Wow, this is an old post! Not sure if you're still interested in answers but here we go.
Just performed this for my GCSE drama performance, we had a group of 5 - 2 girls and 3 guys. We all took on the role of James together, coming together in unison for different parts and splitting up the text into monologues also.
We all multi-rolled as the other character's - we all played the mum as voices off stage, but divided roles like the judge to individual people.
We interpreted the text as intended to be performed very minimal, to small audiences. We performed in the round, with the audience around us so we were completely enclosed. Around the edge of the circle, we had mirrors to represent reflection.
We wanted to turn it into more physical theatre however, because while the words were powerful we wanted a mixture of simplistic monologues mixed with just the craze and maddness going on inside James's head.
I'm most proud of a scene we divised ourselves, independent of the text. The scene with the 'Slasher Film' we thought to be very significant - this was the turning point where he started to crave the bloodlust.
Using a red sheet, we had this intense music playing and a strobe light going and coreographed the 'slasher film' James was watching, and portrayed him literally being sucked into it, first of all being thrown around by this sheet into the audiences faces but then beginning to enjoy the bloodlust, and gaining control of the knife so he winds up figuratively stabbing someone. The 'knock on the door' brings him back to reality, where's he's imagined all this bloodlust in his head.
I loved the text. It left it so open to interpretation, and i'm so proud of what we managed to devise. Its such a powerful piece of writing!