Iain Banks died just a few weeks before his first novel became an opera in the hands of composer Ben Frost and librettist David Pountney; the result, premiered in August in Bregenz, arrives in the UK in the same staging – also the work of Frost, working with set designer Mirella Weingarten.

Its chief visual image is unforgettable: a stretch of earth that slowly rears up before the audience, spilling out its secrets in front of them. Out of it rise the conjoined bodies of the three female singers – Lieselot de Wilde, Mariam Wallentin and Jördis Richter – who together represent Frank, the teenage serial killer whose internal landscape the opera explores; they also play the central character's father, brother and victims.

Though the material recognisably derives from Banks's text, the action is viewed through the eyes of Frank – whom the novelist once described as a "normality-challenged teenage eccentric with severe violence issues" – and as a result, it feels less like an independently viable narrative than a satellite work, or even a homage. How much of it would make sense to someone unfamiliar with the book is uncertain.

Yet in terms of the miasma of alienation suffusing the score – whose other constituents are an obliquely objective string quintet of players from the Rekyavík Sinfónía, and electronics that shake the venue as well as churning up the innards of those inside it – its power to fascinate and disturb is palpable. Add in the extraordinary physicality of the three singers, whose folk-inflected vocal lines underscore their resemblance to those groups of weird sisters encountered in innumerable fairytales, and the show becomes a deeply unsettling theatrical experience, nakedly operatic in the way the music pours out of the performers to overwhelm the audience.

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