Key Words: Gambling, Risk, Hazard, Ludopathy.

Abstract: Following some historical and cultural insights, the essay deals with the game as competition, pleasure, simulation, i.e. as an ordinary, creative, relaxing element present in all civilizations. It addresses (1) pathological gaming, i.e. an activity which drives away anxiety and loneliness, like many of today’s widespread pastimes and time wasters. (2) Gambling, full of challenges, vertigo, dangers,
spectacularity in which, risk, adrenalin, success, and the demonstration of being strong and courageous count more than money more than the money. (3) Pathological gambling (Gambling Abuse Pathology, GAP), the last stage of a sad path of the individual who, starting from the beauty and positivity of gambling, arrives at mental illness recorded in international psychiatric diagnostic manuals. (4) Finally, the essay address existential interpretations (5) and political-moral evaluations (6). We should not play the game for fun, joking or gambling, but seriously, with a critical spirit, psychic health and appropriate human goals. The best game will always be the one without gambling, where everyone has fun, fraternizes and freely rejoices.

“We are never more fully alive, more completely ourselves or more deeply engrossed in anything, than when we are at play.” This is argued by Charles E. Schaefer (2011), an American psychologist who, not surprisingly, is also the proponent of the ‘Theory of Play’ that advocates its importance for the personal expression of children aged 3 to 11.

For the children, in fact, playing is not just a hobby but also a serious activity: almost a “job”. It is through the game that they learn the body boundaries of themselves and of others, the interaction and knowledge of the world around them. From an early age, it is essential that they learn ‒ just like the language and the walking ‒ to play.

As human beings we play in all ways ‒ chasing, joking, improvising, hiding ourselves, learning, simulating, imagining, pretending ‒ and we can play anywhere, in all kinds of setting. However, the distinctive feature of the game remains voluntariness, the fact that it cannot be an activity we do because we are forced to. We play because we can and because we want to.

We play because we are free, to find out who we are and who we could or would like to be. Yet today, we have lost sight of the importance of the game as an inclination, a lifestyle, perhaps even as a design principle for the society, which is why the musician Pat Kane (2017) argues that we should abandon our fixation on “the work ethic” and rather adopt the “ethic of gambling” instead!

Many human beings, animal and even natural activities are imbued with playful components to the point that the game becomes an existential paradigm. We, thus, speak about the “game of life”, “getting involved”, “power games”, “games of the imagination”, “playing on the stock market”, “it is part of the game”, “the art as a game of forms”, etc. Let’s examine the game theme and its disease (ludopathy) through four distinct moments that are variously connected between them and, on an increasing scale which, starting from the normality and positivity of the game and going through ambiguity and abuse, leads to the full-blown disease. The steps that we will follow are the following: “game”, “pathological game”, “gambling”, and “pathological gambling”.

1. Historical-Cultural Panorama

Let us take a quick look at the past. We notice that for Heraclitus, a man is like a “pawn moved on a chessboard”. For the Stoics, a man must “play his role on the world stage, as an actor on stage, in accordance with the laws of Moira and Logos”. Plato exhorts practicing the “best games”, predisposing virtue and truth, and not playing just for pleasure. In Aristotle, playing is fun and relaxation, almost a medicine to be cultivated with a measured recreational purpose.

In the Middle Ages, religions condemned various games, considered as useless time wasters and, above all, because they were imbued with sinful passions. Saint Thomas, referring to Aristotle, states that the game is not just fun but must “recreate the spirit and quiet the soul”, otherwise it can be a source of harmful passions. Nicholas Cusano divinizes the game with all its symbolic meanings that refer to infinity (the sphere and the ball games), to the constant harmony (repetition of laws), to happiness. For Schiller, a man is mature and civilized, when he is indeed capable of playing with spiritual forms, in lightness and freedom, free from the burdensome constraints of usefulness and work.

Even God and the Nature play, according to Novalis and Nietzsche; while Schleiermacher turns playing into an ethical modality that increases sociability. E. Fink (1969) and M. Heidegger (1991) have a metaphysical conception of the game: “the whole being is a cosmic toy” (says the first); “since the Being is the one who founds without any other foundation, he plays, just like the game is the destiny that launches the being to men” (the second affirms). For Wittgenstein (1967) the whole language is a game, just as linguistic games are philosophies and mathematics, that is, rules that determine the meaning of things and differentiate the fields of reality. J. von Neumann (2021) is the founder of the modern theory of social games and there are several contemporary gaming studies:

a) From ethological perspective (one learn behaviors such as defense and, control aggression).

b) From psychological perspective (especially on child and animal play, with the creation of aptitude tests).

c) From pedagogical perspective, which sees the game as a stimulator of psychophysical faculties, as discovery and exploration (Piaget, Dewey, Millar, Groos, Nogrady, Claparèd, Vygotskij).

d) In psychoanalysis, where E. Berne makes the psychological games, an important backbone for understanding intersubjective dynamics, where roles are exchanged and misunderstood, scripts are lived, communication takes place on parallel levels (explicit / intended messages and encrypted / implicit / unaware messages).

e) In psychotherapy, with “ludotherapy”, as a technique that favors expressiveness, empathy, socialization, sharing of objects and interests in problematic individuals (A. Freud, M. Klein), the “psychotherapeutic game between patient and operator” (Winnicott, 1974), the “psychodrama” (group healing games: J. Moreno, 1985).

f) In psychiatry, with T. S. Szasz (1966, 1972) for whom everyone plays at impersonating a role, to form a functional identity to the system, to disentangle between rules and conditions, using certain symbols (where the hysteric is the hysteric, the doctor is the doctor, the family members do the same, etc.). But these would be personal tactics and pre-defined role-playing games that only a psychiatry as a science of language, a psychology of sign and communication (capable of listening to the patient before stigmatizing him with easy diagnosis) can understand, helping who is in need, to first of all find himself, thus allowing him to play his life more consciously.

That said, we lack a universal definition of game and, there is no game prototype from which to draw others or a single disciplinary approach, with which to look at it. Just think that in some languages, the term “gaming” is the same as “playing”, like in the English verb to play. Thus the game is a complex and polyvalent reality, full of disproportions between the resources used and the result obtained, full of opposites and oxymora: simulation without deception, serious / non-serious, useful / useless, enemies / friends, repetition / variation, relaxation / excitement, no-cost / lucrative, reality / representation, reality / fantasy and reality / fiction (the latter are typical especially in children, who pass easily from a level to another, from real to magical, from buyer to seller, from actor to director, discharging their anxieties and desires on symbolic-objects).

All this often leads to an instrumental use of the term “game”, as in the crimes recorded by the crime reports, in which the guilty people justify themselves by affirming that it was only a “game”; or like free sex practiced in swingers clubs, where couples (including spouses) justify their behavior as being a simple and harmless “game”. Or when young participants in beauty contests claim that they do it “for fun”, while often hiding from themselves and from others who do it, to show off their shapes shamelessly and sell them to the highest bidder with the hope, maybe, of a future in the entertainment world!

Many years ago ‒ again on the subject of instrumentalising the term “game” ‒ two public figures made a bank robbery but were killed by the guards, however the whole press said that it was a joke, a bet, a “game” that ended in a tragedy: the two did not intend to steal!

Then, a man killed his lover hammering her on the head, made her body disappear in a river, but justified himself saying that the lover died during an “erotic game” (the news report many of these cases where, in the “erotic game”, a player ends up murdered!).

Another one killed his future son-in-law while “playing” with a loaded and ready-to-use gun, calling for help late and saying that the unfortunate had injured himself with a comb and was screaming only in a panic attack! Anthropological and linguistic education should perhaps be taken care of, in order to avoid such absurdities!

Despite the absence of a unique game concept, it takes place within some spatial-temporal coordinates and with some conditions for which, commonly accepted classifications are given that group the games into two species: 1) those stimulating the psychophysical faculties (perception, learning, motor skills, reuse of energy supplies, intuition, etc.); 2) those activating special behaviors (competition, imitation, socialization, fun, respect for the rules).

Caillois’ classification is also well known, based on the different purposes of the game: 1) ambition to win thanks to one’s own merit (pleasure of competition, duel, confrontation); 2) abdication of the will in favour of a passive and anxious expectation of fate (pleasure of chance); 3) the ability to assume a personality that is foreign and different from one’s usual one (pleasure of the mask); 4) spasmodic search for danger and abandonment (pleasure of vertigo).


A first form of game mystification is, for example, the “pathological game” (simple ludoprathy, game mania). Card solitaires, pinball machines, yo-yos, puzzles, pre-installed electronic games on smartphones, prize competitions, hitting a target, etc. Although these games keep their legitimate function and can constitute a relaxing moment and a pleasant habit, too often they are abused and therefore become obsessive, futile and not very enriching games.

Hardly anyone cares about this, even though they are widespread, with obvious waste of energy and time otherwise better used for the benefit of oneself and one’s neighbor. Just think of how many children are ‘abandoned’ all day long with their video games, so much so that they become addicted to them and buy their functionality on other levels. At the end of 2017, the national news even told of a son being taken away from his mother accused of neglecting him and making him ludopathic!

And no one cares when, by all means, one is reached by advertisements inviting one to participate in games and contests of all kinds; or as when, in many seemingly harmless games (destinated even to the youngest), dynamics such as “accumulate points”, “potential winnings”, “have fun with luck”, etc., are inserted, so as to prepare and shape the psychology of the future gambler. Gambling is considered as an antidote to loneliness, but it is precisely gambling that can increase situations of loneliness, marginalization and suffering, especially when it becomes pathological.


A second mystification of the game is characterized by a moderate level of hazzard, danger and spectacularization of the risk. Strictly speaking, gambling is only when money or other valuable assets are bet without the ability to collect the stakes later on and, when the game outcome depends exclusively or mainly on chance and not on the player’s skill who deludes himself that he can control the events. However, in a broader sense, we can include in this second category: a) the extreme sports; b) the young people transgressive games; c) certain professional activities (“sponsored players”). However, there is a simple gambling that is, occasional, not necessarily pathological or expensive, such as betting between friends, the New Year’s lottery, charity fishing, occasional scratch cards, etc. or certain typical games in some cultures and peoples: pai gow, domino, bets on dogs and horses, Sunday slip, etc.

For transcultural psychology, what in one context is perceived as gambling, in others is not, perhaps it is just a system for redistributing wealth; hence the various games in these first two categories (“pathological gambling” and “gambling”) are mostly socially accepted forms of play. In any case, however, these non-problematic forms of recreation can produce firstly risky gamblers (one plays regularly wasting time and money) and then actual pathological gamblers.

Let us leave out from this category, those macabre games in which you bet on the most disgusting things, such as, for example, the misfortunes of others, the date of death of public figures and even ‒ in the USA ‒ of those condemned to death. Here we win when the execution is postponed, or when the offender takes his own life or is murdered before, by the other inmates!

Various authors have also seen in gambling, a symbolic figure that shifts the “hazard”, from gambling to life itself. The player does not so much challenge the fate of numbers and money, but challenges life that is to say, in a supreme way the death itself, albeit momentarily, in the self-illusion of always mastering and overcoming it, something that gives him a certain feeling of omnipotence (but which mostly hides forms of masochism and unconscious self-harm).

4. pathological gambling and psychiatric diagnosis

A final step towards the full mystification of gambling brings us to the psychiatric field, that is, into gambling abuse (ludopathy) or gambling addiction (azzardomania) or compulsive gambling (Gambling Abuse Pathology, acronym GAP). The term ludopathy derives from the Latin ludus: public, religious and civil spectacles, organized in ancient Rome (but ludus also means joking, school, dialectical exercise), and from the Greek pathos (pain, suffering), therefore, in full, we mean by ludopathy, the “pathological addiction to hazard games; the inability to resist betting, with all the emotional excitement of the case”. “Hazard” comes from the Arabic az-zahr (dice, game of dice for money).

The phenomenon of the game of hazard is not unprecedented in history: from the ancient middle Ages people to the Greeks (bets on the Olympic Games), from the ancient Romans (bets on gladiators) to today, it has involved very famous people. However, today the game of hazard has reached a planetary dimension, entering in every home and hitting males and females of all ages, social classes and cultural levels.

The figure of the inveterate but distinguished player of high social extraction is therefore overcome. Consumerism, free time, economic resources and new mass media technologies (“net-pathologies”), allow to play always, repeatedly and anywhere: casinos, shopping centers ‒ the new Sunday sanctuaries ‒ betting offices, gaming rooms, betting shops, tobacconists, bars and even entire neighborhoods and cities (Las Vegas). The offer is very wide: roulette, lottery, lotto and its derivatives, bingo, totip, scratch cards, blackjack, slot machines, online auctions, video-lottery, pachinko, tagò, win-for-life, cards games, etc. However, in the GAP the game is so mystified, suffered and uncontrollable, that the lack of numerous positive elements listed above, takes it out of the very name of “game”! Some countries have taken control of gambling (“gambling” state?) and are in commercial relations with the private agencies that manage it.

The Diagnostic Statistical Manual of Mental Disorders (DSM-5, 2014c) offers the chapter “Substance-Related Disorders and Addiction Disorders”, where it states: “the behaviors derived from the gambling disorder are able to activate reward systems and produce symptoms comparable to those activated by the substances of abuse”, i.e. the mechanism of gambling addiction is analogous to that of drug addiction!

The DSM lists nine criteria for determining clinically significant compromising of the disorder on three levels (mild, moderate, severe). Within a period of 12 months the individual (our summary):

1. He needs increasing amounts of money to obtain the desired excitement, but it is not just a question of financial availability, as one can have it, and persist in the vice.

2. He is restless or irritable if he tries to reduce or stop playing.

3. Has already made unsuccessful efforts to stop, control or reduce gambling even during periods of re-mission of the disorder.

4. Has persistent thoughts and worries about gambling and relives past experiences, analyses obstacles, plans next bets, thinks about how to find money.

5. Often, he/she gambles when feeling uncomfortable, helpless, guilty, anxious, depressed or during traumatic events such as conflicts at work or love disappointments.

6. After losing, he retries and chases his losses. However, it is not just a question of frequency: gambling remains a problem whenever it is the product of a problem and if it causes problems (even if one gambles infrequently).

7. Lies to hide the extent of involvement and the very fact of playing.

8. Endangers or has already lost significant relationships such as affection, work, study, career.

9. He/she relies on others to obtain money (but helping him/her to repay debts, while appearing to be a quick fix, can be both dis-educating and de-responsible), or he/she openly enters into illegality (theft, fraud, embezzlement, etc.) to try to solve desperate financial situations.

Other possible characteristics of the gambler are distortion of cognitive processes (denial, superstition, sense of power); belief that money is the cause of all evils; restlessness, impulsiveness, competitiveness, boredom, escape; comorbid phenomena (eating disorders, bipolar disorder, feelings of hostility / challenge towards the environment, self-destructive / self-punishing tendencies, use of alcohol and tobacco).


We are all immersed in play from birth and we all like to play. However, play is often a double-edged sword, as when, for example, we idealize it and make it a symbol around which to revolve everything; or when it becomes an outlet to hide existential discomforts and fill empty time badly; or when it becomes an obsessive activity: fixation, irresistibility to impulse, automatic and irresponsible action.

Often the GAP does not show any revealing signs and the individual plays in secret (this is why we speak of a ‘hidden disease’), deluding himself that gambling can solve things, free him from slavery and work (presumed economic profitability), redeem injustices, rediscover lost serenity to return to reality and regain dignity. Thus one mocks destiny, one competes with the Bank, one underestimates the risks of one’s own disadvantaged condition, one believes that the loss is paradoxically a quasi-win, a delayed win (as when the winning number is lower/upper by one digit than the one played) and therefore one chases losses to try to recover them. At the same time, one refuses help and alternative ways of dealing with discomfort (creating new hobbies, changing habits, entrusting one’s substances to a third party, spending more time with friends). The GAP is a tragically serious reality, a playing with fire that spares no one and digs chasms between facts and expectations.

For psychoanalysis, gambling is an eroticising activity substituting for a social system that does not fulfil desires; a hiatus between impulses and identifying reality; a form of masochism with compulsive and remorseful phases; an epiphenomenon of the unconscious with various potential symbolic meanings. The game can also represent self-reliance in superior entities that regulate the world (Chance, Goddess Fortune, Providence, the State), only to condemn them as exacting and punitive entities. The game is not devoid of malice, insofar as the ill fortune of the losing opponent is scorned.

For cognitivist psychology, GAP is a mental dysfunction consisting in the rational illusion of mastering random or magical events, with probabilistic calculations that are completely unfounded: for instance, betting on the delay of lotto numbers, as if they had a memory or must come out! For behaviourism, the game is the possibility of immediate revenge, of the taste for speed and repetition. For certain psychiatry, it is linked to neurological alterations, marker transmission and even genetic aetiology. Other psychological approaches have placed the focus on the gambler rather than on the game ‒ for the purpose of possible therapy ‒ by classifying it as suggestible, emotional, maladaptive, a-risk, pathological, etc.

Finally, there are various psychotherapies on offer, although overcoming an addiction is never easy, nor is maintaining its recovery; just think of how many people stop smoking, taking drugs or drinking only to start again several times; so much so that, for all forms of addiction, one prefers to speak of “protracted remission” rather than recovery.


After centuries of prohibition and police lists of banned games, in the years 2001-2003 Italy liberalized gambling, becoming the leading consumer in Europe and among the top five in the world. GAP is an authentic social plague, a scientific business in the hands of the strong powers of politics, finance, the underworld, and multinationals (“ludocracy”). Governments tax gambling, directly manage some of it and encourage it with advertising campaigns; but then they include gambling in the health care system with its direct costs (medical, psychological and pharmacological expenses), indirect and social costs (usury, infiltration of crime, bankruptcy of companies, money laundering, loss of work days, school failures, violence, increase in illegal gambling, suicides).

In this regard, it is believed that gambling is a negative multiplier in an economic system, since, although it certainly enriches some ‒ the few operators in the sector ‒ overall it subtracts resources for goods and services and does not stimulate the economic fabric of a territory. Restrictive regulations on its spread are therefore desirable, as well as educational and pre-emptive interventions in socialising places (families, schools, oratories, communities) to make young people aware of the problem. Something has been done with law no. 189/2012, which seeks to protect minors, requiring advertising to warn of the risk of addiction and inform on the actual chances of winning; while the Constitutional Court ruling no. 220/2014, allows individual municipalities to place restrictions and restrictions on gambling in their territory.

The Church has in the past condemned many games (gambling or not, e.g. for a long time even chess!), deeming some of them “devilish vices”; while for the rabbis, “he who plays dice for money is a robber of the soul”! Any recreational practice that exploits the person and disrespects his or her dignity, damages physical or mental health, offends beauty and prudence. It does not contribute to the development of individual skills and the perfecting of virtues and jeopardizes the household economy by unjustifiably exposing oneself to fortune, disclaims responsibility by blaming others, turns desires into a trade, in short, all diseducational games that disregard dangers and values are morally unacceptable.

The Catechism of the Catholic Church, while saying that “games of chance and betting are not in themselves contrary to justice, they become so when they deprive the person of what he needs to live and when the passion for gambling becomes slavery” (no. 2413). This is precisely the case with GAP, for which it remains “an activity contrary to public order, morality and the ethical sense of the community; prohibited by articles 718-722 of the Penal Code [except in authorised cases]” (Occhetta, 2014).

Above all, and this is a fundamental point, its “code of chance” should be annulled in the game to make it a pure game (an end in itself with all its positives) and not a means (stratagem) to earn something! We should not play the game as a joke or as a gamble, but seriously, i.e. with a critical spirit, ethics, mental health, and proper purpose.

The best game will be the one without bets, where nobody wins and nobody loses, where everybody has fun and everybody fraternises. Finally, we must recover the theological value of playful gratuitousness, as in Proverbs 8:30, where Wisdom daily delights in the earth and delights the Lord, or in Sirach 32: “enjoy yourself and bless those who shower you with good things“. We must experience the game with a breath of transcendence, as an expectation of the time when “children will play over the holes of poisonous snakes and the wolf and the lamb will be together” (Isaiah 11). Therefore, St Paul invites Christians to compete for incorruptible rewards:

“Don’t you know that in the stadium races, all run but only one wins the prize?” You must also run, in order to get it. However, every athlete is temperate in everything; they do it to obtain a corruptible crown, we instead an incorruptible one. Therefore, I run, but not as one who is aimless; I do boxing, but not like someone who beats the air, on the contrary I stretch my body hard and drag it into slavery, so that it does not happen that after having preached to others, I am disqualified myself”(1 Corinthians 9, 24- 27).

Against the senselessness and evils of the world, the freedom of play can become a redeeming energy, an altruistic impulse, a serene disenchantment, a prelude to that realm in which rule and spontaneity are no longer enemies and in which the spirit, freed from all conflict, will enjoy a transfigured world.

(1),  professore di Antropologia filosofica ed Etica, I.S.S.R. Ecclesia Mater (Pontificia Università Lateranense – Roma);

(2), saggista, filosofo, teologo, bioeticista e psicopatologo, cultore di estetica e filosofia dei linguaggi all’Università dell’Insubria (Varese).

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