An unflinching look at addiction

Dr Sally Marlow (National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience King’s College London) reviews 'People, places and things', a play by Duncan Macmillan at the National Theatre, London.

People, Places and Things opens with a period scene of a woman’s disintegration, which feels familiar. It soon becomes apparent that it is Chekhov’s The Seagull, and we are watching Nina, but along with the familiarity is a sense that something is out of kilter. We realise that we are watching a play within a play, and it is not Nina’s disintegration we are witnessing, but the actress who plays Nina. 

Cut to a white medical setting where Nina, as she refers to herself, is checking in to a rehab facility. Dark humour masks the desperation of her situation as she instructs her mother over the telephone to get rid of all the drink and drugs at her flat. She is assessed by a doctor, and refuses to give her real name – in fact we never really know who she is right until the end of the play. 

Stunning stage direction follows in which Nina (Denise Gough, who gives a stand-out and exhausting performance of anger, energy and emotion throughout the play) goes through detox from drugs and alcohol. First the walls begin to break down, and then Nina after Nina appear from the same bed, tortured and writhing, one soiling herself, one ripping pages out of a book, in scenes reminiscent of descriptions detox patients give of delirium tremens. 

We move to group therapy, the therapy of choice in Addiction, where Nina is now Emma. Various stages of therapy are played out in a kaleidoscope of switching characters and timeframes around Emma like piggy in the middle. It culminates in a furious scene where Emma refuses to accept that it is she who is broken, rather it is the world which needs fixing. Gough is extraordinary here. An angry, cynical polemic is delivered by a woman who has no idea who she is or what she feels, her emptiness highlighted by her profession – she acts because she has no identity, no personality, and can feel no truth unless she speaks the fictional words of others. When that fails, drugs and alcohol are her truth.   

In the second half Emma is now Sarah, and checking back into rehab after a major relapse. Sarah is ready to do the work Nina and Emma could not do, and she moves towards some sort of resolution.  Group therapy provides a safe space for her to rehearse how she will make amends to her family, and she is able to graduate from the treatment programme and return home.

Some details in the play did not ring true, mainly in the portrayal of the therapist. Few therapists would use the word ‘addict’, with all its pejorative undertones. Even fewer would break good practice and safeguarding protocols at the insistence of a client. It may make good theatre to allow things to kick off in group therapy, but it’s rarely what would happen. 

It would be too easy for me as an addiction researcher to get hung up on things which weren’t quite right, rather than focusing on the play as a whole, and the performances within it. I applaud the play for not flinching from the ambiguity of addiction, and for not serving up feel-good clichés, nor the simplistic alternative of despair and despondency. In the final scene we witness just how much damage Nina/Emma/Sarah/whoever has done to her family, and her mother’s need to sabotage her daughter in return is one of the most powerful scenes I can recall in any play. The treatment programme in the play is based on the Alcoholics Anonymous 12 step model with its central tenet of spirituality, but there is no spiritual awakening for our protagonist. People, Places and Things is a very good play indeed. 

- Reviewed by Dr Sally Marlow, National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience King’s College London. 

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