Puppies, Participants and Patients: Thinking of care roles as choreographic tools

Hamish MacPherson

15, December 2016, Performing Care Symposium, Central School for Speech and Drama

Meg Stuart

In the video playing above, I am carrying out an exercise with artist and friend Paul Hughes called ‘Use Me’ by choreographer Meg Stuart (Peeters 2010).

It’s an exercise that she has come back to many times in her process as a way to warm up dancers imaginations as well as their bodies and it’s been used to produce material for her work Splayed Mind for example.

In the exercise there’s at least three elements that work to produce the choreography of this duet.

Firstly there are two distinct fixed roles - one passive and one active.

Secondly there are practical suggestions of what the active person could do. Stuart writes:

“Try different actions to find different relationships, stories, images. Put your head on their shoulder, imagining they are your lover. Tell a story in their ear. Work with memories of touch, like scratching, kissing or tickling. See them as an abstract shape. (…) lie on top of them (…) teach them how to move” and so on

The finally element and the most important to this presentation is that there are roles to try out, that relate to real-world, imaginary or impossible relationships. Stuart writes:

“Both partners identities shift as they stay in their fixed occupations of passive or active.” offering a list of roles that the participants can try including

Lover and Lover

Intruder and Hostage

Voyeur and Object

Vampire and a Familiar place

Protector and A fantasy


Guardian and Victim


Rescuer and Burden”

I am particularly interested in how the use of named roles can be considered in terms of care relationships. And what use these roles can have in developing care relationships.

Distinctions between a theatrical space and a non-theatrical space can be undone from at least two directions. From a sociological tradition Irving Goffman and others in the area of Dramaturgical sociology adopt frames from the theatre - things like roles, scenes and audiences to think about human relations generally. And from a choreographic tradition such as my own, expanded choreography extends the application of choreographic theory and practice beyond the theatrical setting to human and other relations more generally.

Of course care is only one way to read Stuart’s exercise and to do so ignores other things that it involves but the exercise is a starting point to think about how we can play with roles as a choreographic tool and how those roles can produce or reveal particular performances and aesthetics of care.

The roles in the exercise might involve drawing on existing understandings and recollections of caring relationships, for example if we are treat the passive person as we would a lover. And this is not just a representation of care because I know Paul is alive and aware of what is happening and so I am considering how exactly we are holding or moving or touching the other. With roles or actions that do not relate explicitly to typical caring relationships for example more abstract arrangements, there remains an underlying caring relationship of colleagues, friends and fellow humans and so I, the active partner, am taking into account how I touch or lift another - vulnerable - human being.

But there are other states, actions and images that the exercise call for that are less obviously about care.


Intimate care

The ethics of care focuses on the moral consequences of attending to and meeting the needs of the particular others for whom we take responsibility. (Virginia Held)

What I am interested in about in Stuart’s exercise is intimate care which is ideally characterised by Tamara Metz in three ways.

One. It is unmonitored by the state or other outside parties

Two. It is not primarily involving a material transaction

Neither Paul or I were paid but he took part wanting to help me and out of an interest in my practice and ideas. Just as I am interested in his practices and ideas. And we have a kind of cautious but also very open friendship in development. But there is work to be done here to understand whether the context of a performance or practice or workshop remains intimate if there are material transactions. If I were to pay him or if an audience were to pay us to perform this. How do such situations test the meaning of intimate care.


One. It is unmonitored by the state or other outside parties

Two. It is not primarily involving a material transaction

Three. most importantly here intimate care is “characterised by deep, diverse, particular and non-contractual ‘terms’, ties and motivations”

Deep here means to the point of life sustaining. That they are diverse means they are material, emotional, physical and spiritual.

The particularities and diversities of intimate relationships are worked out in private in different ways verbally and non verbally; and as I have mentioned they are importantly not contractual - unlike the care of a nanny for a child for example.


Our intimate relationships may be named in broad terms for example friends, parent and child, uncle and niece, husband and wife, lover, companion etc. that end up being negotiated at a macro-sociological level. By this I mean that although the exact ways that each of these is constituted and practiced varies from case to case and from time to time, because they are words and made with language, there is some kind of working and contested understanding at a social level. For example we might think how husband has been expanded to include men in same sex unions; or how godparent can now refer to people with a non-religious interest in a child’s upbringing.

Or when people feel that a term like ‘husband’ cannot accommodate changing practices and arrangements or cannot be purged of their heterosexist, patriarchal origins, terms like partner and significant other are put into use as alternatives.

The development of these terms occurs case by case but the pace at which they might evolve at a social level is often slow and generational.

However different kinds of care roles can be invented and negotiated more quickly at the micro (face to face) or meso (group) level for example in professional, sub- or informal cultures.  As Metz puts it “protected from outside interference, [intimate caring] relationships can serve as meditating institutions and sites of potential resistance to the totalizing tendencies of states” p125 since the state also has the upper hand in deciding how many relationships are constituted.

A mundane example is to have particular names for people in particular intimate relationships - what we might call pet names.


Kink sub-cultures are particularly well known for the adoption of roles and practices that allow for the adoption of non-normative intimate and sexual relationships.

For example the roles of dominant and submissive which may be fixed through a relationship or may switch even within a particular encounter

In a study of of dominant and submissive BDSM roles in 2005 Hébert and Weaver 2005 write that

“Most participants, including both dominants and submissives, indicated that dominants should be, and usually are, empathic and understanding. Both roles stressed that dominants need to be caring and sensitive to how the submissive is feeling.”

A particular variation of the dominant submissive dynamic is daddy - little dynamic. The littletakes the role of an innocent, playful individual. They are not role-playing a child - although some others may do this for sexual or non-sexual enjoyment - rather taking on the characteristics of a child, a puppy, a goblin and so on. The daddy may be any gender but takes on a nurturing parental role.

Medical aside

As an aside I would like to turn briefly to non intimate care in medicine which involves both formal roles of patient - including specific diagnoses - and and medical professional. But there is also a fair amount of literature that describes the unofficial terminology used by medical professionals to describe patients.

Sometimes these are affectionate for example Boyfriend refers to “A little old man who is a simple joy to take care of. This patient is sweet and unintentionally funny.”

but more often the literature describes derogatory terms like

Albatross “A chronically ill patient who will remain with a doctor until one or other of them expire”

or GOMER which stands for Get Out of My Emergency Room. Usually a male patient whose senility, chronic illness or lack of compliance portends troublesome and unrewarding care. (Coombs et al 1993)

These might often be presented as a way to avoid slipping into intimate care for example a study this year into What makes a compassionate relationship between caregiver and patient?  highlighted that “Professional training emphasises the importance of developing an ability to detach oneself from the patient’s distress and personal circumstances. (…) In order to protect themselves from such anxiety health professionals need to be sure that they don’t identify with patients.” (Goodrich 2016)

But a study from 1961 by medical sociologist Becker and colleagues (Boys in White) suggested that the detachment of name calling may be as much to do with disdain for patients that are not obedient and useful to their own progression within the existing system. (Wear et al 2006)

We are getting a little away from this presentation now but it does remind us that names are not automatically pro-care and that care practices - including those in performance settings) - may also be vehicles or even covers for power plays.


So I see here a connection with Stuart’s exercise where roles are used to play with different forms of intimate caring relationships albeit cycling through them with some speed, fluidity and ambiguity.

Her’s is a particularly interesting exercise for me but other contemporary western European choreographers and American choreographers working in western Europe have been working with roles as choreographic tools and it is perhaps not a coincidence that these people are friends and colleagues with Stuart and each other as well as peers.

For example in Hana Lee Erdman’s work Animal Companion people enter an exhibition space where they are offered the opportunity to engage with an ‘animal companion’ (a human performer) who accompanies them during their visit.

Then there is Alice Chauchat who works with companions and lady companions - she works in the same circles as Lee Erdman so these ideas are in circulation - to choreograph relations between performers, the dance and the the audience.

And Keith Hennesy works with death and dying rituals in which the passive person takes the role of a corpse to be cared for.

And so in my own enquiry which has begun with an experience of these other practices that I have mentioned.

Traditionally choreography has been an aesthetic of mastery. Of certain kinds of skills and crafts. But how can care and particularly intimate care be an aesthetical practice as well as an ethical one.

I am starting to produce a lexicon of care roles taken from across different fields - choreography, kink, medicine and others. Not to produce a definitive menu of caring relationships because both personally and artistically we will want ambiguity and diversity and complexity. Rather such a lexicon can highlight the complexity and diversity of care relationships. And in their application they immediately become disturbed. A lexicon starts from the concrete real world practices of care and builds a bigger but not abstracted understanding of how what care might be.

So how might such a lexicon be used this expand the repertoires of care practices we have available to us as artists, citizens and humans - as beings constantly in relation to other people, beings and things.


Coombs RH, Chopra S, Schenk DR and Yutan E. (1993) Medical Slang and its Functions’ in Social Science and Medicine. 1993 Apr; 36 (8) :987-98.

Goodrich, Joanna (2016) What makes a compassionate relationship between caregiver and patient? Findings from the ‘anniversary’ Schwartz Rounds in Journal of Compassionate Health Care

Hébert, Ali and Weaver, Angela (2015) ‘Perks, problems, and the people who play: A qualitative exploration of dominant and submissive BDSM roles’ in The Canadian Journal of Human Sexuality (2015),24(1):49

Metz, Tamara (2010) Untying the Knot

Peeters, Jeroen (2010) Meg Stuart: Are We Here Yet? Damaged Goods. Les Presse Du Reel

Wear, Delese, Aultman, Julie M., Varley, Joseph D. and Zarconi, Joseph (2006) ‘ Making Fun of Patients: Medical Students’ Perceptions and Use of Derogatory and Cynical Humor in Clinical Settings’ in Academic Medicine May 2006 - Volume 81 - Issue 5 - pp 454-462