Bored and spoiling for a flight: capabilities lost and found in lockdown
PMCID: PMC10715406
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Abstract
Human beings are dynamic; our innate faculties beg to engage in activities. To achieve fullness and human dignity, people “convert” personal capabilities into active “functionings,” Amartya Sen explains. This means that staying still is not a normal state. It can feel like punishment. Forced inactivity will generate resentment, resistance, and boredom that can fester until pent-up energy explodes violently, or implodes in depression. Boredom defaults on capabilities and resources in many cases. In other cases, stillness is a gift. It can stimulate the imagination to fill in emptiness with memories and new explorations. Either boredom builds toward doing damage, or it releases energy to think and to create. What people don't do is stay put, mentally or physically. Authorities-including police, judges, teachers, parents –should take this dynamic human condition into account and reconsider the effects of conventional command and control policies. Then they can choose between violence and creativity as alternative outlets for the energy that boredom generates. Short of facing up to human dynamism, decision-making may continue to favor strong-arm tactics, which trigger the violence and pain that policing is meant to mitigate. Is it surprising that apparently peaceful peoplebecome enraged in lockdown conditions? Do adults wonder why students drop-out of school and suffer escalating rates of depression and suicide? Boredom is certainly not the only cause for these disastrous effects, but to ignore it risks remaining complicit with processes that perpetuate personal and collective dysfunctions. Complicity with harmful practices will miss opportunities to channel frustrated energy toward developing human capabilities. Authorities are responsible for promoting peaceful development. We are all responsible.[2] Normally, people stay busy with routine activities. We work, play, attend to family and to friends. Particular activities have even become our public badges of identity, as is evident in surnames (Cooper, Baker, Taylor, Farmer, etc.) that trace back to work that ancestors answered to. Lockdown during COVID-19 meant that many otherwise occupied people had few outlets for energy. Those who knew how to meditate managed to assuage anxiety through contemplation and the pursuit of ideal emptiness.
Full Text
Human beings are dynamic; our innate faculties beg to engage in activities. To achieve fullness and human dignity, people “convert” personal capabilities (Sen, 1999) into active “functionings,” Amartya Sen explains. This means that staying still is not a normal state. It can feel like punishment. Forced inactivity will generate resentment, resistance, and boredom that can fester until pent-up energy explodes violently, or implodes in depression. Boredom defaults on capabilities and resources in many cases. In other cases, stillness is a gift. It can stimulate the imagination to fill in emptiness with memories and new explorations. Either boredom builds toward doing damage, or it releases energy to think and to create. What people don't do is stay put, mentally or physically.
Authorities—including police, judges, teachers, parents—should take this dynamic human condition into account and reconsider the effects of conventional command and control policies. Then they can choose between violence and creativity as alternative outlets for the energy that boredom generates. Short of facing up to human dynamism, decision-making may continue to favor strong-arm tactics, which trigger the violence and pain that policing is meant to mitigate. Is it surprising that apparently peaceful people become enraged in lockdown conditions? Do adults wonder why students drop-out of school and suffer escalating rates of depression and suicide? Boredom is certainly not the only cause for these disastrous effects, but to ignore it risks remaining complicit with processes that perpetuate personal and collective dysfunctions. Complicity with harmful practices will miss opportunities to channel frustrated energy toward developing human capabilities. Authorities are responsible for promoting peaceful development. We are all responsible.
Normally, people stay busy with routine activities. We work, play, attend to family and to friends. Particular activities have even become our public badges of identity, as is evident in surnames (Cooper, Baker, Taylor, Farmer, etc.) that trace back to work that ancestors answered to. Lockdown during COVID-19 meant that many otherwise occupied people had few outlets for energy. Those who knew how to meditate managed to assuage anxiety through contemplation and the pursuit of ideal emptiness. But many mortals—including myself—either fail at efforts to concentrate on breathing, for starters, or they have not tried. Maybe people don't know about the disciplined techniques and the goal of inactivity; or maybe they are not drawn to doing what looks like doing nothing. Wanting to do something when it seemed that very little could be done prepared the conditions for widespread boredom. Households became laboratories for studying boredom, hothouses in fact, or petri dishes. The unbidden experiment is an opportunity and, therefore, an obligation to reflect on the dynamic and to expand a range of appropriate responses for future challenges. Either we will have learned something in the laboratory to help design a new paradigm for human energy under constraints, or we will consider the damaging effects of constraint mere anomalies in conventional, if disappointing, approaches to security, education, and mental health. To use Sen's term, we will “muff” the opportunity to develop.
When work and play activities ended abruptly in worldwide house arrest during the COVID-19 pandemic, human dynamism hit a wall, an interior wall of domestic confinement. The explosive effects of inactivity blew up beyond predictable proportions. Consider the spike in domestic violence as one unintended consequence of public health policy. Soon after the doors locked, alarming reports across countries and social classes repeated and confirmed statistics that seemed unbelievable.
Early on, “The World Health Organization has highlighted a 60% spike in calls to European domestic violence hotlines in April” (Mahase, 2020). Brazil's Public Health Forum registered an increase of 431% for the same period (through social media, given the danger of retaliation by eavesdropping partners) (Bueno et al., 2020, p. 13), while New York's Governor Cuomo appointed a Task Force to find innovative solutions for the sudden rise in home-based crimes, after reporting a 33% spike in April 2020 (New York State Task Force, 2020). Data have been also confirmed in a number of studies (African News Agency, 2020; Boserup et al., 2020; Bradbury-Jones and Isham, 2020; Campbell, 2020; Leslie and Wilson, 2020; Miltimore, 2020; Mlambo-Ngcuka, 2020; Usher et al., 2020; World Health Organization, 2020). Governments worldwide asked how to offset the aggressive repercussions of lockdown, according to The Council of Foreign Relations (Bettinger-López, 2020).
The question of what to do begs the question of why the lockdown increased domestic violence. Loss of jobs, alcohol, and psychological stress are still common and convincing answers (see footnote 22). Familiar responses to violence continue to be vital, including hotlines and shelters for victims and punishment for perpetrators. But neither the known causes nor the standard remedies managed to reduce the incidence of domestic violence even before the pandemic. By now, the limits of conventional approaches are evident. They amount to secondary or tertiary interventions, after threats are made or damage is already done. Something more is needed, urgently. It is primary prevention to stop violence before it starts (Walden and Wall, 2014). Prevention will include education about violence and newly learned practices that undo habits of power. In order to diffuse dangerous behaviors before they develop into aggression, we must first identify nonviolent but simmering conduct that can become explosive. Recognizing triggers for potentially violent behavior is a step toward proposing innovative remedies. One trigger is so evident that it has passed under the radar of many specialists and authorities: Boredom. People get bored in confinement. This is a hypothesis worth pursuing. Arguably, men may get more bored than women even under normal conditions (Gosline, 2007; Talbot, 2020; Westgate and Steidle, 2020). The effects of domestic boredom could turn out to be unremarkable, compared with the intense stresses of joblessness, poverty, and a bleak future. But this unexplored stressor is an opportunity for new and effective interventions to mitigate violence, even if they cannot end it or replace the need for economic security.
The question of what to do begs the question of why the lockdown increased domestic violence. Loss of jobs, alcohol, and psychological stress are common and apparently compelling answers (see footnote 22). These familiar responses to violence can still make sense, if hotlines connect and safe houses shelter while perpetrators submit to control. But neither known causes nor standard remedies had managed to reduce the incidence of domestic violence even before the pandemic. By now, it should be clear that conventional approaches treat symptoms rather than causes. Therapy for violence responds to symptoms of damage already done. Prevention is in order (Walden and Wall, 2014) through unfamiliar proposals. To diffuse dangerous behaviors before they develop into aggression, it will be important to recognize triggers for potentially violent behavior.
The failure is partly conceptual. It is a curable calcification that this essay addresses. My purpose is to explore better responses to current and future crises. A cure for staying stuck requires perseverance and patience along with imagination, Thomas Kuhn concluded from observing paradigm shifts in the history of science (Kuhn, 1962). Change takes an intentional will to shift from a familiar paradigm of cause and effect to alternatives (Kuhn, 2021). If experts stick to parameters of conventional thinking, the lockdown will have amounted to a mere pause from making sense, a blip, rather than a grant of time in a laboratory for new thinking. The shift in thinking about boredom begins by admitting that the conventions of keeping order simply don't work. Parents, teachers, or jailors impose conventional demands for obedience to everyone's peril. Potentially disruptive children and other wards may respond with a backlash that ignites the undesirable behavior that the demand for obedience had meant to control. This anomaly between command control and out of control responses is no mere interruption of rational expectations. It is evidence of a conceptual error, because people are normally dynamic. A correction can start by acknowledging the dynamism and supporting human capabilities. The difference between control and support amounts to a shift in paradigm, from obedience to autonomy, from being the subject of another's will to becoming a self-realizing agent.
This shift is part of a general overhaul in development studies. No longer persuaded by the conventional Gross Domestic or National Profit (GDP or GNP)—a single mathematical measure that ignores abysmal differences in living standards between rich and poor people—the United Nations and other agencies now prefer a Human Development Index (HDI) of three criteria (longevity, literacy, income). Pakistani economist Mahbub ul Haq proposed the HDI to support people-centered policies The improvement came from a collaboration with Amartya Sen who had alerted economists to the difference between wellbeing and being well-off. Sen's “Capabilities Approach” to human development gives account of real people, their situated resources and their opportunities to use those resources (Sen, 1985). Use is key, Sen points out, to convert what people have into what they can do with what they have. Maybe peasants have crops but no transportation to sell them in markets, or citizens have the right to vote but no expectation that their votes will count. The distinction between assets and making good on assets depends on one's capacity to convert “being” into “doing.”
Announced in 1974, this conceptual shift from a one-size-fits-all GDP to customized considerations resonated with a generation of feminists who were unmasking the male privilege and willful blindness of “universality” in law and economics. “[T]he full human diversity among people is insufficiently acknowledged in many normative theories, such as theories of distributive justice. This also explains why the capability approach is often favorably regarded by feminist philosophers, or philosophers concerned with care and disability issues (e.g., Khader 2008, Terzi 2008, 2010),”. Most notably, Martha Nussbaum took Sen's lead to multiply criteria for wellbeing by proposing a basic list of rights in order to identify actionable gaps that prevent people from “creating capabilities.” But Sen demurs from lists: “What I am against is the fixing of a cemented list of capabilities. (Sen, 2004)” “There is nothing illegitimate or defeatist in recognizing that the valuation rankings of wellbeing may have gaps.” While he concurs that we need bare and basic criteria, even helping ul Haq to devise the three-pronged HDI, anything more, he argues, would miss the specific priorities and conditions of real lives.
Where domestic violence is concerned, we know that a significant difference is gender (Peterman et al., 2020). Even when men don't start fights at home, they tend to finish them with force. Statistics on this age-old abuse had already scaled up alarmingly before COVID-19, maybe because increasing numbers of women were choosing to report crimes that would earlier have cost them economic security or would have seemed too commonplace to register. Improved reporting before lockdown put the spike in sharp perspective. What made so many more men violent during house arrest than before? It is worth considering a subjective differential for men and women in forced confinement.
An interpersonal criterion like boredom for evaluating violence at home doesn't interfere with Sen's intentionally unfinished framework. Rather, it makes good on his defense of moving pieces. Consider the ways in which subjective desires and capabilities interact with shared consequences to recognize that setting priorities amid changing circumstances includes interpersonal dynamics. Personal criteria alone may miss some potentially dangerous dimensions of individual development. The danger lurks in Sen's focus on personal wellbeing, one human being at a time. “Thus narrowed, personal wellbeing related to one's own life will reflect one's standard of living.” This self-possession is aspirational in some cases and unthinkable in others. Sen assumes that people can and should make reasonable and free choices about their identities and affiliations, but the assumption is hardly reasonable in the real world of gender hierarchies and familial ties. This oversight may miss Sen's own cue about framing capabilities in collective contexts. Sen, like Nussbaum, stays with the individual, though he prefers improvisation in the volatile variety of contexts while she prefers more structure.
Does a conceptual framework centered on single persons allow a vestige of liberal universalism to persist in the capabilities approach? Universalism assumes that people are ideally equal and therefore interchangeable in theories of value and in measurement. An instance of this paradigm is the one-size-fits-all GDP that lingers beyond its expiration date. Despite being pronounced dead for decades, the single economic aggregate that obscures inequities doesn't quite die. A “zombie concept,” it haunts and hinders human development. As a corrective to outdated paradigms of development, the capabilities approach proposed by Sen and pursued by Nussbaum adds criteria of measurements to a misleading aggregate (Sen, 2000; Nussbaum, 2000). By multiplying the criteria, they can focus on individuals rather than on whole nations. But even this deeper view risks missing an important dimension of development by blurring the interlocking forest with a focus on individual trees (Sen, 2001). “[W]e have responsibility for what we desire (and the need to relate it to what we value), whereas we have no such direct responsibility for the desire of others.” Perhaps the operative word here is “direct,” because surely a culturally bound desire is a collective responsibility.
Gender-determined roles are zombie concepts too. Legal and economic discrimination by gender has been condemned for centuries and outlawed in more recent history, but the prejudices and practices of male superiority continue to skew access to rights and resources (Prager, 1996). Nancy Chodorow named the process of unequal gender formation “the reproduction of mothering (Chodorow, 1978).” One result of this formation is that women take charge of children and men achieve a paradoxical authority when children invest power in fathers as a safeguard against tyrannical mothers. Women rule at home. No wonder men can feel disabled when housebound. Surely they get more bored than women do during lockdown, since a consequence of gender specific training is that women know how to use domestic space to exercise agency, while men count on other spaces to convert their capabilities into functioning. Some readers may be skeptical about this gendered boredom quotient; they may also dismiss the relevance of boredom for making sense of explosive behavior. Those readers may also identify as male. Women don't doubt the gender difference or the threat, generally speaking. They recognize the syndrome of male listlessness, frustration, and rage. Differential levels of male and female boredom offer a speculation worth pursuing in order to craft new practical responses.
Nussbaum targets tenacious gender disparities as obstacles to women's development. By definition, disparities are comparative and therefore, interpersonal, a dimension that sometimes falls out of focus in Nussbaum's defense of autonomous selves, one woman at a time. To appreciate this slip from real and relational identity to ideal autonomy consider the example that launches Creating Capabilities (2011): “[A] small woman in her early thirties” Vasanati had abandoned an abusive husband and returned to her family of origin. The example is telling beyond the conclusions that Nussbaum draws about Vasanti's courage and about women's solidarity through Sewa, a collective of working women. But Vasanti's brothers also played decisive transitional roles. As members of a Gujarati family, they were not obliged to take back a married woman, however abusive her husband became. When the brothers rescued their sister, their decision was unscripted. Their capabilities functioned to judge and to act. The brothers enabled Vasanti to become autonomous, first alone and then through Sewa. We might call this development a collective or a cascade conversion of family and community resources into a personal triumph that would bring more ripple effects. Nussbaum does give the brothers credit for valuing Vasanti's safety over community norms, but the narrative doesn't feature the structural connection between the woman's step forward and the men's accompaniment. Their advances were mutual. The brothers' decision enabled their sister to be free; and the sister's demand sparked her brothers' choice. Paradoxically, independence can depend on mutual support. But mutuality plays a minor role for Nussbaum. When she distinguishes between internal and combined capabilities, the difference refers to innate faculties and developed talents in an individual. Though they overlap, “innate equipment… into advanced capabilities” refers to the development of an individual.
From her activist legal perspective and in Sen's ethical economics, the social element of wellbeing shows up, but mostly as a function of personal development. This is close to a contradiction since sociability is a structural connection between a self and others rather than a personal pastime. The focus on individuals means that social values or criteria for measuring development remains surprisingly underdeveloped. For both theorists, sociability as mutual care fades perilously; it flattens into a dimension of personal growth. This is a curious loss of depth perception, after both Sen and Nussbaum remind us that Adam Smith considered sociability to be a significant contributor to the collective Wealth of Nations. In fact, Smith's earlier Moral Sentiment begins with mutuality, “an interest in the welfare of others, and make their happiness necessary to him, even if he gets nothing from it but the pleasure of seeing it.” Perhaps understandably, given the tug today toward group-based recognition and authenticity, Sen and Nussbaum stay clear of communitarian claims. They put particular people first, and Sen acknowledges the incalculable variety of cultural resources that often include personally crafted hybrids of competing cultures. A capabilities approach that supports the autonomy of individuals understandably resists giving priority to culturally cozy traditions that can trump dynamic conversions. Culture, in Sen's formulation, is not the end, or objective, of community life, but the means for development. It is a field for improvisational activity rather than a legacy to protect.
Boredom is a personal experience that can flare into interpersonal trouble. It begins by oppressing an individual who cannot tolerate empty time. But when boredom builds toward violent interruptions of the tedium, victims are collateral damage. Shouldn't a boredom quotient figure among the criteria for wellbeing that Sen can enlist when appropriate? It is the elephant in the room of development theory, silently seething and preparing to pounce on an individual's reason and autonomy with consequent casualties nearby. Victims include battered partners, children, older parents, all of whom lose their own autonomy, resources, and agency for development, when lockdown is experienced as lockup. In wartime, this conversion of boredom into agency is linked to atrocities, and tedium is worth tracking in police brutality. Conversions of energy into action are not always pro-social. This caveat to the capability approach points to a loose end in Sen's defense of pluralism regarding values. Sometimes, pathologies of power, revenge, violence will demand a more normative framework to distinguish abuse from empowerment (Wolff and De-Shalit, 2007).
To support human thriving, we have an opportunity (read obligation) to consider the interpersonal, social, dimension of capabilities that Adam Smith featured for personal wellbeing and that Sen updates: the opportunity is to promote in others the skills and the pleasures that support their wellbeing, and ours by extension. Perhaps this represents a double paradox. On the one hand, development is understood in the capabilities approach as self-development. Collective advances follow from exercises of personal autonomy. On the other hand, pleasure is often understood as a diversion from development, literally going off track. How can helping others to feel pleasure support one's own self-development? A short answer is that other people who don't feel pleasure are at risk of feeling rage. Self-interest will be well served by preempting other people's rage and the violence it ignites. Regarding ethical worries about pleasure, Sen and Smith relax the concern when they recover the link from pleasure to dignity and autonomy. “To lead a life without shame, to be able to visit and entertain one's friends, to keep track of what is going on and what others are talking about, and so on, requires a more expensive bundle of goods and services in a society that is generally richer.”
Pleasure has had bad press since the philosophically hedonist heyday of British utilitarianism. Sen revives its ethical work. What would wellbeing mean without enjoyment? A standard of living makes sense “through some object of value—in this case, some type of pleasure.” The reluctance to embrace an ethics of enjoyment and sociability has made pleasure a perverse pursuit. People seek it out, perhaps assuming it must come at a moral cost. Enjoyment seems tinged by sinful desire in a capitalist culture that devalues diversion and enshrines hard work. (Max Weber called this “an-hedonic” culture Calvinist). But pleasure and play have been ethical values at least since Aristotle and then for a long line of thinkers that extends, for example, through John Finnis, who included aesthetic experience as a dimension of personal development.
Boredom is a lack of surprise, a death of sensation. Empty time can feel like deprivation rather than the luxury of leisure to think and to make things. For people who know how to use it, unprogrammed time is the resource of freedom to be converted into a functioning—in Sen's terms. But for bored people who resent empty time, the resource withers or flips into something monstrous. Boredom flattens freedom into frustration. Either a hiatus of activity will end in an engaging activity or in acting out. The tension that comes from inactivity is volatile, and the energy will come out one way or another. Since people have a range of innate faculties that can be converted into functionings, it makes sense to foster creative faculties. This is a matter of choice, arts over aggression. Skeptics may assume that choosing is limited to some people who are creative. Kant assumed this. That's why he featured judgment over creativity as the universal faculty for civic development. But the assumption about predetermined access to or exclusion from creativity condemns us to expect more spikes in violence and more depression and suicide. The threats of interpersonal and self-harm are likely to increase. We can anticipate continuing and recurring boredom from loss of jobs, resignation from jobs, confinement to refugee camps, prisons, failing schools, and possibly renewed house arrest.
Fortunately, people are innately creative, despite the skeptics. Creativity is hard-wired in the human condition. Our challenge is to recognize the resource and to make good on our innate faculties of imagination and judgment. These dimensions of being can be converted into skill-based doings to develop capabilities. It was Kant's disciple, Friedrich Schiller, who gave this natural resource a name, Spieltrieb, playdrive. During the Terror of the French Revolution, Schiller elevated this faculty to the level of a drive to interrupt the spirals of violence that had locked the other two drives—Reason and Passion—into mutually murderous opposition. How do you interrupt the escalating, self-destructive, spirals? Schiller's answer was to bridge the feuding forces through play and art. Anyone can play, and we can learn to make art that will repurpose energies and divert the attention of enemies from hatred to delight in new forms. Rage today includes flares from the counterintuitive trigger of doing nothing. Whether despair and death follow from revolution or from being bored, Schiller would urge us to take a step back and redirect our energies from aggression to artmaking. There is really no alternative, because without the “disconnection” from habits and interests that art provokes, people lose agency and stay caught in spiraling structures. Convention may shun the arts as impractical in dire conflict, but Schiller knew that it was the missing agent of reconciliation. Without art, conflict has no escape route. The opposite of play is not work or seriousness, anthropologist Gregory Bateson would explain for socio-ecological reasons; it is boring one-dimensionality that leads a species to extinction.
Psychoanalyst Donald Woods Winnicott would come to Schiller's same conclusion. We have no evidence that Winnicott read Letters on Aesthetic Education (1794) (see foot note 52), but he was equally dedicated to play. Schiller had written “man is truly human when he plays, and he plays when he is truly human,” as if presaging Winnicott's work. The therapist included his own practice among creative activities: “Psychotherapy takes place in the overlap of two areas of playing, that of the patient and that of the therapist. Psychotherapy has to do with two people playing together.” This means free and “non-purposive” artmaking.
The instinct to create shows up immediately, says Winnicott, when a newborn searches for its mother's breast. The breast materializes because the mother plays too, bending to the baby's will to welcome it as creator of its world. The early games multiply throughout life as “play is the continuous evidence of creativity, which means aliveness (Abrams and Hjulmand, 1996).” People play at affecting the world, not only in response to hostility or to loss, as Melanie Klein thought. Creativity is an innate drive—Schiller's playdrive—to achieve tacit control over existing, often conflicting, materials and demands, as when a fifth grader cures her anxiety about math by drawing scary but funny comic strips. In professional “Newspeak” this recourse to pleasure is called “self-administered art therapy.” We can call it play. Riskiness spikes both art and analysis with dangers of unpredictability, dangers that cannot be abolished if therapy is to proceed. So, the work demands a steadiness that can anticipate and survive aggressive surprises meant to unhinge the playmate, including the clinician. “The drive is potentially ‘destructive'… But destruction of an object that survives, that has not reacted or disappeared, leads on to use (Winnicott, 1969).” And using people, Barbara Johnson understood after reading Winnicott, amounts to loving them (Johnson, 2000).
A nadir of activity and a peak of interaction made for a perfect domestic dust storm during lockdown. Reduced access to psychologists and psychoanalysts, the lack of money to pay them even when therapists were available on electronic platforms, and the failure to focus on the elephant of boredom in the room all converged to heighten domestic violence during lockdown. Already elevated statistics that spiked during house arrest should now prompt us to recognize an antidote to the malady of boredom. It is the friendlier face of the elephant. If boredom is a common and unacknowledged threat, art making is a common but underemployed resource. Rising levels of anxiety, depression, abuse, and suicide prompt mental health providers to explore support from non-clinical practices. Are there effective resources outside the clinic? There are. In fact, a social approach to wellbeing is well known, and new pioneer programs train lay counselors and peer mentors to offer support. These resources could substantially expand and deepen by adding the under-explored option to engage artists as allies.
Low resourced settings are particularly fertile for this option because poor areas are often rich in arts. Traditions of storytelling, music, dance, weaving, cooking, mask making, poetry, pottery, etc. still thrive in everyday activities alongside modern practices. Artist Pedro Reyes notes that Latin America, for example, may be poor in finances and in politics, but in art it is a treasure house. This can be said of the global south in general. Consider an example from Peru's highlands. Peasant women there cultivate up to 4,000 varieties of mostly inedible potatoes, just for their color and shape, to lay out designs for new weavings. The challenge for therapy in economically poor environments—and everywhere else—is to dignify art as a worthy partner for therapy.
Stigma has been an obstacle. It is an equal opportunity blight. On one side, people with mental illness don't seek help when stigma stops them; on the other side, providers often present a stigma against taking art seriously. They tend to dismiss creativity as unscientific, even risky, and inappropriate. The arts seem either inconsequential or downright harmful. While creativity is no sure pathway to mental health, and though artists may continue to be afflicted by the demons that drive them, it is worth considering the differing degrees of affliction when art is an outlet and when it is not. Memoirs offer testimony to the power of creativity as a coping mechanism for mental illness. But clinicians and researchers have been reluctant to credit artmaking as therapy, as a medium for amelioration, even when the making seems meaningless. Art is therapy. The reason is clear. Artmaking is active. To create something new demands dynamic faculties of mind (Stuckey and Nobel, 2010). When people make art, they become observers, exercise judgment, experience autonomy, make decisions, and anticipate communication through visual or performative languages, including words repurposed for poetry and prose. To assume that art works because it makes meaning is to miss the magic of making itself. Art works because it wedges a distance between what is and what could be. Augusto Boal–founder of Forum Theater and author of Theater of the Oppressed (Boal, 2000) put it this way:
“Only the human being is tri-dimensional (the I who observes, the I-in-situ and the not-I) because it alone is capable of dichotomy (seeing itself seeing). And as it places itself inside and outside its situation, actually there, potentially here, it needs to symbolize that distance which separates space and divides time, the distance from ‘I am' to ‘I can be', and from present to future; it needs to symbolize this potential, to create symbols which occupy the space of what is, but does not exist concretely, of what is possible…So, it creates symbolic languages: painting, music, words.”
Rational choice theorist Jon Elster counted on artists to illustrate good decision making, because artists know how to limit options and manage constraints (Elster, 2000). This cluster of mental and emotional talents can channel explosive energies into “symbolic destruction,” Winnicott's name for artmaking (Winnicott, 1991). The dichotomy that Boal identifies between being and observing can crack fissures in lockdown states of anxiety and depression, to let the outside world slip in. At a mental hospital in Paris, Boal discovered that on stage, when performing for other patients and their doctors, even acutely afflicted people would budge beyond their static clinical narratives. On stage, patients become actors to be observed by themselves and by others. Both actors and spectators occupy a fictional space that distances and estranges habitual stories which—from this unfamiliar perspective—can be told differently. After acting, sessions with therapists went better at the hospital. Aesthetic space was the opening.
Artists are not victims. They are neither stuck in one-track narratives nor stopped by debilitating circumstances. Instead, artists are agents who transform problems into challenges; they recycle found materials into new products. Whether or not the products have aesthetic value for connoisseurs, the therapeutic effect of artmaking comes from the process, often with byproducts of pride in the work and in oneself. Sometimes artmaking reveals buried trauma that a talking cure doesn't easily access. This contribution has attracted the sleuthing attention of psychoanalysts. But other times, artmaking is untethered to repressed meanings. It simply exercises freedom to explore materials and their arrangements. Artmaking can be a purposeless exercise of agency and choice, a self-authorizing therapy against lethargy and listlessness.
Even unhappy people, like Boal's hospitalized actors, will accept an invitation to play, though they may bristle and retreat from unfairly demanding prompts given by many clinicians to find meaning or purpose. The invitation to participate in artmaking can be as unassuming as making a meal or getting dressed, putting together pieces of clothing to create an outfit. Arts may include drawing a picture or singing. (The Spanish verb interpretar for making music captures the inevitable innovation through performance.) Other, more intentional, traditional, or international, art practices can follow and develop or morph over a lifetime. The everyday nature of low-stakes artmaking sidesteps the stigma that would single out mentally distressed people for special attention. This mitigating feature of inconspicuous inclusion emerged in a pilot program for ninth graders in the Kibera slum of Nairobi where roughly half the youth are clinically depressed. The arts-literacy pilot did not single out mentally ill classmates, since all participated. The simple prompt to make art from a required text charmed even reluctant readers to create liberating interpretations, through drawings, rap routines, riddles, dance, theater, and other art forms of their choice. One result was a significant reduction in depression and anxiety. Another was enhanced pleasure in reading. Parallel projects in a Buenos Aires mental hospital confirm the findings (see footnote 82).
Genres and styles of artmaking will vary among regions and even between households, but the practice of making new things and performances from available materials and conditions is hard-wired in human beings. “Art making is an innate human tendency, so much so it has been argued that, like speech and tool making, this activity could be used to define our species (Dissanayake, 1992).” If artmaking is a human birthright, as philosophers and educators have long noted, we can count on a creative mental faculty to address boredom. We can also count on an abundant roster of mentors to channel energy into artmaking. Artists are everywhere. They can rise to the challenge of what to do with unbidden free time. Should we consider free time to be an inevitable trigger for trouble and prepare more prisons? Or can it be a resource for the conversion of capabilities into functions?
“There is nothing either good or bad, but thinking makes it so,” Shakespeare quipped. Interpretation makes the capabilities approach work in unscripted ways. Prepared scripts of behavior can “muff” genuine advantages, Sen observes. Free time, one of those unacknowledged advantages, is muffed when bored people feel helpless without prescribed activities. Policy makers may be equally stuck in predetermined scripts. Sen counts on people's innate reasonableness to take advantage of opportunities. But Shakespeare's lesson about interpretation adds creativity to reasonableness. The addition turns information into something new. In fact, Sen defends creativity as a dimension of reason (Sen, 2012). He stretches Bentham's identification of material and mental satisfaction to leave room for “creative discontent and constructive dissatisfaction.” Creativity is born of dissatisfaction. New ideas and things respond to “what is missing.” While Bentham's brand of happiness depended on desire-fulfillment, Sen warns that this goal will short-change capabilities if poor or oppressed people adjust to desires within reach. His update of utilitarian philosophy, elaborated by commentators and critics, points out that desires are not always constructive. Sometimes they are antisocial, like interrupting intolerable boredom by inflicting pain on others. Fulfilling a personal desire can come at a high cost to others. Can we provide creative programs that embrace freedom rather than fear it?
Sen's exhortation to be flexible about culturally conditioned values raises an ethical challenge: Should a community always support the conversion of personal capabilities into functions? Should we assign a positive value, for example, to the conversion of unbearable boredom into violence? How should policy respond to this danger in Sen's non-normative thinking? Nussbaum answers with a list of fundamental norms to respect. But Sen's non-normative lead takes us in a different direction. It would recognize the danger of violence as an incentive to prepare alternative pathways from boredom to self-expression. The alternatives to physical and verbal violence could be the varied forms of “symbolic violence” called art. A non-normative approach to thriving need not restrict or reprimand aggressive energies. Instead, energies can be channeled into pleasant, even passionate activities. A range of non-destructive activities could add up to a framework for redesigning policies of violence prevention. The utilitarian tone of this lead recalls Jeremy Bentham's brand of hedonism, to increase pleasure and happiness for the greatest number of people (Bentham, 2003). Sen notes that by now, the word “utility” has been hijacked by economists who use it to mean maximization of resources, whether or not this fulfillment of market-driven desire leads to greater happiness. “Mathematical exactness of formulation has proceeded hand in hand with remarkable inexactness of content.”
Levels of boredom will not figure in GDP calculations, based on national aggregates that fudge glaring economic inequalities. But the capabilities approach can acknowledge boredom as a variable for wellbeing. If boredom were considered a resource of time and freedom, providing creative activities would help people use what they have to do what they can. Sen illustrates the difference between having and doing with the example of a bicycle: Someone who knows how to ride, turns the object into a resource, whereas someone else does not. The process is “equally concerned with the conversion of more intangible resources, such as human capital and public goods (Nussbaum et al., 1993).” Training in creative arts, for example, turns free time into a resource. The conversion begins with a choice of perspective: To see the menacing elephant in the room as a platform for freedom. “There is nothing either good or bad, but thinking makes it so.” If the capabilities approach is best understood “as a ‘thin' framework, which can be filled in by ‘thicker' theories and applications (Qizilbash, 2012),” why not fill in with the right to be creative, the Spieltrieb, our most characteristically human capacity (von Schiller, 2015).
Under lockdown, there were mitigating circumstances that delayed this now urgent moment of stock taking. The rush of first responses to COVID's rising levels of infection and fatality kept us fixed on daily statistics, detailed by country, city, and neighborhood, while corollary crises of inequities of food supply and services intensified. Violence at home and in public, dropouts from school and from work, despair among young and old, are familiar crises that demand sharper focus than we have given. Perhaps there is a systemic malfunction in societies that value competition over collaboration, consumption over creativity. After the urgency to develop and distribute COVID-19 vaccines abated, a respite from immediate clinical questions is time to face the horrors of interpersonal and self-inflicted violence, suicides, massacres, police abuse. A paradigm shift is in order.
Had legal and healthcare agencies considered a paradigm shift during lockdown, away from the familiar formula of staying still, masked, isolated, and controlled, had they dared to defamiliarize inactivity and noticed that it allowed an elephant to occupy the room, policy might have improvised creative programs. The lens of human capabilities might have re-framed the crushing beast of boredom into an enabling companion for play. Play can convert faculties into capabilities. The hiatus in conversion activities didn't figure among the causes that experts linked to the spike in domestic violence. Instead, they pointed to increased levels of alcoholism and drug abuse. Of course addictions increased, but this finding doesn't address root causes or possible remedies. Arguing that drunkenness and drugs were causes of violence is like observing that suicide is caused by depression without asking why a person is depressed. What caused higher consumption of drink and drugs? Observers duly reasoned that it was the loss of jobs and social isolation. Does that make addiction inevitable and domestic violence unavoidable under conditions of lockdown? Financial hardship and lack of social contact were indeed conditions of lockdown, while work and play were on hold. But these constraints demand creative policies to mitigate the menace of violence. Otherwise, expert observations about joblessness and addiction would suggest that domestic violence is a tragic but necessary price to pay for the clinical advice to stay home. Nothing to be done about it.
Primary prevention is a public health strategy that includes reducing risk factors (Celentano and Szklo, 2019). Although prevention was originally designed to avert disease, this strategy has become essential to mitigate risk factors related to violence against women, now that domestic violence is recognized as impacting physical health, mental health, and social wellbeing (Walden and Wall, 2014). Among the risk factors for violence against women, studies recognize gender inequality, social norms and practices that condone violence, weak sanctions, and insufficient resources for support (Flood and Webster, 2007). Still lacking are the resources for dealing with boredom. This is a significant concern for public health policies that aim to prevent pathologies. Rather than “simply accepting or reacting to violence, its starting point is the strong belief that violent behavior and its causes can be avoided” (World Health Organization, 2002, p. 45). Boredom is one of the causes yet to be featured in recommendations for redress of blindness to causes of violence.
Men get bored at home and boredom made them more violent during lockdown. Conventional gender roles still structure many families and make the home the space of engagement for women, and disengagement for men. The challenge was to develop enjoyable activities for men at home. Soccer, for example. How does one translate (literally to move from one place to another) some of the pleasures of the open-air playing field to home based activities? Amigos do Bem got busy improvising answers. On readily available communications platforms such as WhatsApp and Facebook, technology helped to move soccer from the field to the house where offers of exercise, lessons in fancy footwork, live webinars, video games, book clubs, and art making multiplied the pleasures of being at home. Boredom could be banished from domestic life. During the lockdown, the WHO discovered soccer too. It announced an alliance with FIFA, to engage the world of soccer in a campaign against domestic violence (Al Jazeera News, 2020). To what extent can enjoyable soccer-related experiences mitigate this risk factor for violence at home? It was a practical question about reducing violence by mitigating boredom.
For children during lockdown, boredom was a bane of their diminished lives. The effects of missing school, friends, and activities were almost immediate. And the after-effects show high levels of depression and despair worldwide. Psychological wellbeing has by now become an earnest concern for many public and private agencies. Though Amartya Sen had not taken mental health into serious account when he began to develop his capabilities approach, it soon became an important horizon for him.
Transforming lessons into play may sound naughty or daring, unless we remember that “school” (σχoλ scholē) means leisure in both ancient and modern Greek. School is the time and space for exploration and discovery. So, the playful paradigm shift is a paradoxical recovery of ancient wisdom that recognized the dignity of pleasure. Paradigm shifts feel risky. Like moving from cozy dank slums to airy new neighborhoods, switching from outworn assumptions to new ideas raises resistance even when the novelty promises improvements. Take the familiarity of domestic settings for example, where boredom looms like an elephant. Clearly, the threat of domestic violence demands consideration of both the dangers and the mitigating opportunities. But there has been little consideration of boredom at home by authorities, health professionals, or policymakers. People tend to ignore boredom. The issue itself sounds tedious rather than triggering. Even for those who can be persuaded to perceive the rumbling threat and to consider the creative cure, more familiar and less effective thoughts about idleness and arts may survive the new knowledge. Zombie paradigms haunt us. One such zombie concept is that art is decorative and pleasant, but not necessary for wellbeing. In fact, art should be understood as a convenient name for change itself. How can change happen without imagining counter-factual and surprising alternatives to what already exists? Considered to be decoration or a luxury, art has been narrowly understood as a product of culture rather than as the dynamic process of making. Better understood as a “verb” than a “noun,” art is something intentionally made to interrupt the boredom of habit and to revive care for the world. Art is artifice, in Viktor Shklovsky's elegant formulation. The simple word raises difficulties in European languages because art, like culture, has two incommensurable meanings: the decorative or collectible product vs. the exploratory process; the shared patrimony of practices and beliefs vs. the creative interruption of that patrimony.
Change requires interruption. It is an art of improvisation, risk-taking and judgment. But policy makers usually prefer a sure bet. Perhaps this is one reason for overlooking art as a resource for development. Art takes risks. If culture means only a legacy of shared sites and beliefs that bond communities, the bridging capacity is forfeited. Making new artistic projects can bridge diverse communities and foster social capital through the conversion of personal capabilities into enhanced social functionings and collaboration. For decision makers who manage to make the shift from considering only the GNP as the index of development to adopting a capabilities approach, the corollary will be to promote wellbeing through behavioral changes. In the spirit of Amartya Sen, these changes will value personal autonomy and self-fulfillment while taking local conditions and preferences into account. It is a creative improvisation, “a simultaneous and two-way relationship between functionings and capabilities.”
Sections
"[{\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B33\", \"fn0001\"], \"section\": \"Introduction\", \"text\": \"Human beings are dynamic; our innate faculties beg to engage in activities. To achieve fullness and human dignity, people \\u201cconvert\\u201d personal capabilities (Sen, 1999) into active \\u201cfunctionings,\\u201d Amartya Sen explains. This means that staying still is not a normal state. It can feel like punishment. Forced inactivity will generate resentment, resistance, and boredom that can fester until pent-up energy explodes violently, or implodes in depression. Boredom defaults on capabilities and resources in many cases. In other cases, stillness is a gift. It can stimulate the imagination to fill in emptiness with memories and new explorations. Either boredom builds toward doing damage, or it releases energy to think and to create. What people don't do is stay put, mentally or physically.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0002\"], \"section\": \"Introduction\", \"text\": \"Authorities\\u2014including police, judges, teachers, parents\\u2014should take this dynamic human condition into account and reconsider the effects of conventional command and control policies. Then they can choose between violence and creativity as alternative outlets for the energy that boredom generates. Short of facing up to human dynamism, decision-making may continue to favor strong-arm tactics, which trigger the violence and pain that policing is meant to mitigate. Is it surprising that apparently peaceful people become enraged in lockdown conditions? Do adults wonder why students drop-out of school and suffer escalating rates of depression and suicide? Boredom is certainly not the only cause for these disastrous effects, but to ignore it risks remaining complicit with processes that perpetuate personal and collective dysfunctions. Complicity with harmful practices will miss opportunities to channel frustrated energy toward developing human capabilities. Authorities are responsible for promoting peaceful development. We are all responsible.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0003\"], \"section\": \"Lockdown laboratory\", \"text\": \"Normally, people stay busy with routine activities. We work, play, attend to family and to friends. Particular activities have even become our public badges of identity, as is evident in surnames (Cooper, Baker, Taylor, Farmer, etc.) that trace back to work that ancestors answered to. Lockdown during COVID-19 meant that many otherwise occupied people had few outlets for energy. Those who knew how to meditate managed to assuage anxiety through contemplation and the pursuit of ideal emptiness. But many mortals\\u2014including myself\\u2014either fail at efforts to concentrate on breathing, for starters, or they have not tried. Maybe people don't know about the disciplined techniques and the goal of inactivity; or maybe they are not drawn to doing what looks like doing nothing. Wanting to do something when it seemed that very little could be done prepared the conditions for widespread boredom. Households became laboratories for studying boredom, hothouses in fact, or petri dishes. The unbidden experiment is an opportunity and, therefore, an obligation to reflect on the dynamic and to expand a range of appropriate responses for future challenges. Either we will have learned something in the laboratory to help design a new paradigm for human energy under constraints, or we will consider the damaging effects of constraint mere anomalies in conventional, if disappointing, approaches to security, education, and mental health. To use Sen's term, we will \\u201cmuff\\u201d the opportunity to develop.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0004\"], \"section\": \"Lockdown laboratory\", \"text\": \"When work and play activities ended abruptly in worldwide house arrest during the COVID-19 pandemic, human dynamism hit a wall, an interior wall of domestic confinement. The explosive effects of inactivity blew up beyond predictable proportions. Consider the spike in domestic violence as one unintended consequence of public health policy. Soon after the doors locked, alarming reports across countries and social classes repeated and confirmed statistics that seemed unbelievable.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B21\", \"B9\", \"B24\", \"B2\", \"B7\", \"B8\", \"B10\", \"B20\", \"B22\", \"B23\", \"B40\", \"B48\", \"B5\"], \"section\": \"Lockdown laboratory\", \"text\": \"Early on, \\u201cThe World Health Organization has highlighted a 60% spike in calls to European domestic violence hotlines in April\\u201d (Mahase, 2020). Brazil's Public Health Forum registered an increase of 431% for the same period (through social media, given the danger of retaliation by eavesdropping partners) (Bueno et al., 2020, p. 13), while New York's Governor Cuomo appointed a Task Force to find innovative solutions for the sudden rise in home-based crimes, after reporting a 33% spike in April 2020 (New York State Task Force, 2020). Data have been also confirmed in a number of studies (African News Agency, 2020; Boserup et al., 2020; Bradbury-Jones and Isham, 2020; Campbell, 2020; Leslie and Wilson, 2020; Miltimore, 2020; Mlambo-Ngcuka, 2020; Usher et al., 2020; World Health Organization, 2020). Governments worldwide asked how to offset the aggressive repercussions of lockdown, according to The Council of Foreign Relations (Bettinger-L\\u00f3pez, 2020).\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B42\", \"B16\", \"B39\", \"B43\"], \"section\": \"Lockdown laboratory\", \"text\": \"The question of what to do begs the question of why the lockdown increased domestic violence. Loss of jobs, alcohol, and psychological stress are still common and convincing answers (see footnote 22). Familiar responses to violence continue to be vital, including hotlines and shelters for victims and punishment for perpetrators. But neither the known causes nor the standard remedies managed to reduce the incidence of domestic violence even before the pandemic. By now, the limits of conventional approaches are evident. They amount to secondary or tertiary interventions, after threats are made or damage is already done. Something more is needed, urgently. It is primary prevention to stop violence before it starts (Walden and Wall, 2014). Prevention will include education about violence and newly learned practices that undo habits of power. In order to diffuse dangerous behaviors before they develop into aggression, we must first identify nonviolent but simmering conduct that can become explosive. Recognizing triggers for potentially violent behavior is a step toward proposing innovative remedies. One trigger is so evident that it has passed under the radar of many specialists and authorities: Boredom. People get bored in confinement. This is a hypothesis worth pursuing. Arguably, men may get more bored than women even under normal conditions (Gosline, 2007; Talbot, 2020; Westgate and Steidle, 2020). The effects of domestic boredom could turn out to be unremarkable, compared with the intense stresses of joblessness, poverty, and a bleak future. But this unexplored stressor is an opportunity for new and effective interventions to mitigate violence, even if they cannot end it or replace the need for economic security.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0007\", \"B42\"], \"section\": \"Lockdown laboratory\", \"text\": \"The question of what to do begs the question of why the lockdown increased domestic violence. Loss of jobs, alcohol, and psychological stress are common and apparently compelling answers (see footnote 22). These familiar responses to violence can still make sense, if hotlines connect and safe houses shelter while perpetrators submit to control. But neither known causes nor standard remedies had managed to reduce the incidence of domestic violence even before the pandemic. By now, it should be clear that conventional approaches treat symptoms rather than causes. Therapy for violence responds to symptoms of damage already done. Prevention is in order (Walden and Wall, 2014) through unfamiliar proposals. To diffuse dangerous behaviors before they develop into aggression, it will be important to recognize triggers for potentially violent behavior.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B18\", \"B19\", \"fn0008\"], \"section\": \"Paradigm shift\", \"text\": \"The failure is partly conceptual. It is a curable calcification that this essay addresses. My purpose is to explore better responses to current and future crises. A cure for staying stuck requires perseverance and patience along with imagination, Thomas Kuhn concluded from observing paradigm shifts in the history of science (Kuhn, 1962). Change takes an intentional will to shift from a familiar paradigm of cause and effect to alternatives (Kuhn, 2021). If experts stick to parameters of conventional thinking, the lockdown will have amounted to a mere pause from making sense, a blip, rather than a grant of time in a laboratory for new thinking. The shift in thinking about boredom begins by admitting that the conventions of keeping order simply don't work. Parents, teachers, or jailors impose conventional demands for obedience to everyone's peril. Potentially disruptive children and other wards may respond with a backlash that ignites the undesirable behavior that the demand for obedience had meant to control. This anomaly between command control and out of control responses is no mere interruption of rational expectations. It is evidence of a conceptual error, because people are normally dynamic. A correction can start by acknowledging the dynamism and supporting human capabilities. The difference between control and support amounts to a shift in paradigm, from obedience to autonomy, from being the subject of another's will to becoming a self-realizing agent.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0009\", \"fn0010\", \"B31\", \"fn0011\"], \"section\": \"Paradigm shift\", \"text\": \"This shift is part of a general overhaul in development studies. No longer persuaded by the conventional Gross Domestic or National Profit (GDP or GNP)\\u2014a single mathematical measure that ignores abysmal differences in living standards between rich and poor people\\u2014the United Nations and other agencies now prefer a Human Development Index (HDI) of three criteria (longevity, literacy, income). Pakistani economist Mahbub ul Haq proposed the HDI to support people-centered policies The improvement came from a collaboration with Amartya Sen who had alerted economists to the difference between wellbeing and being well-off. Sen's \\u201cCapabilities Approach\\u201d to human development gives account of real people, their situated resources and their opportunities to use those resources (Sen, 1985). Use is key, Sen points out, to convert what people have into what they can do with what they have. Maybe peasants have crops but no transportation to sell them in markets, or citizens have the right to vote but no expectation that their votes will count. The distinction between assets and making good on assets depends on one's capacity to convert \\u201cbeing\\u201d into \\u201cdoing.\\u201d\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0012\", \"fn0013\", \"fn0014\", \"B36\", \"fn0015\", \"fn0016\"], \"section\": \"Paradigm shift\", \"text\": \"Announced in 1974, this conceptual shift from a one-size-fits-all GDP to customized considerations resonated with a generation of feminists who were unmasking the male privilege and willful blindness of \\u201cuniversality\\u201d in law and economics. \\u201c[T]he full human diversity among people is insufficiently acknowledged in many normative theories, such as theories of distributive justice. This also explains why the capability approach is often favorably regarded by feminist philosophers, or philosophers concerned with care and disability issues (e.g., Khader 2008, Terzi 2008, 2010),\\u201d. Most notably, Martha Nussbaum took Sen's lead to multiply criteria for wellbeing by proposing a basic list of rights in order to identify actionable gaps that prevent people from \\u201ccreating capabilities.\\u201d But Sen demurs from lists: \\u201cWhat I am against is the fixing of a cemented list of capabilities. (Sen, 2004)\\u201d \\u201cThere is nothing illegitimate or defeatist in recognizing that the valuation rankings of wellbeing may have gaps.\\u201d While he concurs that we need bare and basic criteria, even helping ul Haq to devise the three-pronged HDI, anything more, he argues, would miss the specific priorities and conditions of real lives.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B28\", \"fn0017\"], \"section\": \"Paradigm shift\", \"text\": \"Where domestic violence is concerned, we know that a significant difference is gender (Peterman et al., 2020). Even when men don't start fights at home, they tend to finish them with force. Statistics on this age-old abuse had already scaled up alarmingly before COVID-19, maybe because increasing numbers of women were choosing to report crimes that would earlier have cost them economic security or would have seemed too commonplace to register. Improved reporting before lockdown put the spike in sharp perspective. What made so many more men violent during house arrest than before? It is worth considering a subjective differential for men and women in forced confinement.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0018\", \"fn0019\"], \"section\": \"Paradigm shift\", \"text\": \"An interpersonal criterion like boredom for evaluating violence at home doesn't interfere with Sen's intentionally unfinished framework. Rather, it makes good on his defense of moving pieces. Consider the ways in which subjective desires and capabilities interact with shared consequences to recognize that setting priorities amid changing circumstances includes interpersonal dynamics. Personal criteria alone may miss some potentially dangerous dimensions of individual development. The danger lurks in Sen's focus on personal wellbeing, one human being at a time. \\u201cThus narrowed, personal wellbeing related to one's own life will reflect one's standard of living.\\u201d This self-possession is aspirational in some cases and unthinkable in others. Sen assumes that people can and should make reasonable and free choices about their identities and affiliations, but the assumption is hardly reasonable in the real world of gender hierarchies and familial ties. This oversight may miss Sen's own cue about framing capabilities in collective contexts. Sen, like Nussbaum, stays with the individual, though he prefers improvisation in the volatile variety of contexts while she prefers more structure.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0020\", \"B34\", \"B25\", \"B35\", \"fn0021\"], \"section\": \"Little women, big men\", \"text\": \"Does a conceptual framework centered on single persons allow a vestige of liberal universalism to persist in the capabilities approach? Universalism assumes that people are ideally equal and therefore interchangeable in theories of value and in measurement. An instance of this paradigm is the one-size-fits-all GDP that lingers beyond its expiration date. Despite being pronounced dead for decades, the single economic aggregate that obscures inequities doesn't quite die. A \\u201czombie concept,\\u201d it haunts and hinders human development. As a corrective to outdated paradigms of development, the capabilities approach proposed by Sen and pursued by Nussbaum adds criteria of measurements to a misleading aggregate (Sen, 2000; Nussbaum, 2000). By multiplying the criteria, they can focus on individuals rather than on whole nations. But even this deeper view risks missing an important dimension of development by blurring the interlocking forest with a focus on individual trees (Sen, 2001). \\u201c[W]e have responsibility for what we desire (and the need to relate it to what we value), whereas we have no such direct responsibility for the desire of others.\\u201d Perhaps the operative word here is \\u201cdirect,\\u201d because surely a culturally bound desire is a collective responsibility.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B29\", \"B12\", \"fn0022\", \"fn0023\"], \"section\": \"Little women, big men\", \"text\": \"Gender-determined roles are zombie concepts too. Legal and economic discrimination by gender has been condemned for centuries and outlawed in more recent history, but the prejudices and practices of male superiority continue to skew access to rights and resources (Prager, 1996). Nancy Chodorow named the process of unequal gender formation \\u201cthe reproduction of mothering (Chodorow, 1978).\\u201d One result of this formation is that women take charge of children and men achieve a paradoxical authority when children invest power in fathers as a safeguard against tyrannical mothers. Women rule at home. No wonder men can feel disabled when housebound. Surely they get more bored than women do during lockdown, since a consequence of gender specific training is that women know how to use domestic space to exercise agency, while men count on other spaces to convert their capabilities into functioning. Some readers may be skeptical about this gendered boredom quotient; they may also dismiss the relevance of boredom for making sense of explosive behavior. Those readers may also identify as male. Women don't doubt the gender difference or the threat, generally speaking. They recognize the syndrome of male listlessness, frustration, and rage. Differential levels of male and female boredom offer a speculation worth pursuing in order to craft new practical responses.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0024\", \"fn0025\"], \"section\": \"Little women, big men\", \"text\": \"Nussbaum targets tenacious gender disparities as obstacles to women's development. By definition, disparities are comparative and therefore, interpersonal, a dimension that sometimes falls out of focus in Nussbaum's defense of autonomous selves, one woman at a time. To appreciate this slip from real and relational identity to ideal autonomy consider the example that launches Creating Capabilities (2011): \\u201c[A] small woman in her early thirties\\u201d Vasanati had abandoned an abusive husband and returned to her family of origin. The example is telling beyond the conclusions that Nussbaum draws about Vasanti's courage and about women's solidarity through Sewa, a collective of working women. But Vasanti's brothers also played decisive transitional roles. As members of a Gujarati family, they were not obliged to take back a married woman, however abusive her husband became. When the brothers rescued their sister, their decision was unscripted. Their capabilities functioned to judge and to act. The brothers enabled Vasanti to become autonomous, first alone and then through Sewa. We might call this development a collective or a cascade conversion of family and community resources into a personal triumph that would bring more ripple effects. Nussbaum does give the brothers credit for valuing Vasanti's safety over community norms, but the narrative doesn't feature the structural connection between the woman's step forward and the men's accompaniment. Their advances were mutual. The brothers' decision enabled their sister to be free; and the sister's demand sparked her brothers' choice. Paradoxically, independence can depend on mutual support. But mutuality plays a minor role for Nussbaum. When she distinguishes between internal and combined capabilities, the difference refers to innate faculties and developed talents in an individual. Though they overlap, \\u201cinnate equipment... into advanced capabilities\\u201d refers to the development of an individual.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0026\", \"fn0027\", \"fn0028\", \"fn0029\"], \"section\": \"Little women, big men\", \"text\": \"From her activist legal perspective and in Sen's ethical economics, the social element of wellbeing shows up, but mostly as a function of personal development. This is close to a contradiction since sociability is a structural connection between a self and others rather than a personal pastime. The focus on individuals means that social values or criteria for measuring development remains surprisingly underdeveloped. For both theorists, sociability as mutual care fades perilously; it flattens into a dimension of personal growth. This is a curious loss of depth perception, after both Sen and Nussbaum remind us that Adam Smith considered sociability to be a significant contributor to the collective Wealth of Nations. In fact, Smith's earlier Moral Sentiment begins with mutuality, \\u201can interest in the welfare of others, and make their happiness necessary to him, even if he gets nothing from it but the pleasure of seeing it.\\u201d Perhaps understandably, given the tug today toward group-based recognition and authenticity, Sen and Nussbaum stay clear of communitarian claims. They put particular people first, and Sen acknowledges the incalculable variety of cultural resources that often include personally crafted hybrids of competing cultures. A capabilities approach that supports the autonomy of individuals understandably resists giving priority to culturally cozy traditions that can trump dynamic conversions. Culture, in Sen's formulation, is not the end, or objective, of community life, but the means for development. It is a field for improvisational activity rather than a legacy to protect.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0030\", \"B46\"], \"section\": \"Little women, big men\", \"text\": \"Boredom is a personal experience that can flare into interpersonal trouble. It begins by oppressing an individual who cannot tolerate empty time. But when boredom builds toward violent interruptions of the tedium, victims are collateral damage. Shouldn't a boredom quotient figure among the criteria for wellbeing that Sen can enlist when appropriate? It is the elephant in the room of development theory, silently seething and preparing to pounce on an individual's reason and autonomy with consequent casualties nearby. Victims include battered partners, children, older parents, all of whom lose their own autonomy, resources, and agency for development, when lockdown is experienced as lockup. In wartime, this conversion of boredom into agency is linked to atrocities, and tedium is worth tracking in police brutality. Conversions of energy into action are not always pro-social. This caveat to the capability approach points to a loose end in Sen's defense of pluralism regarding values. Sometimes, pathologies of power, revenge, violence will demand a more normative framework to distinguish abuse from empowerment (Wolff and De-Shalit, 2007).\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0031\", \"fn0032\"], \"section\": \"Little women, big men\", \"text\": \"To support human thriving, we have an opportunity (read obligation) to consider the interpersonal, social, dimension of capabilities that Adam Smith featured for personal wellbeing and that Sen updates: the opportunity is to promote in others the skills and the pleasures that support their wellbeing, and ours by extension. Perhaps this represents a double paradox. On the one hand, development is understood in the capabilities approach as self-development. Collective advances follow from exercises of personal autonomy. On the other hand, pleasure is often understood as a diversion from development, literally going off track. How can helping others to feel pleasure support one's own self-development? A short answer is that other people who don't feel pleasure are at risk of feeling rage. Self-interest will be well served by preempting other people's rage and the violence it ignites. Regarding ethical worries about pleasure, Sen and Smith relax the concern when they recover the link from pleasure to dignity and autonomy. \\u201cTo lead a life without shame, to be able to visit and entertain one's friends, to keep track of what is going on and what others are talking about, and so on, requires a more expensive bundle of goods and services in a society that is generally richer.\\u201d\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0033\", \"fn0034\", \"fn0035\"], \"section\": \"Little women, big men\", \"text\": \"Pleasure has had bad press since the philosophically hedonist heyday of British utilitarianism. Sen revives its ethical work. What would wellbeing mean without enjoyment? A standard of living makes sense \\u201cthrough some object of value\\u2014in this case, some type of pleasure.\\u201d The reluctance to embrace an ethics of enjoyment and sociability has made pleasure a perverse pursuit. People seek it out, perhaps assuming it must come at a moral cost. Enjoyment seems tinged by sinful desire in a capitalist culture that devalues diversion and enshrines hard work. (Max Weber called this \\u201can-hedonic\\u201d culture Calvinist). But pleasure and play have been ethical values at least since Aristotle and then for a long line of thinkers that extends, for example, through John Finnis, who included aesthetic experience as a dimension of personal development.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0036\"], \"section\": \"Art is therapy\", \"text\": \"Boredom is a lack of surprise, a death of sensation. Empty time can feel like deprivation rather than the luxury of leisure to think and to make things. For people who know how to use it, unprogrammed time is the resource of freedom to be converted into a functioning\\u2014in Sen's terms. But for bored people who resent empty time, the resource withers or flips into something monstrous. Boredom flattens freedom into frustration. Either a hiatus of activity will end in an engaging activity or in acting out. The tension that comes from inactivity is volatile, and the energy will come out one way or another. Since people have a range of innate faculties that can be converted into functionings, it makes sense to foster creative faculties. This is a matter of choice, arts over aggression. Skeptics may assume that choosing is limited to some people who are creative. Kant assumed this. That's why he featured judgment over creativity as the universal faculty for civic development. But the assumption about predetermined access to or exclusion from creativity condemns us to expect more spikes in violence and more depression and suicide. The threats of interpersonal and self-harm are likely to increase. We can anticipate continuing and recurring boredom from loss of jobs, resignation from jobs, confinement to refugee camps, prisons, failing schools, and possibly renewed house arrest.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0037\", \"fn0038\", \"fn0039\", \"fn0040\", \"fn0041\", \"fn0042\"], \"section\": \"Art is therapy\", \"text\": \"Fortunately, people are innately creative, despite the skeptics. Creativity is hard-wired in the human condition. Our challenge is to recognize the resource and to make good on our innate faculties of imagination and judgment. These dimensions of being can be converted into skill-based doings to develop capabilities. It was Kant's disciple, Friedrich Schiller, who gave this natural resource a name, Spieltrieb, playdrive. During the Terror of the French Revolution, Schiller elevated this faculty to the level of a drive to interrupt the spirals of violence that had locked the other two drives\\u2014Reason and Passion\\u2014into mutually murderous opposition. How do you interrupt the escalating, self-destructive, spirals? Schiller's answer was to bridge the feuding forces through play and art. Anyone can play, and we can learn to make art that will repurpose energies and divert the attention of enemies from hatred to delight in new forms. Rage today includes flares from the counterintuitive trigger of doing nothing. Whether despair and death follow from revolution or from being bored, Schiller would urge us to take a step back and redirect our energies from aggression to artmaking. There is really no alternative, because without the \\u201cdisconnection\\u201d from habits and interests that art provokes, people lose agency and stay caught in spiraling structures. Convention may shun the arts as impractical in dire conflict, but Schiller knew that it was the missing agent of reconciliation. Without art, conflict has no escape route. The opposite of play is not work or seriousness, anthropologist Gregory Bateson would explain for socio-ecological reasons; it is boring one-dimensionality that leads a species to extinction.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0043\", \"fn0044\", \"fn0045\", \"fn0046\"], \"section\": \"Symbolic destruction\", \"text\": \"Psychoanalyst Donald Woods Winnicott would come to Schiller's same conclusion. We have no evidence that Winnicott read Letters on Aesthetic Education (1794) (see foot note 52), but he was equally dedicated to play. Schiller had written \\u201cman is truly human when he plays, and he plays when he is truly human,\\u201d as if presaging Winnicott's work. The therapist included his own practice among creative activities: \\u201cPsychotherapy takes place in the overlap of two areas of playing, that of the patient and that of the therapist. Psychotherapy has to do with two people playing together.\\u201d This means free and \\u201cnon-purposive\\u201d artmaking.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0047\", \"B1\", \"fn0050\", \"fn0051\", \"B44\", \"B17\"], \"section\": \"Symbolic destruction\", \"text\": \"The instinct to create shows up immediately, says Winnicott, when a newborn searches for its mother's breast. The breast materializes because the mother plays too, bending to the baby's will to welcome it as creator of its world. The early games multiply throughout life as \\u201cplay is the continuous evidence of creativity, which means aliveness (Abrams and Hjulmand, 1996).\\u201d People play at affecting the world, not only in response to hostility or to loss, as Melanie Klein thought. Creativity is an innate drive\\u2014Schiller's playdrive\\u2014to achieve tacit control over existing, often conflicting, materials and demands, as when a fifth grader cures her anxiety about math by drawing scary but funny comic strips. In professional \\u201cNewspeak\\u201d this recourse to pleasure is called \\u201cself-administered art therapy.\\u201d We can call it play. Riskiness spikes both art and analysis with dangers of unpredictability, dangers that cannot be abolished if therapy is to proceed. So, the work demands a steadiness that can anticipate and survive aggressive surprises meant to unhinge the playmate, including the clinician. \\u201cThe drive is potentially \\u2018destructive'... But destruction of an object that survives, that has not reacted or disappeared, leads on to use (Winnicott, 1969).\\u201d And using people, Barbara Johnson understood after reading Winnicott, amounts to loving them (Johnson, 2000).\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0052\"], \"section\": \"Symbolic destruction\", \"text\": \"A nadir of activity and a peak of interaction made for a perfect domestic dust storm during lockdown. Reduced access to psychologists and psychoanalysts, the lack of money to pay them even when therapists were available on electronic platforms, and the failure to focus on the elephant of boredom in the room all converged to heighten domestic violence during lockdown. Already elevated statistics that spiked during house arrest should now prompt us to recognize an antidote to the malady of boredom. It is the friendlier face of the elephant. If boredom is a common and unacknowledged threat, art making is a common but underemployed resource. Rising levels of anxiety, depression, abuse, and suicide prompt mental health providers to explore support from non-clinical practices. Are there effective resources outside the clinic? There are. In fact, a social approach to wellbeing is well known, and new pioneer programs train lay counselors and peer mentors to offer support. These resources could substantially expand and deepen by adding the under-explored option to engage artists as allies.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0053\", \"fn0054\"], \"section\": \"Stigma\", \"text\": \"Low resourced settings are particularly fertile for this option because poor areas are often rich in arts. Traditions of storytelling, music, dance, weaving, cooking, mask making, poetry, pottery, etc. still thrive in everyday activities alongside modern practices. Artist Pedro Reyes notes that Latin America, for example, may be poor in finances and in politics, but in art it is a treasure house. This can be said of the global south in general. Consider an example from Peru's highlands. Peasant women there cultivate up to 4,000 varieties of mostly inedible potatoes, just for their color and shape, to lay out designs for new weavings. The challenge for therapy in economically poor environments\\u2014and everywhere else\\u2014is to dignify art as a worthy partner for therapy.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0057\", \"B38\", \"fn0058\", \"fn0059\", \"fn0060\", \"B6\"], \"section\": \"Stigma\", \"text\": \"Stigma has been an obstacle. It is an equal opportunity blight. On one side, people with mental illness don't seek help when stigma stops them; on the other side, providers often present a stigma against taking art seriously. They tend to dismiss creativity as unscientific, even risky, and inappropriate. The arts seem either inconsequential or downright harmful. While creativity is no sure pathway to mental health, and though artists may continue to be afflicted by the demons that drive them, it is worth considering the differing degrees of affliction when art is an outlet and when it is not. Memoirs offer testimony to the power of creativity as a coping mechanism for mental illness. But clinicians and researchers have been reluctant to credit artmaking as therapy, as a medium for amelioration, even when the making seems meaningless. Art is therapy. The reason is clear. Artmaking is active. To create something new demands dynamic faculties of mind (Stuckey and Nobel, 2010). When people make art, they become observers, exercise judgment, experience autonomy, make decisions, and anticipate communication through visual or performative languages, including words repurposed for poetry and prose. To assume that art works because it makes meaning is to miss the magic of making itself. Art works because it wedges a distance between what is and what could be. Augusto Boal\\u2013founder of Forum Theater and author of Theater of the Oppressed (Boal, 2000) put it this way:\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0061\"], \"section\": \"Stigma\", \"text\": \"\\u201cOnly the human being is tri-dimensional (the I who observes, the I-in-situ and the not-I) because it alone is capable of dichotomy (seeing itself seeing). And as it places itself inside and outside its situation, actually there, potentially here, it needs to symbolize that distance which separates space and divides time, the distance from \\u2018I am' to \\u2018I can be', and from present to future; it needs to symbolize this potential, to create symbols which occupy the space of what is, but does not exist concretely, of what is possible\\u2026So, it creates symbolic languages: painting, music, words.\\u201d\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B14\", \"B45\", \"fn0062\"], \"section\": \"Stigma\", \"text\": \"Rational choice theorist Jon Elster counted on artists to illustrate good decision making, because artists know how to limit options and manage constraints (Elster, 2000). This cluster of mental and emotional talents can channel explosive energies into \\u201csymbolic destruction,\\u201d Winnicott's name for artmaking (Winnicott, 1991). The dichotomy that Boal identifies between being and observing can crack fissures in lockdown states of anxiety and depression, to let the outside world slip in. At a mental hospital in Paris, Boal discovered that on stage, when performing for other patients and their doctors, even acutely afflicted people would budge beyond their static clinical narratives. On stage, patients become actors to be observed by themselves and by others. Both actors and spectators occupy a fictional space that distances and estranges habitual stories which\\u2014from this unfamiliar perspective\\u2014can be told differently. After acting, sessions with therapists went better at the hospital. Aesthetic space was the opening.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0063\", \"fn0064\"], \"section\": \"Stigma\", \"text\": \"Artists are not victims. They are neither stuck in one-track narratives nor stopped by debilitating circumstances. Instead, artists are agents who transform problems into challenges; they recycle found materials into new products. Whether or not the products have aesthetic value for connoisseurs, the therapeutic effect of artmaking comes from the process, often with byproducts of pride in the work and in oneself. Sometimes artmaking reveals buried trauma that a talking cure doesn't easily access. This contribution has attracted the sleuthing attention of psychoanalysts. But other times, artmaking is untethered to repressed meanings. It simply exercises freedom to explore materials and their arrangements. Artmaking can be a purposeless exercise of agency and choice, a self-authorizing therapy against lethargy and listlessness.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0065\", \"fn0066\"], \"section\": \"Stigma\", \"text\": \"Even unhappy people, like Boal's hospitalized actors, will accept an invitation to play, though they may bristle and retreat from unfairly demanding prompts given by many clinicians to find meaning or purpose. The invitation to participate in artmaking can be as unassuming as making a meal or getting dressed, putting together pieces of clothing to create an outfit. Arts may include drawing a picture or singing. (The Spanish verb interpretar for making music captures the inevitable innovation through performance.) Other, more intentional, traditional, or international, art practices can follow and develop or morph over a lifetime. The everyday nature of low-stakes artmaking sidesteps the stigma that would single out mentally distressed people for special attention. This mitigating feature of inconspicuous inclusion emerged in a pilot program for ninth graders in the Kibera slum of Nairobi where roughly half the youth are clinically depressed. The arts-literacy pilot did not single out mentally ill classmates, since all participated. The simple prompt to make art from a required text charmed even reluctant readers to create liberating interpretations, through drawings, rap routines, riddles, dance, theater, and other art forms of their choice. One result was a significant reduction in depression and anxiety. Another was enhanced pleasure in reading. Parallel projects in a Buenos Aires mental hospital confirm the findings (see footnote 82).\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B13\"], \"section\": \"Stigma\", \"text\": \"Genres and styles of artmaking will vary among regions and even between households, but the practice of making new things and performances from available materials and conditions is hard-wired in human beings. \\u201cArt making is an innate human tendency, so much so it has been argued that, like speech and tool making, this activity could be used to define our species (Dissanayake, 1992).\\u201d If artmaking is a human birthright, as philosophers and educators have long noted, we can count on a creative mental faculty to address boredom. We can also count on an abundant roster of mentors to channel energy into artmaking. Artists are everywhere. They can rise to the challenge of what to do with unbidden free time. Should we consider free time to be an inevitable trigger for trouble and prepare more prisons? Or can it be a resource for the conversion of capabilities into functions?\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0067\", \"fn0068\", \"B37\", \"fn0069\", \"fn0070\", \"fn0071\"], \"section\": \"Stigma\", \"text\": \"\\u201cThere is nothing either good or bad, but thinking makes it so,\\u201d Shakespeare quipped. Interpretation makes the capabilities approach work in unscripted ways. Prepared scripts of behavior can \\u201cmuff\\u201d genuine advantages, Sen observes. Free time, one of those unacknowledged advantages, is muffed when bored people feel helpless without prescribed activities. Policy makers may be equally stuck in predetermined scripts. Sen counts on people's innate reasonableness to take advantage of opportunities. But Shakespeare's lesson about interpretation adds creativity to reasonableness. The addition turns information into something new. In fact, Sen defends creativity as a dimension of reason (Sen, 2012). He stretches Bentham's identification of material and mental satisfaction to leave room for \\u201ccreative discontent and constructive dissatisfaction.\\u201d Creativity is born of dissatisfaction. New ideas and things respond to \\u201cwhat is missing.\\u201d While Bentham's brand of happiness depended on desire-fulfillment, Sen warns that this goal will short-change capabilities if poor or oppressed people adjust to desires within reach. His update of utilitarian philosophy, elaborated by commentators and critics, points out that desires are not always constructive. Sometimes they are antisocial, like interrupting intolerable boredom by inflicting pain on others. Fulfilling a personal desire can come at a high cost to others. Can we provide creative programs that embrace freedom rather than fear it?\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0072\", \"B4\", \"fn0073\"], \"section\": \"Stigma\", \"text\": \"Sen's exhortation to be flexible about culturally conditioned values raises an ethical challenge: Should a community always support the conversion of personal capabilities into functions? Should we assign a positive value, for example, to the conversion of unbearable boredom into violence? How should policy respond to this danger in Sen's non-normative thinking? Nussbaum answers with a list of fundamental norms to respect. But Sen's non-normative lead takes us in a different direction. It would recognize the danger of violence as an incentive to prepare alternative pathways from boredom to self-expression. The alternatives to physical and verbal violence could be the varied forms of \\u201csymbolic violence\\u201d called art. A non-normative approach to thriving need not restrict or reprimand aggressive energies. Instead, energies can be channeled into pleasant, even passionate activities. A range of non-destructive activities could add up to a framework for redesigning policies of violence prevention. The utilitarian tone of this lead recalls Jeremy Bentham's brand of hedonism, to increase pleasure and happiness for the greatest number of people (Bentham, 2003). Sen notes that by now, the word \\u201cutility\\u201d has been hijacked by economists who use it to mean maximization of resources, whether or not this fulfillment of market-driven desire leads to greater happiness. \\u201cMathematical exactness of formulation has proceeded hand in hand with remarkable inexactness of content.\\u201d\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0074\", \"fn0075\", \"fn0076\", \"B26\", \"B30\", \"B41\"], \"section\": \"Stigma\", \"text\": \"Levels of boredom will not figure in GDP calculations, based on national aggregates that fudge glaring economic inequalities. But the capabilities approach can acknowledge boredom as a variable for wellbeing. If boredom were considered a resource of time and freedom, providing creative activities would help people use what they have to do what they can. Sen illustrates the difference between having and doing with the example of a bicycle: Someone who knows how to ride, turns the object into a resource, whereas someone else does not. The process is \\u201cequally concerned with the conversion of more intangible resources, such as human capital and public goods (Nussbaum et al., 1993).\\u201d Training in creative arts, for example, turns free time into a resource. The conversion begins with a choice of perspective: To see the menacing elephant in the room as a platform for freedom. \\u201cThere is nothing either good or bad, but thinking makes it so.\\u201d If the capabilities approach is best understood \\u201cas a \\u2018thin' framework, which can be filled in by \\u2018thicker' theories and applications (Qizilbash, 2012),\\u201d why not fill in with the right to be creative, the Spieltrieb, our most characteristically human capacity (von Schiller, 2015).\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0077\"], \"section\": \"Stigma\", \"text\": \"Under lockdown, there were mitigating circumstances that delayed this now urgent moment of stock taking. The rush of first responses to COVID's rising levels of infection and fatality kept us fixed on daily statistics, detailed by country, city, and neighborhood, while corollary crises of inequities of food supply and services intensified. Violence at home and in public, dropouts from school and from work, despair among young and old, are familiar crises that demand sharper focus than we have given. Perhaps there is a systemic malfunction in societies that value competition over collaboration, consumption over creativity. After the urgency to develop and distribute COVID-19 vaccines abated, a respite from immediate clinical questions is time to face the horrors of interpersonal and self-inflicted violence, suicides, massacres, police abuse. A paradigm shift is in order.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0078\"], \"section\": \"Connect the dots: desire and capability\", \"text\": \"Had legal and healthcare agencies considered a paradigm shift during lockdown, away from the familiar formula of staying still, masked, isolated, and controlled, had they dared to defamiliarize inactivity and noticed that it allowed an elephant to occupy the room, policy might have improvised creative programs. The lens of human capabilities might have re-framed the crushing beast of boredom into an enabling companion for play. Play can convert faculties into capabilities. The hiatus in conversion activities didn't figure among the causes that experts linked to the spike in domestic violence. Instead, they pointed to increased levels of alcoholism and drug abuse. Of course addictions increased, but this finding doesn't address root causes or possible remedies. Arguing that drunkenness and drugs were causes of violence is like observing that suicide is caused by depression without asking why a person is depressed. What caused higher consumption of drink and drugs? Observers duly reasoned that it was the loss of jobs and social isolation. Does that make addiction inevitable and domestic violence unavoidable under conditions of lockdown? Financial hardship and lack of social contact were indeed conditions of lockdown, while work and play were on hold. But these constraints demand creative policies to mitigate the menace of violence. Otherwise, expert observations about joblessness and addiction would suggest that domestic violence is a tragic but necessary price to pay for the clinical advice to stay home. Nothing to be done about it.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B11\", \"B42\", \"B15\", \"B47\"], \"section\": \"Lockdown countdown\", \"text\": \"Primary prevention is a public health strategy that includes reducing risk factors (Celentano and Szklo, 2019). Although prevention was originally designed to avert disease, this strategy has become essential to mitigate risk factors related to violence against women, now that domestic violence is recognized as impacting physical health, mental health, and social wellbeing (Walden and Wall, 2014). Among the risk factors for violence against women, studies recognize gender inequality, social norms and practices that condone violence, weak sanctions, and insufficient resources for support (Flood and Webster, 2007). Still lacking are the resources for dealing with boredom. This is a significant concern for public health policies that aim to prevent pathologies. Rather than \\u201csimply accepting or reacting to violence, its starting point is the strong belief that violent behavior and its causes can be avoided\\u201d (World Health Organization, 2002, p. 45). Boredom is one of the causes yet to be featured in recommendations for redress of blindness to causes of violence.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"B3\"], \"section\": \"Lockdown countdown\", \"text\": \"Men get bored at home and boredom made them more violent during lockdown. Conventional gender roles still structure many families and make the home the space of engagement for women, and disengagement for men. The challenge was to develop enjoyable activities for men at home. Soccer, for example. How does one translate (literally to move from one place to another) some of the pleasures of the open-air playing field to home based activities? Amigos do Bem got busy improvising answers. On readily available communications platforms such as WhatsApp and Facebook, technology helped to move soccer from the field to the house where offers of exercise, lessons in fancy footwork, live webinars, video games, book clubs, and art making multiplied the pleasures of being at home. Boredom could be banished from domestic life. During the lockdown, the WHO discovered soccer too. It announced an alliance with FIFA, to engage the world of soccer in a campaign against domestic violence (Al Jazeera News, 2020). To what extent can enjoyable soccer-related experiences mitigate this risk factor for violence at home? It was a practical question about reducing violence by mitigating boredom.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0079\"], \"section\": \"Pre-texts as childs-play\", \"text\": \"For children during lockdown, boredom was a bane of their diminished lives. The effects of missing school, friends, and activities were almost immediate. And the after-effects show high levels of depression and despair worldwide. Psychological wellbeing has by now become an earnest concern for many public and private agencies. Though Amartya Sen had not taken mental health into serious account when he began to develop his capabilities approach, it soon became an important horizon for him.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0080\", \"fn0081\", \"fn0082\"], \"section\": \"A caution against caution\", \"text\": \"Transforming lessons into play may sound naughty or daring, unless we remember that \\u201cschool\\u201d (\\u03c3\\u03c7o\\u03bb schol\\u0113) means leisure in both ancient and modern Greek. School is the time and space for exploration and discovery. So, the playful paradigm shift is a paradoxical recovery of ancient wisdom that recognized the dignity of pleasure. Paradigm shifts feel risky. Like moving from cozy dank slums to airy new neighborhoods, switching from outworn assumptions to new ideas raises resistance even when the novelty promises improvements. Take the familiarity of domestic settings for example, where boredom looms like an elephant. Clearly, the threat of domestic violence demands consideration of both the dangers and the mitigating opportunities. But there has been little consideration of boredom at home by authorities, health professionals, or policymakers. People tend to ignore boredom. The issue itself sounds tedious rather than triggering. Even for those who can be persuaded to perceive the rumbling threat and to consider the creative cure, more familiar and less effective thoughts about idleness and arts may survive the new knowledge. Zombie paradigms haunt us. One such zombie concept is that art is decorative and pleasant, but not necessary for wellbeing. In fact, art should be understood as a convenient name for change itself. How can change happen without imagining counter-factual and surprising alternatives to what already exists? Considered to be decoration or a luxury, art has been narrowly understood as a product of culture rather than as the dynamic process of making. Better understood as a \\u201cverb\\u201d than a \\u201cnoun,\\u201d art is something intentionally made to interrupt the boredom of habit and to revive care for the world. Art is artifice, in Viktor Shklovsky's elegant formulation. The simple word raises difficulties in European languages because art, like culture, has two incommensurable meanings: the decorative or collectible product vs. the exploratory process; the shared patrimony of practices and beliefs vs. the creative interruption of that patrimony.\"}, {\"pmc\": \"PMC10715406\", \"pmid\": \"\", \"reference_ids\": [\"fn0083\"], \"section\": \"A caution against caution\", \"text\": \"Change requires interruption. It is an art of improvisation, risk-taking and judgment. But policy makers usually prefer a sure bet. Perhaps this is one reason for overlooking art as a resource for development. Art takes risks. If culture means only a legacy of shared sites and beliefs that bond communities, the bridging capacity is forfeited. Making new artistic projects can bridge diverse communities and foster social capital through the conversion of personal capabilities into enhanced social functionings and collaboration. For decision makers who manage to make the shift from considering only the GNP as the index of development to adopting a capabilities approach, the corollary will be to promote wellbeing through behavioral changes. In the spirit of Amartya Sen, these changes will value personal autonomy and self-fulfillment while taking local conditions and preferences into account. It is a creative improvisation, \\u201ca simultaneous and two-way relationship between functionings and capabilities.\\u201d\"}]"
Metadata
"{\"section-at-acceptance\": \"Medical Sociology\"}"