Care relationships
Care relationships

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Care relationships

1.4.3 Structures that both enable and constrain

Life within a society is made possible by structures. They operate at many levels, from the details of daily life (e.g. the routines of getting up in the morning, or the ritual greetings we use when we meet people) to the broader organisation of society (e.g. the channels through which mass media ‘news’ is generated, or the rules under which benefit payments are made). Even the language through which I am communicating now is a structured system of written symbols. But structures not only enable things to be done, they also impose constraints.

The doctor–patient relationship is a good example. This highly structured relationship gives you access to advice drawn from the large knowledge base and the long-developed practices of the medical profession. However, the very structures of the relationship which make it possible to supply the advice – the polite formality, the assumption of authority by the doctor, the diagnostic procedures, the understood confidentiality of information you give, the rapid decision making – also place tight limits on what can go on within the relationship. Much of the time we are unaware of the limits because we are very used to them. But if, for example, you want to challenge the doctor’s interpretation of your illness and bring knowledge to bear from different source, it can be very hard to do this within the established structuring of the relationship.

Key points

According to Goffman:

  • Our room for manoeuvre in negotiating the ‘definition of a scene’ varies.

  • Some situations are fairly evenly balanced and open-ended. Others are tightly defined and have well-established ‘scripts’ – or power is very much stacked on one side.

  • The term ‘script’ means the conventional ways of speaking and acting in a particular kind of situation.

  • ‘Scripts’ provide a form of structuring within social situations. Like any structures they simultaneously enable things to happen and constrain what can happen.


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