Emma (Denise Gough) doesn’t want to get with the program in People, Places & Things (photo by Teddy Wolff)

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Denise Gough gives a career-redefining performance as an actress struggling through rehab in Duncan Macmillan’s People, Places & Things, which has been extended at St. Ann’s Warehouse through December 3. The broke Gough nearly quit the business before getting the role of Emma, a drug addict and alcoholic who checks herself into a rehab center; her riveting portrayal earned her an Olivier Award. The narrative arc is all too familiar: Emma’s addictions make it hard for her to keep a job, so she’s looking to “graduate” from a rehab to show she’s okay now. She proclaims, “I shouldn’t be here,” to the staff doctor (an excellent Barbara Marten), who replies, “It’s pretty obvious that you should. You came here for a reason. That was a good impulse.” As Emma’s hands shake, the doctor continues, “Your addiction will fight any progress. It’s a parasite and it will fight for its own survival until you’re dead. But progress is possible. I just need to hear you say that you are willing and motivated to make changes.” But Emma resists the twelve-step program, which requires mandatory group therapy. Emma, who at first goes by the name Nina — the play opens with a scene from Chekhov’s The Seagull in which Emma, as Nina, spins out of control — insists she is different from the other members of the group, which is led by a therapist (Marten) and includes Shaun (Himesh Patel), Laura (Laura Woodward), Charlotte (Charlotte Gascoyne), T (Jacob James Beswick), Jodi (Jacqui Dubois), Paul (Kevin McMonagle), Mark (Nathaniel Martello-White), and Foster (Alistair Cope), a former addict who completed the program and now works at the facility, helping others. Although she is an actress, Emma refuses at first to participate in role-playing exercises or share the details of her story; she is used to playing fictional characters onstage, so she steers away from the truth despite repeated admonitions that she must be truthful and hold nothing back. “Drugs and alcohol have never let me down. They have always loved me,” Emma says. “There are substances I can put into my bloodstream that make the world perfect. That is the only absolute truth in the universe.” But soon it is clear that if Emma doesn’t clean up her act, she is going to die.

Emma (Denise Gough) is spinning out of control in Duncan Macmillan play (photo by Teddy Wolff)

A coproduction of the National Theatre and the British Headlong company, the play is superbly directed by Jeremy Herrin (This House, Wolf Hall) with a bold energy that never lets up, with scene changes indicated by loud noises and lightning-like flashes, evoking the ups and downs of addiction, as if synapses are firing wildly. Bunny Christie’s set is a rectangular white-tiled room with hidden doorways in the walls; the audience sits on opposite sides, able to see one another through the whole show. After intermission, the simple move of a desk makes it feel like the entire set has been turned around, like Emma’s life. As Emma seeks her real identity, she suffers hallucinations in which she is surrounded by multiple Emmas, threatening her sanity. Martello-White excels as Mark, a fellow patient who bonds with Emma — and shares the same name as the brother she claims is dead. McMonagle stands out as Paul, a paranoid addict who is first seen shirtless, the words “The End” on his stomach in what appears to be blood. And Marten gives a thoughtful, caring performance as the doctor and the therapist. “You look like my mother,” Emma tells the doctor, who claims that it is just projection. “No, you really fucking look like her,” Emma says. Indeed, later Marten plays Emma’s mother as well. Macmillan (1984, Lungs, Every Brilliant Thing) gets too caught up in religion and recovery; the play suffers when the characters espouse the program, becoming far too preachy and treacly. It works much better when it is more abstract, Emma’s problems relating to twenty-first-century ills that we all can understand. “Self-medicating is the only way to survive in a world that is broken,” she explains. Gough, who was born in Ireland and has been a longtime London denizen, had never been to New York before this show; she was determined to step foot in the city for the first time only as an actress in a play. She is now taking New York by storm, currently off Broadway at St. Ann’s, and next as Harper in the upcoming Broadway revival of Tony Kushner’s Angels in America. We are all fortunate that she stuck with the program, ultimately refusing to give up on her hopes and dreams.