theatre combined

The Effect
Lucy Prebble
Cottesloe Theatre, South Bank, London.

The Curious Case of the Dog in the Night-time
Adapted by Simon Stephens from Mark Haddon’s award-winning novel
Apollo Theatre, London.
Winner of seven 2013 Olivier Awards including Best New Play, Best Actor and Best Director

Reviewer Lynda Woodroffe

Two recent productions at the National Theatre, London, are significant to the world of psychology. The Effect is set in a drug trials centre testing the effects of a new anti-depressant. Two young people, who meet in the introductory session and who are participating for money, are asked to operate certain mental tests, endure observations and physical tests while on the drug, and told to resist personal contact for the period of time during which the tests are being carried out. Although permitted some contact at certain times of the day, they are forbidden free association and it is made clear that leaving the centre would skew results, rendering the trial invalid. They are given tablets and checked to ensure they are swallowed. As is usual, no one involved in the trial knows who is taking anti-depressants and who is taking placebos.

Inevitably, with so much time on their hands, these two young people seek one another’s company and eventually start a relationship that becomes important to them. They have sex and go on an escapade outside of the centre; they fall in love. Their researcher discovers their antics and tells them that the results are now unreliable and they will have to leave. She also tells them that although she doesn’t know which of them has had taken the drug and which the placebo, it is possible that one of the side effects could cause strong emotional attachments. This throws the two guinea pigs into disarray – were their feelings real or imaginary? Can love be induced just by taking a drug? If the drug were stopped, could either or both of them risk the pain of rejection?

The other overt message from this play was that anti-depressants don’t work. The researcher had for many years suffered from depression herself and, based on her belief that it doesn’t work, had resisted taking any medication. Since she had failed in her research task, she is demoted; she falls into another depression and succumbs to taking the tablets.

The question that arises is an important one – about whether anti-depressants do work and, if they do, what effects are in evidence to show that they do? Do they just suppress? Are they able to offer short-term respite for sufferers? Is it all just a placebo effect?

As psychotherapists we will have encountered many clients/patients who rely on anti-depressants to get through their days. Our views vary from those who believe that therapy cannot work under these conditions to those who believe a hundred per cent in the nature argument ie that the chemical imbalance in the brain needs to be pharmacologically addressed. While I have no answers, it is valid to raise the questions. And while the play also did not attempt to answer these questions, and made some errors in its portrayal of research trials, I applaud the author for addressing the notion of what is real? – a question that arises everyday in our practices.

The second play, The Curious Incident of the Dog in the Night-time, was originally put on by the National Theatre where it received such enormous acclaim and interest that it has been transferred for a longer season to the Apollo Theatre in the West End of London.

I read the book some years ago and, although I had not forgotten the main details of the story, I had forgotten the intensity of the circumstances and the extent of the trauma experienced by the family of the main character, Christopher. His superb portrayal by actor Luke Treadaway showed us a deeply isolated person; by the interval I was in tears. The story is about someone very different, who cannot conform to the usual conventions of society and who cannot relate to others with the skills that most of us have learned as we mature from child to adult. We assume, although this is not clarified by the author, that he is a young man who has Asperger Syndrome (AS).

Christopher shows typical characteristics of the syndrome: obsessive and antisocial behaviours, repetitive habits, the inability to understand others and their lives. He reacts to others’ speech literally, without nuance, irony or humour. While that makes the world a very alien setting for Christopher, it also leads him into difficulties with, for example, the police, to whom he responds with sincerity when they use sarcasm.

Christopher had two other important relationships – with his teacher at school and with the neighbour’s dog, Wellington. Although his parents were loving and tried to understand his world, the difficulties they encountered living with Christopher proved too much for them and their marriage failed; his mother left home with her lover.

Distressed by his mother’s departure and the discovery that his father had killed the dog, Christopher steals his father’s credit card and leaves home in search of his mother; he knows her address but has no idea how to reach it. Not only does he not know where the train station is but, when a compassionate stranger tells him of its location, he is still unable to find it as he has no idea what it looks like.

This kind of helplessness, not common to adults, is a nightmare to a child. The disparity here is that Christopher is not a child; he has simply never learned the basic skills of getting around safely in the suburbs and into the larger urban environment. When he eventually finds himself in London, he struggles desperately with noise, the close proximity of others, the speed of the tube train and the constant visual stimuli. He breaks down, lost and terrified, in a world foreign to the one that his mind inhabits.

While this play is an adaptation of the book by Mark Haddon (2003), it is loyal to the details of Haddon’s story and its rendition is even more intense. Sadly, there is a lot of evidence (eg from the work of Simon Baron-Cohen and Sally Bloch-Rosen) to show that people who are classified as different have a rough ride in our society. While it may be fairly unusual for us to find clients with a form of autism in our therapy rooms, it seems surprising that it is not more spoken about since evidence has shown that 50% of people with Asperger Syndrome suffer with depression. They may also suffer anxiety spells, OCD and, to a lesser extent, psychoses and schizophrenia (Baron-Cohen, 2008).

To my mind this suggests necessary adaptations to our training if we are to become effective therapists for people on the autistic spectrum.

Lynda Woodroffe, MA Psych, has lived and worked in London since 1974; initially in education she is now a psychotherapist/counsellor in private practice.

Baron-Cohen, S., and Wheelwright, S. (1999), ‘Obsessions’ in children with autism or Asperger syndrome: Content analysis in terms of core domains of cognition. The British Journal of Psychiatry 175: 484-490
Baron-Cohen, S. (2008) Autism and Asperger Syndrome. Oxford: Oxford University Press
Bloch-Rosen, S.,(1999), Asperger’s Syndrome, High Functioning Autism and Disorders of the Autistic Continuum.
Easton, M. (2003) Asperger Syndrome in the Counselling Room, Counselling and Psychotherapy Journal June 2003
Haddon, M. (2003) The Curious Incident of the Dog in the Night-time. London: Jonathan Cape


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