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A cascading rush of videoed distress—flames, warfare, a frantically beating heart—gives way to a whispered cacophony of despair at the outset of the Factory 449’s remount of its Fringe Fest award-winner, 4.48 Psychosis. Sarah Kane’s ferocious contemplation of the end of life—often termed a theatrical suicide note because she wrote it months before killing herself in 1999 at the age of 28—may be tough sledding emotionally, but as its sold-out festival performances attested, it can be fiercely riveting for audiences. I say “can be,” because the playwright left few hints as to how the show might be produced—no stage directions, no characters, a script that’s little more than words arranged artfully on the page—and it doesn’t always work in performance. The London premiere divided the author’s sentence fragments, therapist’s notes, diary entries, and anguished howls among three actors, to controversial effect; a less well-received Manhattan staging (in French, mostly without surtitles) offered Isabelle Huppert frozen in a spotlight for nearly two hours, occasionally interacting with a shadowy male figure behind a scrim; in Chicago, performances took place in several rooms simultaneously with audience members shuttling between them. Still, however it’s done, the despondent portrait that emerges is of clinical depression viewed from the inside. It’s probably simplistic to view the show as autobiography—the title refers to a pre-dawn moment of wakeful lucidity—but at the Warehouse, with an ashen-faced Sara Barker and nine other performers spotlighted on chairs, it can’t help acquiring the shape of Kane’s own melancholy. John Moletress’ briskly static staging pushes the words straight out front for 48 minutes with little artiface but considerable feeling. Sometimes the performers’ laments overlap in pulsing waves of resignation; other times individual characters emerge to rage or question, then recede as the focus returns to Barker at centerstage—eyes blank, lips tight, at once unreadable and achingly sad. A professionally modulated, cluelessly therapeutic query about her plans elicits an unhesitating, “Take an overdose, slash my wrists, and hang myself.” But if that seems to say it all, it’s really just a starting point for acid reflection, anger, and haunting doubt.