Gambling meets the Black Swan.

Epistemological and institutional problems

by Maurizio Fiasco

1. Universal (pandemic) and Particular (gambling hazard). 2. Critical challenges for scientific thinking of addiction. 3. Isolation, fear, thoughts in the long weeks of “I’m staying at home”. Testimonials. 4 Proposed scientific framework for an epistemology on contemporary gambling, society, individual responsibility. 5. Problem of gambling or focus on the pathological player? 6. Passatism and “pearls of wisdom” on the Problematic Game. 7. The logical procedure of axioms. 8. Addiction as outcome of business strategies vs outdated knowledge of the clinic specialists. 9. Rethinking the psycho-social and clinical approaches in contemporary conditions. 10. Industrial gambling as an abuse of science and technology acquisitions. 11. Ending the State’s dependency to “Sin taxes”

The total health emergency for Coronavirus, among its multiple side effects, has had an impact also on the possibility of playing games for money; that is games played with money and for profit through a megamachine with widely distributed terminals. In other words, not as stated by the Interpretation of the Supreme Court of Justice^[1], since drastic measures have been taken to deal with the pandemic^[2], these have also had an effect on gambling, ultimately stopping much of this practice, which is otherwise widespread in Italy. A sudden halt of the supporting physical infrastructures, since every “physical” door to gambling has been locked for many weeks, due to the country’s lockdown. Among the few types of gambling spared by absolute bans during the nation-wide lockdown was the sale of the coupons of the so-called “instant lotteries”, known under the “Gratta e Vinci” (“Scratch and Win”) name. In general, however, the capillary and insistent pressure to induce gambling money, which was exercised daily, and at all hours, by as many as 240 thousand points of distribution of gambling, was blocked.

The shock of the lockdown forced 265,000 slot machines in coffee/tobacco shops to cease operating, 58,000 VLTs (which are nothing more than slot machines, but in gaming rooms) caused to shut down over nine thousand sports betting box offices and to leave in stand-by another 120 thousand points of sale. However all this has not changed much the fate of the “traditional” or “historical” type of gambling. These types, waste from the past, were already in bad conditions prior to the Covid19 pandemic. For at least five years before, in fact, hippodromes, places for the epic of betting on horse races, had been closed due to the collapse of their revenues. First hippodromes were abandoned by the simple goers, then by the undergrowth of bettors similar to the characters of the cult film “Horse fever”.

Casinos had also plunged into an almost comatose state. All of them: from the Casino of the Vallée to the coast of Sanremo, passing through Venice and arriving at the Campione d’Italia establishment, the largest European gambling infrastructure. Campione d’Italia closed due to bankruptcy, as established by the court in July 2018. This Casino was impossible to be saved, despite the efforts of the prefectoral commissariats and the search for state subsidies. There was therefore no need for Covid 19 for the failure of the Temples of the Belle Époque of gambling. Collapsed together with all their set of symbolisms around “Luck”. The Blindfolded Goddess had also been ostracized, and therefore this symbol had forcibly disappeared: with the disappearance of images, symbols and fantastic experiences, also known to the general public for literary narratives or for the abundant “genre” film production.
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So, with a mandatory stop also for betting, slot machines and various lotteries, two mirror phenomena occurred. On the one hand there was the spontaneous remission of the symptom (precisely because of the universal lock down, obviously including the closing of the access doors to gambling). On the other hand the therapeutic programs for the people who had long since crossed the boundaries of the subjective endurance of gambling disorder, were also halted. All postponed alongside with other health services: from eye exams to psychotherapies.

At this point it is interesting to observe the social attitudes and evaluations, which in various forms come forward, both as statements in the mass media, as with documents of the industry in the sector and even with impromptu sorties in various talk show or online newspapers. In the search of interesting news, information about gambling emerges in the midst of the boring, often cloying news of the pandemic, among bulletins and statistics and in the foreground of the knights of good, fighting in the living rooms inside the home against the coronavirus that terrifies viewers. Between unlikely reports of gamblers who have gone mad for forced abstinence and mass transfers to internet casinos, both data and verifiable experiences have disappeared from the scene. For example, few glimpses have opened on the complaints of online bookmakers about a collapse of their business (even on platforms operating almost as before) and on the lack of episodes of violent or at least excited reactions from quarantined players. Simply it happened that gambling could not go looking for people to engage them in its wheels, and men and women in flesh and blood did not, for the most part, run to find them.

Today a commercial operation is underway which naturally is accompanied by a breath of ideology. It is necessary, and it is hoped, therefore the restoration of the gambling halls. The reason is explicit: because it is one of the signs to hope for a return to normal after a universal trauma. Therefore, in the common sense also the revival of the stakes of money would fall within the perception of a calm after the storm.

To summarize: if on the one hand, for those who had already known the state of pathological dependence, there was the attenuation of the push towards the problematic behavior; on the other hand – as a second side of the coin – the ongoing therapies for many patients were forced to stop. In short, a lesser urge to gambling counterbalanced the risk of frustrating the result of the psychotherapies in progress, precisely because they could not continue. Let us dwell on this “detail” still never reported.

It is foreseeable that the difficulties for patients to have access to care will continue even after the end of the severe limitations on economic activities and people’s movements. Perhaps it will be possible to recover them in the autumn, only after the care services for the pathologies of the physical organism of people have started to function again.

It follows that the programs for the psychic suffering of the person will continue to suffer some restrictions, especially for those that are based on the participation of addicted in a group. In other words, a gap between demand and supply will remain for a certain period of time, since in the months of the medical quarantine only a minority of therapeutic service units managed to compensate with digital tools programs that could not be offered “in person” . The majority of the people in need of such programs have experienced the suspension of therapeutic references.

Now the situation is partially improving, so much so that some self-help groups (AMA) go on “remotely”. But not all therapy methods can transmigrate online, since certain programs require to be carried out “in the person”. And so, inevitably, in front of a dramatic and complex clinical picture, where a face-to-face meeting with the therapist is required, the interruption takes place or the effectiveness of the care provided is reduced.

In general, the thresholds for accessing available services have been raised, both for healthcare companies and for various private entities or individual professionals. This is a point to be underlined: a gap is created between the push that leads to gambling – which precisely will be resumed by industry in the sector – and the availability of prevention and treatment activities, which has suffered a serious “cut”.

All this happens while the lobbies of the gambling sector insist that the gaming rooms reopen as soon as possible, in order not to lose that revenue available to them and that consists in retaining the most interesting consumers: those marked by the GD (Gambling Disorder) . Public authorities should therefore consult those professionals concerned with gambling phenomena/addiction before deciding whether to authorize reopening gaming rooms. At least it should be avoided to consider the possibility of restarting the gambling machine before the whole care system of therapeutic treatment services has started to function regularly.

Dramatic challenge for scientific thinking on addiction .

The unforeseen event of the pandemic and the strong precepts that were mandatory to adopt have made available the evidence that scientific research on gambling addictions was trying to reach. Scientific research has been trying to prove, amid the lively controversies on gambling disorders, the relationship between individual freedom and health, on “predisposing” and “environmental” factors, on protective resources and on the etiologies of addiction, to support public regulation to be adopted. No experimental method or cohort study, or any observation, in fact, can be of help as much as the universal condition of the population for causes not predetermined by any organized system (such as the case of the Covid19 pandemic). Knowledge is organized in the making of reality, testing theoretical assumptions.

It is therefore a question of reconstructing a complex phenomenon – gambling in contemporary society – while it is undergoing an unprecedented and unpredictable revolution, with epochal dimensions, in a season that puts the entire globalized world in front of a “tragedy of common evils “.

So I define, with a dry paradigm, the “tragedy of common evils”, that is the background that inevitably also affects our theme: there are huge dangers (“evils”) shared universally that cannot be faced by individuals – even by those who appear to be holders of a huge wealth – acting for the private interest. In other words, “common evils” dissolve every foundation of Adam Smith’s utilitarianism (“private vices, public virtues” thanks to the “invisible hand of the market”) when it comes to achieving survival (or even just a sufficient state of health) of the individual facing a universal tragedy: nuclear war, floods, desertification, intolerable pollution of air and water.

Reciprocally, collective action is necessary because, many goods that cannot be relinquished for human life, can be enjoyed only as “common goods”, both material (air, water, environment, etc.) and intangible (language, culture, etc. .). But the condition of these “common goods” is really risky, to the point that there is a “tragedy of common goods”: shared resources are threatened by both private exploitation (which therefore would deny them to parts of humanity that have natural ownership) and complete destruction (and therefore for all human beings, abstractly considered as “rational actors”). Why can this happen? Because a “property right” on such “common goods” has not been well defined. A right of property that is neither of a private nature nor of state detention, but of the common sphere: precisely the “common goods” of humanity.

In the “tragedy of the common evil pandemic” the apology of legalized gambling versus the illegal “black market” gambling has suffered a heavy blow. This apology supported the idea that the former (legalized gambling) was a necessary tool to defeat, in the name of utilitarianism, an activity that challenges the law of the state (illegal gambling), in the face of a constant: the generalized propensity of men and women to engage in challenges to obtain money from chance, while jeopardizing material and immaterial goods of great importance, if not subsistence .

To frame the current state of the dynamics of gambling pathologies, it is necessary to start from what is available in the contemporary world, avoiding the risk of scientific and pragmatic conservatism: since it is natural that such is the attitude and the upheaval aroused in professionals, researchers and scientists who all perceive the sudden obsolescence of their respective theoretical backgrounds as well as a large part of the pragmatics they elaborate.

Since gambling has become “mass” behavior, industrially produced and encouraged, a scenario has gradually emerged that makes some, recurring reading models obsolete. We refer to categories and interpretative schemes that date back to when consumption and abuse were not rampant, and the places and times of gambling were defined, placed in limited spaces and for reserved occasions. The commonly diffused image consisted of three poles: on one side there was an elitist one of the casinos and casinos (some authorized, many others illegal) and, on the other hand, there were two other poles: the popular one of the lotteries and bets in the racecourses and the plebeian and deviant one of the clandestine gambling dens. In any case, the structures and methods of offering gambling were characterized by a separate organizational position in times and spaces, with little overlap with those of the daily life of the population.

Disruptive Innovation: an obligatory alternative to yearning for the status quo antea, but also as the only real chance to save, using them in the best way possible, the science and experience developed in many years of hard sacrifice and in the name of absolute intellectual honesty .

Isolation, fear, thoughts in the long weeks of “I’m staying home”. Testimonials

First testimony

“I am suffering from Gambling Disorder, and despite being treated for more than two years, the situation has not changed. However, in this period, since I bet on sports and the sports have stopped, I haven’t played for 45 days.

I have heard that some games will be reopened shortly, perhaps tomorrow and that there are cases of gamblers who are in abstinence crisis. I fear that this might be an excuse. In fact, I’m much better. I don’t think about the game, I have never suffered in this period despite the fact that I am unemployed and with serious economic problems due to the game.

I dream every night, which I haven’t done for years and I’m afraid thinking about when sport will start again at full speed “.^[3]

Second testimony

“Who would have said it!

Who would have said that the greatest tragedy since the post-war period to date would have had at least one positive side. Who?

I am almost ashamed to say it, thinking of the hundreds of thousands of deaths that the virus is causing in the world. But stopping any form of play helped me. I thought I couldn’t resist and instead …

Instead my life is changing. And I hope it’s a definitive change.

I have not played one euro anymore and, above all, I have no desire to do so.

I started talking to my children again, to read, to reflect, to write. Just like I did when I was a boy.

In short, I started to live again, to smile, to cry, to get excited.

And it is no small thing. Now I have more determination to keep going and put a a stop (also hopefully definitive) on the troubles of the past.

I will still need help, of course, but now I’m sure I can capitalize on that help. I thank God. But then I wonder: Could gambling (because it is not right to call it a game) be closed forever?

I know that the state earns from it and those gains are part of the national budgets, but closing that sector, with due precautions, would mean saving several families.

It is not a convenience speech. It is simply what I learned from my story.

I dream of going back to the football pools that I played with my father. Few lire that were used to pay the ticket to listen to “All the football minute by minute”.

It was a party, you won or lost, not the shit I came to know later on^[4] “

Third testimony

“Then the world stopped abruptly and our patients and their families showed us something very important that I would like to take into account for the future and inform our policy makers: we do not die, we do not you get sick, we don’t suffer from lack of gambling!

“… and observed with video calls we discovered that these people [the players in treatment] were taking action to do everything possible, some alone and others with family members: suddenly they seemed like people who had returned to being normal, capable of painting a house, of going to work without getting lost elsewhere, devoting themselves to gardening, playing with children, making peace with their spouses and even offering themselves for social volunteering activities “^[5].

Fourth testimony

“Despite the doubts about the feasibility of non-vis-à-vis group psychotherapy, I chose to continue the therapeutic work through one of the many platforms for distance communication.

Since the beginning of March, online group psychotherapy sessions have started, according to the same times and traditional session rules. Forty of these sessions have been already completed to date and which, before the end of the emergency, could exceed two hundred session.

And it is precisely in a period of dramatic and isolation like the present one that the continuation of group therapeutic work becomes fundamental, albeit in an unorthodox way. Modalities which, net of their limits, are proving even advantageous in some respects: attendance at sessions has increased, exceeding 90% after the third week. But the most interesting factor is that these session have given us the opportunity to involve in family therapy hitherto reticent or unable to participate because they reside abroad “^[6].

Fifth testimony (or rather first quote)

“… in our country, Regions and Municipalities have, superficially enough, looked for solutions for the management of the phenomenon and have intervened, mostly, with the aim of limiting the number of gaming rooms through measures that – according to the research institutes – prove to have little impact and at least ineffective.

First of all, what is defined as a “distance meter”, ie the ban on opening rooms or installing slot machines less than a certain distance from churches, schools and other sensitive places. Recent data show that instead a part of the problematic players (on average 10%) often choose to go to rooms away from the home, just to hide the inconvenience that can result. Doxa (2019) highlights that most players have no problem choosing a room further away: 69% of sports betting players, 65% of Slot players and 61% of players belonging to the Video Lottery Terminal would move to another store. Only 12% – emerges from the study – would stop playing if they closed the usual place of play “^[7].

Proposed scientific framework for an epistemology on contemporary gambling, society, person

At the climax of its performance – 110 and a half billion euros, 120 million man days spent by consumers placed in various locations – the gambling industry also crossed the Black Swan. And it was not the figure in the the work of Piotr Ilic Chaikovskij, but it was much closer to the metaphor proposed by Nassin Taleb, a mathematician, financier, philosopher, historian and psychologist of Lebanese origin, to explain, in his homonymous work, how the learning of the past, creating certainties of knowledge, can play very bad jokes: to the point of making men unprepared in the face of financial catastrophes, the disappearance of entire civilizations that had remained prosperous up to that moment, after centuries and centuries of material, spiritual and scientific development.

So the Black Swan is for all investors. Including the gambling industry, which in addition to letting consumers gamble money and social life, can itself be counted – for its business constructs – as a gambler. And not so much for the obvious “bench” position in contrast to the gambler. The gambling industry risks in fact an unsurpassed collapse, as already anticipated (in unsuspected times) in the microcosm of Campione d’Italia, when the bankruptcy of the largest physical casino in operation in Europe was decreed in July 2018 .

The collapse of the companies is caused not only by the collapse of consumption in the physical places where money is bet, but also by the ceased continuation of the multilevel marketing of finance derived from state concessions: which offered the illusion of snatching indefinite profit margins from the growing public gambling offer. What else could be expected, before the Black Swan, from a business that has multiplied eleven times in twenty years?

Well, the economic and financial aspects of a business with the aforementioned numbers and such market strategies are of great importance today also for those who professionally commit themselves to offering aid and therapies to people with mental suffering resulting from gambling abuse. While the industrial-commercial complex of gambling is looking for ways to relaunch its “services” (for example by studying digital platforms or physical installations compatible with Covid’s anti-contagion rules), the general background of the various phases of the restoration of normalcy in the daily life of the populations, it obviously also affects scholars, operators, analysts and the whole arc of the addiction clinic, such as the ones dealing with gambling disorder.

Gambling problem or focus on the pathological player?

A curious dilemma is revealed when one attempts to frame the institutional and social framework of gambling as a health risk. Usually the emphasis is placed on problem gambling, and not on a much more congruent “gambling problem”. We set aside for the moment the “detail” of the non-evocation of money, of the profit-making characterizing it. So, Problem gambling or Gambling problem?

Is it the exception of the gambling game that suffers an interference of pathological aspects that must be framed as a problem? Or is the object of the dispute, precisely the emergence of a gambling issue, where the state allows (indeed promotes) its commercial offer in public? In short: do you have to deal with problem gambling or is it gambling in itself problem?^[8]

The appropriate definition of gambling addiction, finally adopted by the National Health Service thanks to the Balduzzi law decree (2012) and its inclusion in the new Essential Levels of Assistance (2017), still coexists with the state’s propensity to draw from the gambling consumption a supply of income to support the costs of his apparatus. This is how the habit of betting money, pending prizes awarded purely by chance, came to huge proportions and which had never been known in Italy before.

From many sides it is believed that the definition of pathological gambling (problem gambling) can still be built, treating the player as a monad, and attributing to the player a differential psycho-pathological profile. This theoretical and pragmatic operation is proposed as if we did not change since the 1980s, when the gambling offer was limited to the one displayed in one of the four Italian casinos, and there were people from Milan, such as from any other part of the Peninsula, who went to Campione d’Italia, Sanremo, Saint Vincent or the historic casino of Ca ‘Vendranin in Venice. Or, At the opposite social end, from a plebeian or popular social context, when gambling consisted in the days of horse racing, when the bettors reached the racecourses of San Siro, Capannelle or Tor di Valle.

If such “elitist pilgrimages” to the gambling houses had attracted the scientific-professional interest of sociologists, psychologists, anthropologists and economists (even fewer in number) they would have wondered, trying an approach to the theme of gambling, why some people go to bet money and others do not want it. The focus to interpret the behaviors (in the problematic aspects) should have focused on the player’s profile, reconstructing the traits to then proceed to a definition of pathological dependence deriving from the excessive attendance of gambling temples. From the psychosocial profile to the setting in terms of a specialized clinic.

Well, while the panorama remained in the terms just described, the therapists who twenty years ago in Italy dealt with gambling could be counted with the fingers of half of one hand. The reference in clinical literature was, for the few scholars, the book by the Austro-American Freudian analyst Edmund Bergler, one of the first gambling scholars linked to clinical profiles, that is, disorders of the psyche. In his long career he had listened to and in many cases taken under his care, about sixty patients with gambling addiction. Sixty cases in over thirty years of analytical practice. Very few in the United States of America, an immense country where gambling was practiced aggressively, widespread, with a popular tradition dating back to the era of the frontier of colonists, miners, adventurers and hobo^[9] of adventurous and nomadic jobs.

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Bergler in 1957 thus formulated his rigorous paradigm: “in our civilization anyone is potentially a gambler, of the harmless or dangerous variety. In some personalities this latent tendency can reawaken, and then the latent player actually starts playing. This statement may be disturbing and such that many would prefer to contest it. It can be refused, however, only by closing one’s eyes in the face of scientific evidence to the contrary.^[10] “

This model given to us by one of the pioneers of scientific research on the phenomenon can also be recalled in today’s situation. It allows us to face this issue in our contemporary times. The social actors that interact with one another in gambling – the banker and the players – instead of being simple subjects in this systems, are rather placed in the midst of mechanisms and procedures of an economic activity, which has become exceptionally large. On one hand, the entrepreneurial project takes place – the bank has become industry – and on the other side are consumers, that is, the whole population indiscriminately, are treated as a commercial target to be reached and then retained thanks to sophisticated marketing. If anyone (as Bergler says) can evolve into a player (not simply by playing, but by acquiring the identity of a gambler), then the offer of that particular “good” called gambling will have to engage as many paying consumers as possible. The way to obtain growing profits is precisely paved by the immense size of the population that can potentially be the target of gambling products.

Moreover, the frameworks of addiction^[11] apply also in gambling. In general, the consumption of a physical good or a service offered and available can lead to or be associated with a state of dependence. Beyond the natural sphere of addiction to satisfy man’s absolute needs (for example, nutrition), the pathological meaning must be understood as submission to a power that causes significant damage, or that affects the behavior of the person, which alters in sensibly the course of a human existence and which, ultimately, compromises the “complete state of physical, mental and relational well-being” (ie health, according to the meaning of the WHO). An addiction is therefore pathological if it undermines the integrity of the individual, his freedom and which causes suffering both to the addicted and to the people who make up his circle of fundamental relationships, his “significant other”, sometimes pushing himself to even harm to society as a whole.

The causal link between factor – physical-material or immaterial – of a detected addiction and the condition of the individual person is circular and non-linear, that is to say, it concerns the relationship that is established. Anyone who has investigated the issue in depth (one author for all: P. Rigliano, 1998) focuses precisely on the complexity of the relationship, or on the typical interaction of human systems: it concerns the subject, the object of addiction, the context where it takes place, as Gregory Bateson has framed the feedback of events and experiences of the person, which gives structure both to the experience and to the perception-cognition of oneself.^[12]

It is the outcome of a person’s behavior that creates meaning to addiction, and therefore to the replication of the behavior itself. Rigliano gives it a paradigmatic formulation: “Addiction is what results from the cross between the power that the substance [and we add: also an immaterial factor, ed.] Has in power and the power that that person is willing to attribute to the substance” ^[13].

That’s why, referencing back to Bergler, “anyone is potentially a gambler”. But the awakening of latency can take place following a meeting that activates it, even if only because it occurs in an otherwise transitory period of particular exposure to risk. And so that both a substance, a behavior or a relationship can generate a particular experience that can accompany the restructuring that the Self undergoes. The interpretation by the person of the experience in the encounter lays the foundations for its repetition. This is precisely the case of gambling, from which a pathological dependence sine substantia^[14] can originate.

Well, how does exposure to risk look like? How is the transition from latency to persistent manifestation provoked? Is it legitimate to insert factors, devices, references and all the inductive methods into the environment (even saturating it) to the encounter between the fragility of the person (of each person) and the trigger of an addiction?

Due to the few patients under treatment, and a narrow range of addiction types, clinicians and scholars considered it a “niche” phenomenon: that could concern the lives of deviant individuals and personality profiles with non-generalizable features. The psychoanalytic hypotheses, however, drew from the rich materials from the production of great literature. The novel The Player by F. Dostoevsky^[15], the interpretation of S. Freud,^[16] Game at dawn by A. Schnitzler^[17]. A certainly interesting and suggestive issue, a niche phenomenon. But is this a theoretical focus and a complementary search for pragmatics to be recovered even today?

If we can find some essential paradigms that allow us to proceed with the framing of an imposing phenomenon is the available data which shows 110.5 billion euros of consumption and 120 million man-days spent in gambling. However, today there is a renewed scientific request that claims – even among clinicians – to carry out a thorough examination of how the gambling offer was built. It seems clear to me that it is the “narrow door^[18]” to strive first of all to know the constitutive features of an industrial project: which has poured many of the most significant results into programming, production, distribution, presentation on the market, access to consumption. advanced disciplines, from neuroscience to interior design, perception psychology, financial mathematics. The same “creatives”, the technicians enlisted in the strategic marketing of the commercial-financial companies of gambling, have plundered the psychoanalytic literature abundantly: not for the purpose of freeing the person, but to devise effective procedures for customer loyalty of betting and lotteries^[19].

Rhetorical questions, of course. Yet, a curious paradox continues to repeat itself: we examine the pathological addictions as they are today, and we push ourselves to discuss the next scenarios, resorting to theoretical references relating to a truly declining phenomenon.

Passatism and “pearls” on the Problematic Game

As happens in literature, fashion and costume, the alignment of cultured or institutional interpretations does not often correspond to the decline of narrative figures. Common sense makes us perceive what is buried in the way of life of the near past as a trait of the present. This is the case with the phenomenon, indeed with the representations of gambling. The so-called “public discourse” spreads on traits and profiles, which have become passatists with the by now mature revolution that has thrown machines and structures to the nettles; which has deteriorated temples and arenas of the high-risk challenge with cash stakes; which led to the extinction of ‘Luck” and the same magical thought.

The gambling industry, and some of the clinical practitioners, propose operative framework that are obsolete. These social actors continue to propose this vision using dogmatic expressions. Here are some of them, from a choice of those specialists. Here are three examples (among hundreds) of banal tautologies that occur both among Italian authors and by clinicians who also act as international references.

1. Gioacchino Lavanco – Loredana Varveri, Psychology of gambling and betting, Rome, Carocci, 2006: “Most of those who dedicate themselves to gambling, practice it as a form of pastime and fun. It is a social and cultural phenomenon which therefore cannot be demonized as such. However, in some cases, some individuals develop an obsession and a morbid attitude towards the game, coming to establish with it a real form of addiction. ^[20]“

In international literature, other experts repeat similar argumentations, albeit with greater eloquence. The source are industry publications (overwhelmingly editorial products funded by the gambling majors).

2. Gambling has become widely viewed as a socially acceptable form of recreation (Stucki & Rihs-Middel, 2007). For most individuals, gambling is an enjoyable and harmless activity. However, for a small minority of individuals it can become both addictive and problematic with severe negative consequences (Meyer, Hayer, & Griffiths, 2009). Consequently, the expansion of legalized gambling has been identified as an important public health concern (Shaffer & Korn, 2002; Williams, Volberg & Stevens, 2012), and as a result, the number of individuals seeking assistance for gambling-related problems (Abbott , Volberg, & Rönnberg, 2004; Suurvali, Hodgins, Toneatto, & Cunningham, 2008).^[21]

The “most” and the “minority”: but what are the proportions? “Pastime”: time as an asset “not scarce”, but widely available. And then, “social phenomenon”: therefore arose spontaneously throughout the history of the costume. That recourse to linguistic banality [De Mauro, 2014] to repeat “widely considered” (by whom? For which scientific evidence etc?). And the reasoning falls on a “However”: the concessive conjunction … “let’s admit that …”.

3. Claudio Barbaranelli, The game, protection and risk factors: overview of Italian and international studies and focus on research conducted by CERMPA (Sapienza University of Rome), year 2011, June 29, paper: “For most people playing with cash is a pleasant pastime. For some people, however, it can become a real pathology, which leads them to play compulsively. A pathological player is a person in whom the impulse for play becomes an uncontrollable and uncontrollable need, which is accompanied by a strong emotional tension and an inability, partial or total, to resort to a reflective and logical thought. “

Two birds one stone: a) the word “game with winnings in cash” instead of gambling is a ridiculous semantic device; b) to say “a real pathology that brings them”, that is, it is not gambling that leads to pathology, but it is the pathology that “leads” people to be pathological (precisely by playing ” compulsively “). It is necessary to specify, with good reason that the Barbaranelli Center has been financed by Lottomatica since 2010. The signature of the same professor was cited by the concessionaire of the De Agostini Group in the appeal to the Regional Administrative Court of Lombardy, to request the revocation of the order of the mayor of Bergamo which in 2016 limited gambling hours in the city.

Lottomatica, the most important gambling corporation in the world, presented an expert report to document the economic damage it suffered due to the regulation imposed by the Municipality of Bergamo on the slot machine rooms. The expertise was signed by a colleague of prof. Barbaranelli, Prof. Vecchione, researcher at the same university. In this way, there was a conflict between a private and particular interest (the profit of the gambling company) and the universal and public interest that the Municipality of Bergamo wanted to assert to protect citizens. Another detail: since the resulting report was presented on headed paper of the State university “La Sapienza” it suggests the financial support of CIRMPA (inter academic consortium committed to studying the difficulties of minors and the risks of social exclusion-deviance in developmental age!)^[22].

What is the sign of such an approach? The design of the industrial gambling machine is not examined, the properties that connote it in relation to the inviolability of the person are neglected, and it is assumed that the pathology arises exclusively from within the addicted person, that the addiction problem derives from a set of differential characteristics of the subject. It is about treating an individual with social stigmata. Pleural mesothelioma happened to a patient who was in Casale Monferrato^[23], investigating his immune heritage, his psycho-somatic characteristics, oncological familiarity etc. But not on Eternit. This has happened for decades.

Capital interference, therefore, also on gambling pathologies is suffered by clinical professions. They are pushed – according to a vision that confirms the meaning of twenty-year government policies – to regress in the importance of their mission by placing themselves as a mere “remedial” tool. These professions are not framed as services for taking care of people’s health, considered in its inviolable wholeness. The incidence of the antinomies above mentioned, on the prospect of the clinician making the decision is a topic that needs to be further clarified. Is there not an additional risk of induction to cognitive distortion and error?

Secondly, Gambling Disorder is a rare example of pathological addictions where the field of pathogenic “agents” is not institutionally located in a space separate from the field of Institutions. Among the institutions, in a state that recognizes welfare rights, certainly are included the services of the clinical and psychosocial area. The world gambling trade addresses the need of professionals to vouch to a professional niche, in which to obtain work and role gratifications, in exchange for legitimizing a “responsible” game (but without the fundamental condition that is civil liability from the dealer towards the consumer).

Addiction as industry project vs knowledge of the clinician

Today even the clinician, we would say above all he, must obtain the competence of a multidisciplinary and multi-professional reading that also includes numerous aspects, albeit unrelated to his initial specialist preparation. In other words, if he does not want to help direct his efforts out of the way, all he has to do is turn his gaze to an external competence: which is necessary for him to carry out his work with honesty. The seemingly simple questions make it difficult to understand sufficiently the dynamics of addiction. How do the various gambling games work? What change has brought about the use of digital technologies? What is the treatment reserved for customers in online gambling by Gambling corporations?

Moreover, in general, how to neglect that the daily presence of these games “always on”, of the engagement of the person in a universal gamification, in a technological “playfulness” that refers to the flow of reward, levels in succession, jingles that accompany the challenges, new rewards waits etc.)? Can a clinician ignore how the gambling actually practiced by a huge part of the population, thanks to the use of new digital technologies, has reorganized the biorhythms, codified and marked the times of emotions, interpolated the paths of everyday life with the sequences of gratification and of obliterable frustration?

In the mid-nineties, gambling was still a “niche” theme, albeit of undoubted cultural interest: for psychology and psychoanalysis, for literature, for mathematics, for law, for criminology. The solidity of the institutional model that in Italy – for over a century – had confined bets, gambling houses, challenges for money and with money, lotteries in limited spaces and times remained uncontested. However, still distinct from the everyday life of people and cities.

The constituent components of the phenomenon remained very distinct, such that, if the issue of gambling disorder had been addressed, the approach would have led to the exclusive observation of people involved in a pathology, still defined in the class of “disorders behavior and impulse control “. The variables could have been isolated; the gambling machine and the gambler.

Everything has changed. Now gambling is in our everyday life: it interferes in the organization of the daily life rhythms. The offer of gambling activities moves in search of people wherever they are. It affects the morphology, the layout, the structure of places. It alters the normal sequence of life. It stands in intra-family relationships, in the relationships of the individual with the group or with the social groups in which it is inserted: in the scale of the family, of work colleagues, of the neighborhood, of other contexts to which it belongs.

The present is marked by a new paradigm of the “game with money, for money and for profit”. It is proposed here as an enunciated mass industrialized gambling. This framework captures the radical diversity with the phenomenon quo antea. The essential characteristics are given: a) by the combination of gambling and advanced technologies, with the latter having almost completely incorporated the “function of chance”; b) the replacement of games with high payouts and low frequency games with other “low but reachable payout” games by the customer and with very high frequency; c) from having eliminated the compensatory function of the search for luck with the expected gratification, experienced and repeated continuously through the payment of small “non-resolving” sums; d) by the large-scale, high-intensity use of the acquisitions of neuroscience and behaviorism for operative “conditioning”; e) the deployment of marketing and the stabilization of the demand for gambling by aiming at loyalty through addiction; f) from an interdependent business structure with a financial market derived from the trend of gambling revenues.

A mass industrialized gambling is therefore a low-threshold gambling experience, which progressively occupies an increasing portion of social time, which interpolates the itineraries of people’s daily lives, engaging them for many hours of their day, since it is based on reinforcement techniques of behavior and induction to addiction. In general, mass industrialized gambling engages and stabilizes behavior with a bidirectional system which is made possible by the system, both online and physically, of the sequences “input-other investment-expected reward”.

Rethinking the psycho-social and clinical approaches in contemporary conditions

The paradigm proposed above can help to adequately frame the problems created by an offer that is no longer located outside of everyday life. The gambling offer coordinates with the person’s biorhythms, it interferes where significant interpersonal relationships take place, and ultimately invades the private and intimate individual life.

So we need to go to a new definition of addiction, or rather of the Gambling Disorder, which was not by chance in DSM V was changed from from pathology of behavior and impulse control to the structure of an addiction, that is of a real addiction.

E se un trattamento individuale-differenziale impegna comunque il clinico, che deve operare su scala della singola persona, tale concettualizzazione non rappresenta la matrice credibile per un inquadramento generale del fenomeno di massa. L’accento sulle caratteristiche, assunte come uniche e irripetibili della persona giocatore patologico, infatti, non giova granché a supporto di una decisione di politica della salute. La politica della salute si correla alle misure tese a distanziare la popolazione, individuata quale target di una malattia epidemica, dal rischio derivante dal convivere in prossimità con l’agente patogeno, ovvero nel caso del gioco d’azzardo con il fattore di aggressività dell’offerta che spinge e quindi cronicizza il Gambling Disorder.

And if an individual-differential treatment nevertheless engages the clinician, who must operate on an individual person’s scale, this conceptualization does not represent a credible matrix for a general framework of the mass phenomenon. The emphasis on the gambling addict’s characteristics, taken as unique and unrepeatable traits of the pathological gambler, in fact, does not help much in support of a health policy decision. Public Health policy related to measures aimed at the social distancing of the population, identified as the target of an epidemic disease, or in the case of gambling, with the aggressiveness factor of the gambling offer, that pushes it into developing as chronic diseases, the Gambling Disorder.

The amount of spendings in gambling – an ever increasing amount year by year – is the result of how the industrial model was designed and built, drawing from the acquisitions of the neurobiological and psychosocial sciences into it, without the State playing a role of guarantee, protection, against the abuse of technology for the enslavement of the person. So it is clear that it is now necessary to adopt a new paradigm, which binds honest, independent operators to an absolutely precise ethical framework.

Industrial gambling as an abuse of science and technology acquisitions

The “non-neutral” use of science is a theme that can be re-proposed both to reach value judgments on contemporary gambling, and to analyze the adequacy of the warranty rules that the State has issued for integrity of the person and for the protection of the public interest. An author, who has always been a reference to research on education and learning, but whose work has been re-evaluated recently for the interpretation of gambling addiction, offers us at the beginning of his major work precisely the dilemma on the consequences of science.

From the first pages of his masterpiece, Science and human behavior, Burrhus Frederic Skinner (Susquehanna, 20 March 1904 – Cambridge, 18 August 1990) exposes the paradigm in a dry way, quoting a 17th-century Jesuit, Francesco Lana de ‘Terzi, who was the founder of the physics of air navigation. First the Jesuit quote.

“God will never accept the invention of air navigation for the consequences it could have on the civilian government of man..”

“… no city will be safer from attacks since a ship will be able to drop a bomb on it, soldiers will descend directly beyond the walls, make looting, kill humans, burn with fireballs …”

“There will be no place, castle, building, city that can be safe …”

Prodromos. “Essay on some new inventions given to the master art”, 1670

Skinner writes (in the chapter Can science help? The misuse of science): “Lana’s reservation was unfounded. He had predicted the modern air war with surprisingly accurate details – with paratroopers and machine guns along with the bombing. Contrary to his expectations, God suffered that his invention was effective”[two and a half centuries later]

«Science – comments Skinner – is more than a mere description of the events that happen. It turns to discover the ratio, to show how certain events are related to others.

“No technological practice can be scientifically based without identifying the correlations … [even more].. When we identify the coercive forces that act on human conduct (…) “^[24]

History highlights the irresponsibility with which science and science products have been used.

Exit the State Tax Addiction

If the gambler’s behavior is “conditioned”, it cannot be said that public administrations, behind their “impersonality”, do not fall into a similar state.

Having linked taxation to harmful activities- such as excessive consumption of bets and the like – it reproduces the paradox that has already occurred with smoking: the curious pathological dependence also from the side of the State. A symmetry, which can be evoked as a tax addiction. It is expressed in the “compulsive” search for new revenue for public finance. Is the tax revenue from cigarettes 14 billion euros per year? But the cost of the 84,000 deaths from smoking-related cancers is far greater. The algebraic sum of the two items is not processed, cash emergencies are almost always dealt with by recording the forecast of new revenues from additional taxation on tobaccos in the financial statements. The demand for this “good” is in fact rigid, and the 11.5 million smokers will continue to consume what the state monopoly offers. The increase in the price of smoking has no effect on the propensity to inhale burnt tobacco.

For bets, slot machines and lotteries, the state induction spiral of gambling therefore exposes a new symmetry between bureaucratic decision and gambler behavior. The latter, when he loses money, wants to do it again, and therefore continues to invest increasing amounts. Equally immersed in the swamp of debt, the state is overwhelmed by a crisis, in the device of growing expenses and insufficient revenues. In this sense, the public administration also slips into chasing, in the run-up of losses: we want to “redo” to find the money necessary to cover the current expenditure of the equipment.

Here, therefore, exactly like the gambler, the public administration – to be understood here as the complex of bureaucratic and political decision-makers engaged in its procedures – spares itself from adopting a systemic vision. Instead, a rational decision should sound like this: “if we relaunch the production of goods and services, not only do we create jobs, but we also stimulate economic growth. As a result, the revenue from taxes and duties increases.” To summarize, what does not come from the taxation of gambling is offset by taxes on other goods which benefit from the greater availability of money of families (in absence of gambling). The prison of obtuseness, however, forces the public administration to a cognitive shortcut, to a heuristic: under the pressure of the need to stock up on money, bureaucracies and the political class go to find food where they perceive an availability, and the deferral of the structural choice seems to be easily endorsed. For the time being, with the revenue derived from gambling we dab a leakI.

It is similar to say: we are full of debts and then we ask for loans to finance them. Consequently we continue to pay at increasing prices the time obtained “on credit”. Conclusion: the abnormal expansion of the consumption of gambling has become a further structural factor of both the deficit and the debt of the state. In pursuit of losses (and in the flight from responsibility) Government and Parliament project each other into a Pathological Gambling, or an endless spiral.

It seems problematic that there may be an addiction treatment that affects the individual person that is not consistent with the treatment of addictions when they involve an entire country. It is a spiral that is difficult to master when an industrial gaming system is supported by the continuous expansion of the number of participants in the gambling game. The “emancipatory” premise is the restoration of the ethical-political assumptions of that guarantee the rule of a constitutional state.

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1. According to the Supreme Court, the legal notion of gambling identifies the characterizing elements: the randomness of the win and goal of profit. Both are framed in legal cases. A judgment of the Supreme Court (28-04-2009, n. 17842) reminds “how art. 721 of the Italian Criminal Code establishes that, in order to have a gamble, two elements are required, one of an objective nature, represented by the uncertainty of the win or loss, the other of a subjective nature constituted by the profit of the participants “. In conclusion, the random nature of the game is given by fate exclusively and predominantly and not by the player’s ability at the game itself.↑
2. On 11 March 2020, the Director-General of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, declared that COVID19 represents a global pandemic, spreading all over the world latitude. The generalized and widespread alarm according to WHO Pandemic Influenza Risk Management procedures (issued in 2017), was launched just six days after the Alert Phase. On March 23, 2020 it was then stressed that we were facing an exponentially growing pandemic and we were advised to countries not to limit themselves to social distancing, but to adopt aggressive tactics by testing every infected suspect, isolating and treating every case confirmed, tracked and quarantined each contact (this invitation was repeated in the subsequent press release of 27 March 2020). For a detailed reconstruction of the events and an examination of the consequences also under international law, see Ilja Richard Pavone’s online line, The WHO covid-19 pandemic declaration: implications of global health governance, 27 March 2020 , published in the Biolaw Journal, 2020.↑
3. Testimony received by Sen. Endrizzi e published by him on FB on April 27th, 2020 ↑
4. Testimony collected by the author from a long-term gambling addict. ↑
5. Vittorio Foschini, Psychotherapist Alta Specialità SerDP, Ravenna AUSL Romagna, after consulting many colleagues who are working in the field of addiction in his region. In Alea Bulletin, n. 1, aprile 2020 ↑
6. Rolando De Luca, Psicologo Psicoterapeuta, responsabile del Centro di Terapia di Campoformido per ex giocatori d’azzardo e loro familiari, in Alea Bulletin, n. 1, aprile 2020 ↑
7. Martinotti G., Pettorruso M., Clerici M., Sacchetti M., Di Giannantonio M., Il disturbo da gioco d’azzardo. Implicazioni cliniche, preventive e organizzative, in Journal of Psychopathology, 2020;26(Suppl 1) ↑
8. In reference to an intricate unsettled question. ↑
9. In the years of the Great Depression, a vagabond worker who lived in makeshift accommodation was called hobo, cultivating a style of simplicity, the vocation for travel, adventure, inner research and marginalization. Important is the essay by the sociologist of the Chicago School Nels Anderson, The Hobo (trad. It. Il vagabondo, Donzelli, Rome, 2011). ↑
10. E. Bergler (1899-1962), Psychology of gambling, New York: International universities Press, 1958, 244 pages, trad. It. Psychology of the player, 1974, Newton Compton Italiana. The easy-to-read text of the Austro-American author has curiously not been published again despite the fact that interest in the topic has gained adequate prominence in scholars and in general in the public. ↑
11. Addiction: from the Latin addicere (addico, addixi, addictus), enslavement, reduction in slavery, forced dependence, confiscation. Gambling Addiction – Pathological Gambling is defined by the World Health Organization and described in DSM V, that is the complete repertoire of psychic suffering worthy of therapy, which is the standard approved by the American Psychiatric Association. In the fifth edition of the DSM (2013) the word Pathological Gambling was replaced by the wording Gambling Disorder (in Italian, Disturbo da Gioco D’azzardo). See APA, DSM-5 Diagnostic and statistical manual of mental disorders, Italian edition edited by M. Biondi, Raffaello Cortina publisher, Milan 2014. ↑
12. G. Bateson, Towards an ecology of the mind, Adelphi publisher, Milan 1977. ↑
13. P. Rigliano (a cura di) (1998). In-dipendenze, pag. 48, Torino: Gruppo Abele. ↑
14. The first institutionalization of the clinical aspects of excessive gaming consumption “with money” and “for money” takes place with the so-called decree-law of 13 September 2012, n. 158 (“Balduzzi decree”) which provides for the treatment of gambling addictions among the obligations of the NHS. In addition, Article 7, paragraph 5. introduces protection and caution measures, including the obligation for managers of gaming rooms and establishments in which there is an offer of public games to exhibit at the entrance and inside the local, the information material prepared by the NHS aimed at highlighting the risks related to the game and to signal the presence on the territory of assistance services dedicated to the care of people with related diseases. With the Decree of the President of the Council of Ministers (Prime Ministerial Decree) of January 30, 2017, gambling diseases, now technically defined as Gambling Disorder, have joined the complex of Essential Assistance Levels. The new Decree in fact completely replaces the Prime Ministerial Decree of 29 November 2001, with which the LEAs were defined for the first time. ↑
15. Luigi Cancrini’s essay was pioneering, “A drug addiction without drugs”, published on the occasion of a re-edition of Fëdor Dostoevskij’s masterpiece, The player, EdUP, Rome 1996. ↑
16. Trad. It. In Complete Works of S. Freud, volume 10, Turin, Ed. Bollati Boringhieri, 1966-1980. ↑
17. Arthur Schnitzler, Spiel im Morgengrauen, 1927. Ediz. It. Adelphi, 1983 ↑
18. “Make every effort to enter through the narrow door. For many, I tell you, will try to enter and will not be able” (Luke 13:24) ↑
19. An impressive repertoire of such senseless use of the sciences of the psyche could be organized for bleak and commercial purposes. Just a few examples of the institutional communication of the Monopolies of a few years ago, well before the ban on advertising became fully operational in 2019: “AAMS [Monopolies Agency] brings you closer to dreams (…) And just as the Lottery ticket poses a potential win for everyone, AAMS allows each person’s imagination to open the door to fantasy, without fear “. The genius of the Neapolitan playwright has also been crushed: “Eduardo De Filippo said: ‘Life is a game that needs to be supported by illusion’. Is this always true? Yup! Illusions help us live, but in our case illusions often become reality. “In 2007-2008, still one of hundreds of examples, advertising “branded” by the State Monopolies resorted to the archetypal figure of the horse to address women, even touching pornography with a female target. In wanting to be benevolent, the images and slogans used that constant reference to the “fantasy of the girls who imagine being saved by the Prince on a horse, a phallic symbol, as the Greek heroes had ‘saved’ Helen of Troy by means of a horse who had penetrated the city “(cfr. Iakov Levi, Biancaneve e altre vergini, in Scienza e psicoanalisi. Rivista multimediale di psicoanalisi e scienze applicate, http://www.geocities.ws/psychohistory2001/Biancaneve.html 2002) ↑
20. Lavanco is a director, presented at the launch of the foundation, of the Unigioco Foundation, born on the initiative of Gamenet S.p.A. [Gambling concession holder] and the Eurispes Institute [private research body permanently entrusted with research and activities commissioned by gambling companies]. Among the stated aims: “to create a solid and genuine game culture and to make it a central point in the cultural production process of our country”. ↑
21. Filipa Calado,and Mark D. Griffiths, Problem gambling worldwide: An update and systematic review of empirical research (2000–2015), Journal of Behaviour Addiction, 2016 Dec 1; 5(4): 592–613: “Gambling has become widely viewed as a socially acceptable form of recreation (Stucki & Rihs-Middel, 2007). For most individuals, gambling is an enjoyable and harmless activity. However, for a small minority of individuals it can become both addictive and problematic with severe negative consequences (Meyer, Hayer, & Griffiths, 2009). Consequently, the expansion of legalized gambling has been identified as an important public health concern (Shaffer & Korn, 2002; Williams, Volberg & Stevens, 2012), and as a result, the number of individuals seeking assistance for gambling-related problems (Abbott, Volberg, & Rönnberg, 2004; Suurvali, Hodgins, Toneatto, & Cunningham, 2008). ↑
22. On 8 March 2017, the Regional Administrative Court of Brescia rejected the three appeals against the Mayor’s order and strictly judged the same “expert reports” of Lottomatica. ↑
23. In Casale Monferrato, industrial district in the north-west of Italy, the Eternit Company produced building materials with asbestos, which was found to be highly cancerogenous. ↑
24. Burrhus F. Skinner (1904-1990) Science and Human Behaviour, ed. B.F. Skinner Foundation, 2007 ↑

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