I recently attended Here are the Fragments, an immersive, self-directed theatre experience at the Theatre Centre about Dr Chauvet, a black immigrant psychiatrist who is diagnosed with schizophrenia later in life. It tackles topics of intersecting identities, as a racialized minority, as a psychiatrist and as a patient, all while bringing attention to the underlying impacts that colonialism and racism can have on health and the treatment patients receive in the health care system.
I have to spend the first while incoherently marvelling at the artistry of a self-directed play! I had no idea what to make of the concept until the moment I walked into the set – a large, multi-roomed space. With a story line slowly unspooling in the background, we were encouraged to walk around freely and explore.
Imagine that you are exploring a dimly lit space to a background soundtrack that is at times a collage of noises, at other times a cacophony of voices. Some partitioned spaces were physical locations in which the story took place: the psychiatrists office, hospital wards, his home kitchen, and his son’s apartment. The way all the locations coexisted in time and space facilitated the looping storyline – and questioned the ability to compartmentalize work and life, and self and others. Other parts of the set were more abstract, with a dark, fantastical design: multiple small booths contained audio recordings, writings, images. Some explored patient experiences of schizophrenia. Some provided insights into specific characters, such as select books from the psychiatrist’s library, landmarked with bookmarks and annotations. Others provided background and context for the plot; a scientific paper on avatar therapy lay in a few key spots, giving one the chance to familiarise oneself with it, while in another room, a character invited audience members to listen to recordings of patients undergoing Avatar Therapy to perform content analysis.
The omnipresence of auditory stimulation throughout the experience can’t go unremarked. The constant background thrum of speaking, of overlaid voices, and of voices booming and projected from every which direction, perhaps shows us a bit of what having voices in the head can mean. The many pairs of headphones dangling from the ceiling or set in small booths carry other voices – patient stories, clanging, word salad, the whispers of other audience members reading into microphones – though of course we have the option to just take them off.
The whole play was such a feat of coordination. Even while wandering through the set, regardless of where I was located, I was able to keep up with the storyline. Perhaps it was because I happened to be close to the actors as they acted out the next scene, or at times it was hearing their voices projected throughout the space, or otherwise it was catching site of the grainy security camera feed filming what is happening. The storyline itself was paced to accommodate this as well; it began languidly allowing for time to familiarize yourself with the set, and as the story came to a head, the pace began to accelerate, accessory rooms darkening to to direct us all together in one space for the final scenes.
I can imagine how everyone must have had a different experience – but it was also interesting to think about how the overall feel of the performance itself was shaped by the audience. “It’s different every time,” the writer told me afterwards. “Sometimes the audience is talkative – this group was very quiet.” Indeed, I noticed our shyness – initially I noticed that I and others even had trouble watching the actors; instead of looking straight on, we would just dart furtive glances in their direction. Being able to wander around and be in such close quarters with them, yet with them seemingly unaware of our presence, felt voyeuristic. Some of the set was deliberately so – two chairs tucked into a cozy nook below a garland of lights were set behind a back-less bookshelf so you could peer between the shelves, over the rows of books to watch the physician at his desk. On one side, a screen played a constant grainy and green-hued security camera footage of the various rooms. Being positioned as an observer reminded me of how intimate the content of psychiatry can be, and how some of the more stigmatized psychiatric illnesses can make the intimate more public than perhaps the individual would prefer.
Throughout the play, themes of colonialism, and one’s identity within colonial systems, arose. I found it easiest to understand the significance of colonialism by applying it to the framework of social determinants of health. Social determinants are the non-medical factors that can impact one’s health – think finances, education level, where you live. Perhaps they give an individual the resources to afford medications or the ability to take time off to see a doctor. Or more indirectly, they can affect access to healthier foods, walkable neighbourhoods, leisure time, stress or exposure to noxious substances – all of which can impact health. Colonialism, and the racist structures that have emerged from it, have also been acknowledge to be social determinants of health. It makes sense, considering how racism can cause health-impacting chronic stress, can impair one’s access to quality health care, and can impact one’s economic situation or access to education. The effects can manifest in higher rates of health problems in many marginalized communities. For example, higher rates of mental health problems have been proposed to be “the result of relatively high levels of social, mental and emotional distress that cause poor quality of life.” However, we often don’t talk about these social determinants enough. Within the medical system, these the broader underlying factors predisposing individuals to mental health concerns such as the “colonial situation […] can become obscured and a discussion of the social situation replaced by a medical explanation of health and community problems.”
Particularly in Canada, there are inextricable ways that colonialism is woven into the fabric of almost all institutions, both historically and now. Here are The Fragments emphasized the colonial origins of western psychiatric care through the writings of Franz Fanon, historical pictures and writings. As the plot continued, it became clear that even as a psychiatrist and a member of the institution, as a black man the main character is nowhere near insulated from oppression as well.
Racism and oppression, imbued throughout colonial institutions, will impact mental health – but its insidious nature means that therapies and treatments prescribed can be colonial as well. In a room filled with vintage televisions playing a recorded group conversation, a question one of the psychiatrists posed: “How can someone receive helpful care from a person who looks like their oppressor?”
Dr. Chauvet’s episodes of psychosis were compassionately depicted, but viscerally, in a way that does not shy from intensity of the experience and discomfort. One particular scene is perhaps familiar to us all, of a person standing on the sidewalk, while internally preoccupied and caught in an episode: clanging, word salad, with medical terms such as “tar-tar-tar-tardive dyskinesia” spilling out from his mouth. But here in the play, the voices in Dr. Chauvet’s head are represented by other actors that flit around the edges of his vision, emphasizing their physicality to the audience.
In the end, it is the support of the psychiatrist’s family that remains and makes a difference for him. His son researches avatar therapy and together they construct an avatar of the most persistent voice in his head, that of an abusive co-worker. The avatar speaks of white power in every way – an old, white man, a doctor, with a deep voice and a white coat. With his son’s help, Dr. Chauvet confronts it, asserting himself against the sway of white hegemony. It doesn’t erase pain or oppression or “disease.” But, as he tells his son in the beautifully quiet ending scene that speaks to the strength of people and their communities, “a tree can lose a limb in every storm and still survive.”
One of the questions that Here are The Fragments left me with, is what would decolonization of psychiatry look like? What has already been changing?
- What Fanon still teaches us about mental illness (The Conversation) – a brief primer on Franz Fanon’s writings about psychiatry
- Challenging Hidden Assumptions: Colonial norms as determinants of Aboriginal mental health (from the National Collaboration Centre for Aboriginal Health) – lays out how colonialism impacts mental health (i.e. as a social determinant of health) within Indigenous communities in Canada
- We need to banish white supremacy from eating disorders treatment (Wear Your Voice) – this article discusses how we can begin to address anti-black racism within therapy, this example in the context of eating disorders treatment
- Psychiatry under the shadow of white supremacy (Nature) – editing this in April 2020, this book review of Mab Segrest’s Administrations of Lunacy caught my eye as a relevant and interesting read.
Like how I had no idea how to start thinking about a self-directed play, but enjoyed myself immensely, at first I was not sure how to conceptualize this golden beet cheesecake in a way that was actually palatable. The prospect of making a cheesecake with beets had been on my mind for a while, especially considering the backlog of garden beets. But as I got started, I started feeling more and more doubtful. “This is a terrible idea,” I lamented to my mum as I piled roasted golden beet quarters into the food processor. “A waste of perfectly good butter and cream cheese,” I wailed as I pureed in the block of cream cheese. But after fiddling the flavours – tasting, adding more cardamom, and more honey I brought this cheesecake to where I wanted it to be, and I ended up adoring this tart!
The filling is certainly beet, but again, subtly so where the flavour of beet is there, but accompanied by other flavours so it isn’t overwhelmingly too beety. In this case, it was cream cheese, which is a nod to the eternally salad-bound pair of beets and goat cheese – and well, it works in dessert too! I also added my favourite spice, cardamom, which I’ve used before to rein in the savoury notes and remind the tastebuds that oh, indeed this tart is a dessert. I’ve since remade the tart and adapted the filling to make it fluffy, delicate and soft – with just a bit of gelatin needed to reinforce the structure.
golden beet and cardamom cheesecake tart
This cheesecake is mild, autumnally spiced with cardamom and a bit sweetly earthy in the way that beets are. It’s certainly beet, but not overwhelmingly so. The beets themselves area already quite sweet so I didn’t need to add much sweetener – but of course, add to your taste! Filling adapted from my previous adaptation of Daily Delicious’s rare matcha cheesecake.
special equipment: tart ring that is 15cm (6-inch) in diametre and 4cm tall. If you are using a more standard 9″ fluted tart ring, increase the filling by 1.5x and double the crust recipe.
- 56g soft butter
- 1/8 tsp kosher salt
- 15g granulated sugar
- 25g beaten room temperature egg (half an egg)
- 105g flour, half all-purpose, half whole wheat
- 90g boiled and peeled golden beets, chopped
- 25g whole milk
- 150g block cream cheese, cut into cubes
- 25g maple syrup
- 20g granulated sugar
- Pinch kosher salt
- 1/2 tsp ground cardamom
- 1 tsp lemon juice, or to taste
- 3/4 tsp gelatin bloomed in 2 tsp water
- 80g whipped cream
Cream the butter with the salt and sugar. Beat in the egg a bit at a time. Lastly add the flour and mix until a cohesive dough is formed. Note that the amount of flour can vary – I find this works best when I am working with half whole wheat and half all-purpose, but if you’re using 100% all-purpose flour you may use a bit more. Conversely, if your dough doesn’t come together, feel free to add a bit more liquid as needed. Knead just a couple of times to smooth out the dough. Roll out to around 1/8″ thick between two sheets of parchment paper, then chill completely.
Have ready a 6″ diametre tart ring that is 4cm high.
For this method of lining the tart ring, I recommend you refer to this photo tutorial. Use the tart ring to cut out a circle from the chilled tart dough and trim the edges so it is slightly smaller in diametre by about 0.25-0.5cm. From the remaining dough, cut a few strips of dough to line the sides of the tart ring.
Place the tart ring on a tray lined with parchment paper. Arrange the strips in the tart ring and the ends together to seal. Then fit the circle of dough into the bottom of the tart ring and press along the seams to seal. (Alternatively, you can line the tart ring with one piece of dough – it will be a bit challenging as it is delicate, but just press together any cracks!). Chill completely.
Preheat the oven to 350F. Dock the bottom of the tart with a fork.
Bake for around 20-25 minutes or until nicely browned. You may wish to brush the tart shell with a little bit of extra beaten egg as an additional seal (and if you have any cracks, that can help seal those as well) and bake for another 2-3 minutes.
Place the chopped cooked golden beets in the food processor along with the milk. Puree, scraping down the sides as needed, until it is as smooth as it will get – it will actually rather resemble mustard. While it will not be perfectly smooth, it will not be noticeable in the final cheesecake.
Add the cubes of cream cheese, maple syrup, sugar, salt and ground cardamom and continue to process until the mixture is homogeneous, scraping down the sides occasionally. Scrape the mixture into a bowl. Taste and add lemon juice to brighten the flavour.
Bloom the gelatin, then melt it by briefly warming it in the microwave (about 20 seconds depending on your microwave). Add some of the cheesecake batter to the gelatin, whisking until fully combined, then scrape it all into the remaining cheesecake batter and whisk together. Whisk in a small dollop of the whipped cream to lighten, then fold in the remainder. Scrape into the prepared tart crust and even out the top with an offset spatula. Place in the fridge overnight to set. Once set, serve with whipped cream.
Update notes: this post was updated November 2020 and then again in Oct 2021.