One scene meanders haphazardly into the next in “The Little Flower of East Orange,” the fifth play by Stephen Adly Guirgis to be staged by his longtime collaborator, Philip Seymour Hoffman, for LAByrinth Theater Company. Yet if there is a slapdash quality to Mr. Guirgis’s semi-autobiographical family drama, “Little Flower” also invokes a pain sharp enough to cut through the haze — the pain of a desperate, destructive love between a demanding mother and her tortured son.

It helps immeasurably that the mother in question, a wheelchair-bound Catholic widow named Terry, is played by the formidable Ellen Burstyn — and that the magnetic Michael Shannon plays Terry’s grizzled, strung-out son, Danny. In their ferocious arguments over whether Danny will continue to take care of Terry or finally strike out on his own, these two are fighting for their lives.

Ms. Burstyn’s riveting performance is all the more remarkable considering that most of it is given from a hospital bed, and the remainder of it is given from a wheelchair.

Terry has been brought to a city hospital in the Bronx after propelling her wheelchair down the steps at the Cloisters in a bid for either death or her children’s attention — it’s hard to say which. Initially, she refuses to tell the hospital staff her name and, by the time Terry finally allows her family to be notified, Danny and his upstanding sister, Justina (Elizabeth Canavan), are in full panic mode.

Danny arrives at Terry’s bedside direct from rehab. Like his mother, who supplements her morphine drip with gulps of scotch, Danny likes to self-medicate. After the flameout of his promising writing career and a bad breakup, he’s stuck in a cycle of depression and addiction. His first question to Terry is blunt and bleak: Why can’t he go anywhere without having her wind up in a hospital and forcing him to come back and tend to her?

The answer to that question goes to Terry’s core, and “The Little Flower of East Orange” is determined to get to that shadowy place. Through a series of hallucinations and conversations, Mr. Guirgis peels away Terry’s defenses, laying bare the ugliness of Terry’s childhood: an abusive, alcoholic father, her terrifying injuries, her early training in martyrdom.

In many ways, the journey back through the dark secrets of Terry’s working-class New Jersey family feels like sepia-toned social drama — an homage to Clifford Odets, produced by a latter-day Group Theatre, perhaps. Ms. Burstyn, who comes out of the Actors Studio, makes the analogy all the more potent — her honest, straight-from-the-gut performance is unforgettable.

Mr. Guirgis’s naturalistic dialogue and the thorny tussle at the heart of this family tap into a strand of 20th-century American drama that believed in the value of holding up one’s ghosts to daylight.

Yet for all its brute honesty and emotional impact, Mr. Guirgis’s play is unsteady on its feet. Mr. Hoffman’s spare set and expert casting put the focus on character and dialogue, diverting attention away from the play’s start-and-stop structure. But that structure — which involves somewhat pat opening and closing monologues, an awful lot of hospital business, unaccounted-for digressions, and an interesting but underdeveloped use of flashbacks — is a wobbly one.

“Little Flower” still feels like an early draft, and though it retains some hot-off-the-presses freshness, it hasn’t worked out the kinks in its mechanics. Mr. Guirgis has often been applauded for being a natural, rough-around-the-edges sort of dramatist. What “The Little Flower of East Orange” makes plain is how much he could achieve if he could combine that raw talent with structural discipline.

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