a medical establishment in which doctors speak BSL or in one scene speak through a translator – but empathy. And the acknowledgement that another language, if it is signed or spoken, has an equal claim to eloquence and expressiveness is an absolute prerequisite for the development of empathy.

If the relationship between doctors and patients in this production is cold, almost callous, it is countered by a touching solidarity which develops between Bassett and Duffy’s patients. It is unclear whether Bassett and Duffy are both patients staying in the same institution, or two sides of the same personality. Bassett takes the parts of the script that are melancholic and seems vulnerable and frightened in the face of his own suffering, and the alien institution in which he finds himself. Duffy on the other hand takes on a representation of depression which is full of anger, raging at the institutional restrictions placed upon him, the power play of the doctors and his companion’s inability to stand up for himself. They relate to one another with tenderness, affection, frustration and protectiveness.

For me, it was this presentation of a friendship at the centre of the play which was most revelatory. Of the many productions of 4.48 Psychosis which I have seen or read about, this is the first to split the text in this way and present a believable friendship specifically between patients. At the end of the play, as the patients approach the possibility of suicide, they perform to one another – giving each other the attention and credibility which has been denied by the doctors. One realises that there is something much bigger and more important at stake here than a simple ‘translation’ from one language into another. Bassett and Duffy sit with each other’s expressions of pain, creating a space in which the other can communicate their experience in language as poetic and non-clinical as they might wish.

This sitting-with is perhaps also a piece of guidance to the audience. On the other side of the Perspex, we are also sitting and observing, and are offered the opportunity to rethink the clinical site as one filled with the potential for trust and connection – if only we would allow those in it to speak their own language, literally and figuratively.

4.48 Psychosis is showing at the New Diorama Theatre until the 13th October

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