Sarah Kane, a British dramatist, was most well-known to the public for the sheer magnitude of criticism that her first play (Blasted) received, which condemned the play's gruesome subject matter and graphic violence. Despite the negative press, her work was heralded by progressive British playwrights such as Howard Barker and Harold Pinter, providing her with the necessary support that enabled her to produce a new play every year until her suicide in 1999 at age 28. Although constantly followed by echoes of that first negative blast from the press, Sarah Kane did not regard herself as bleak or gratuitously violent. "I don't find my plays depressing or lacking in hope," she said, "To create something beautiful about despair, or out of a feeling of despair, is for me the most hopeful, life-affirming thing a person can do."

4.48 Psychosis may be the most obvious manifestation of that credo. Written as she felt herself sinking into depression, she considered the play to be deeply autobiographical. Found posthumously, the work was produced by the Royal Court Theater Upstairs only months after her death. The original script is a unique theatrical work, containing no character designations or stage directions, qualities that further raise the question as to why the piece should be ultimately performed. David Greig seems to have found an answer in his preface to The Complete Works of Sarah Kane: "4.48 Pyschosis is a report from a region of the mind that most of us hope never to visit, but from which many cannot escape. Those trapped there are normally rendered voiceless. That th[is] play was written whilst suffering from depression, which is a destructive rather than a creative condition, was an act of generosity by the author. That the play is artistically successful is positively heroic."

-Johanna Schuster-Craig, 2002

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