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FringeReview UK 2023

The Effect

National Theatre, London

Genre: Contemporary, Drama, Mainstream Theatre, New Writing, Short Plays, Theatre

Venue: National Theatre, Lyttelton


Low Down

It’s as if a decade’s experiment has altered this headlong, mind-rippling play. Returning to the National Theatre after 11 years, Lucy Prebble’s 2012 The Effect directed by Jamie Lloyd now comes out bigger than ever, one of the finest 21st century British plays, questioning identity and emotion under the effect of drugs, placebos, what we imagine ourselves into. What, in fact, the imaginary of love is.

Directed by Jamie Lloyd, Set and Costume Designer Soutra Gilmour, Lighting Design Jon Clarke, Composer Michael ‘Mikey’ J’Asante, Sound Design George Dennis, Movement Directors Sarah Golding and Yukiko Masui (SAY), Fight Director Kate Waters, Intimacy Coordinator Ingrid Mackinnon, Casting Alastair Coomer CDG and Chloe Blake, Staff Director Jonathan Glew.

Till October 7th


It’s as if a decade’s experiment has altered this headlong, mind-rippling play. Returning to the National Theatre after 11 years, Lucy Prebble’s 2012 The Effect directed by Jamie Lloyd now finds the theatre larger (the Lyttelton replaces the then Cottesloe), the text shorter by around 15%.

Lasting 100 minutes, it comes out bigger than ever, one of the finest 21st century British plays, questioning identity and emotion under the effect of drugs, placebos, what we imagine ourselves into. What, in fact, the nature – or imaginary – of love is.

Like the two trial participants, the work’s subtly amplified: sharpened, with dialogue trimmed, micro-kerned, idiomatically compressed (a doctor now says ”gonna” for “going to”), paradoxes heightened.

Prebble’s re-thought The Effect, not just around specific actors as she has both times, but in its emphasis and edge. The feel of some words fall differently. It’s still taut, masterfully structured with stabbing “Dosage 150mg” stages, even clearer with this production, and thrilling.

That’s partly because it’s so classically uncluttered too. No hospital beds so even the previous stark realism’s gone. The one creative remaining from the original production is now prominent. Jon Clark’s lighting this time carves LED rectangles falling on the volunteers, suffuses glooms, opens with a lattice-work filtered through a suspended ceiling that’s raised and never lowered again. Soutra Gilmour’s clinical white space is its tabula rasa, with audience in traverse. Volunteer trials participants inhabit much of the stage, the two doctors sit at either end.

To Michael J’Asante’s music, George Dennis’ increasingly thrubbing sound design traces the dramatic arc, taking over from the lighting.

The Effect’s a clinical romance in several senses. So if there’s chemistry, it’s not always clear where that falls, who even knows it, in a play of accidental double-blinds and consequences. It starts simply. Two young volunteers are paid to take part in a clinical drugs trial, presided over by Dr Lorna James (Michele Austin) once a psychiatrist and now “just” a clinician. She’s been hired by Dr Toby Sealey (Kobna Holdbrook-Smith), always referred to as Toby. They have history, he’s trying to make amends.

The drugs are super-anti-depressants, it’s important young people without depression test it. Everything’s monitored, even increased height, enhanced hearing, word associations (depressives and optimists) including our dopamine secretion of happiness and fight/flight. One side-effect is the highs created make it very likely that young people on this dosage experience heightened feelings.

Sassy psychology-educated Canadian Connie (Taylor Russell, making her stage debut) now twenty-six (Prebble’s weights list hasn’t altered either) finds “Hackney-before-it-fell” Tristan (Paapa Essiedu) a mouthy thirty-year-old challenge. He’s all over her in words, indeed his drop-out uninhibited banter is compelling, as is sharing a birthday.

Tristan’s done this before, knows how you break rules. There’s this abandoned asylum next door. So Dr James encounters them after a deliriously long scene unpeeling each other mentally, stealing a first kiss. They’re not to engage in sexual activity: flooding dopamine screws up the tests.

Key exchanges between James and Connie discover there’s a control, of course. It helps Connie’s a psychology student, can articulate and predict James’s caveats. Someone’s given a placebo. James and eventually Connie think they know who. James and Toby face off on the crucial debate in the play. Tristan’s ardent, now Connie questions her own infatuation levels; things turn ugly.

It’s James who persistently bucks under Toby’s placebo voice. He’s a seductive talker as she knows to her cost. Doing a Ted Talk handling his disdaining surgeon father’s brain is one highlight, proclaiming of his branch: “Thanks to people like you, the Cinderella of medicine finally got to go to the ball.”

But James questions the controlling ballet, the predictive capacities of the mind knowing it’s on medication to mimic or create itself, placebo or not. Prebble asks what ‘natural’ is, what effect drugs really have, perhaps the history of drugs is of failing placebos.

It also dangerously asks just what the limits are of consciousness, or self-creating feelings, of medicine itself. James’s own depression finds the outfall of what happens too difficult. Is there a way back? Toby despite his smarm isn’t heartless. He’s helped James climb back before, but what triggered the initial spiral?

Both pairs of ex and uncertain lovers face off the dramatic effects of unmonitored drugs – not just in the couple’s action either. It’s an astonishingly adroit play, muted but livid with consequences and a living not desiccated argument too. Prebble’s luminous intelligence makes light of coruscating new information and – like the height of the volunteers – raises us all by two centimetres as we watch it.

Both Holdbrook-Smith and Austin face off from opposite ends, bar that one Ted talk. Austin’s containment, her querulous dispensing of advice drugs and doubt describes a crumpling arc, but with greater emotional authority as James faces herself.

Holdbrook-Smith’s Toby in a mellifluous, velvety undertow, exudes suave assurance edged with doubt. It’s as if the scollops of his own brain were beginning to fray, because of James. He’s a brisk if not heartless denier of his own consequences. Beginning to face them he learns something else.

Taylor too is both keenly alert and warily sympathetic as Connie, the probing, self-doubting young woman trying to contain Tristan’s more uninhibited less refined gambits, lucidly interpreting both him and herself. And the couple together are rapt, frighteningly joyous, visibly drawn together with a magnetic jolt. Watching them you have no doubts as to their truth, whatever induces it.

Essiedu’s excellent as mouthy edgy troubled Tristan, always prepared to push out his burning boats. His Tristan’s both boisterous and edged with danger, providing much of the energy generated in this production – Sarah Golding’s and Yukiko Masui’s blocking movement works hypnotically.

It centres on the trial couple, as the doctors stay mostly peripheral, fixed, observing the floundering atoms, but subtly altered by them. Both Kate Waters’ fight direction and Ingrid Mackinnon’s intimacy-work alarm and beguile respectively.

Taylor’s sculptured stillness, Connie’s assumed knowledge of placebos making her doubt and retrofit everything, then her explosive love-equalising gesture has profound metaphorical, as well as medical consequences.

Unlike her TV writing, Prebble’s theatre work alternates between intimate and exuberant. The Sugar Syndrome and The Effect, her first and third plays, are devastating, interior works, perhaps most likely to survive. Whilst her second Enron and her latest, A Very Expensive Poison are large-cast contemporary histories-as-ballets: on the scale of a west-end musical. Will a fifth bring another such unflinching work? We need it.