As a compendium of clichés designed to cause affront among right-thinking lefties, you’d have trouble improving on the rattle bag in Bruce Norris’ dialogue in The Pain and the Itch: a cat has been “euthanised”, a married couple is working on not suppressing emotion, gypsies should be “got rid of” (like the Jews), lip-liner on a little girl panders to “male objectification”.

Norris’ play, which is an abrasive comedy of expository manners at a Thanksgiving dinner, re-enacted for the benefit of a Muslim Somali cab driver whose diabetic wife has died, is the first show directed by Dominic Cooke in his own first season as artistic director. He has done a wonderful job, not least in reminding us of a recently neglected line in smart, liberal anti-liberal American dramaturgy that the Court has always towed, from David Mamet through Wallace Shawn’s Aunt Dan and Lemon to John Guare’s Six Degrees of Separation.

All three of those writers come to mind, but in its savage wit, domestic cruelty, highly polished floor, split-level white design (by Robert Innes Hopkins) and metaphorical use of disease, one is reminded most forcibly of Edward Albee’s woefully under-appreciated The Lady from Dubuque recently at the Haymarket. It is as though a nation eaten away with self-disgust at its own binge capitalism and knackered political ideology should create comedies of self-lacerating punishment. Norris’ two brothers, Cassius (“Cash”) and Clay – born to squabble and fight – represent two strands of national smugness.

Clay (Matthew MacFadyen) is a nauseatingly “correct” house husband - anxious to pacify the cab driver (God knows why) - whose high-flying business executive wife Kelly (Sara Stewart) hoovers up the table crumbs between courses with her new baby clamped to her chest in a sling. Cash (Peter Sullivan) is a laid-back plastic surgeon who openly abuses his young trophy Serbian wife Kalina (Andrea Riseborough) and casually prescribes some ointment for Clay and Kelly’s little daughter.

That daughter, Kayla (Shannon Kelly is one of three sharing the role), is a fat little spoilt kid suffering from a genital infection. Something rotten in the state of Middle America stretches from the noise in the attic to the tooth marks on the avocadoes, from the cab driver’s dead wife through the rape endured by Kalina in her battle-scarred homeland to the history of “abuse” fashionably claimed by both of Kayla’s parents and the irritation of their irritating daughter.

Not the least of Norris’ skills is the way in which he controls the shape of his play – the opening scene triggers a flashback of incidents – until arriving at its point of departure. The rituals of a Thanksgiving meal are inadequate to paper over the cracks of interconnected sham marriages. The brothers' mother Carol (Amanda Boxer) does her best, but makes it worse every time she opens her mouth. By the end, she can’t even turn on the television without the porn channel popping up unbidden.

This seems another way of saying things have run completely out of control at home and abroad. This unsettling play – first seen at the Steppenwolf Theatre in Chicago three years ago, and later Off-Broadway – leaves an audience with no consolation, or cause for optimism, whatsoever.

- Michael Coveney