When we still see someone who spends a little too much time on slot machines in bars, many of us are reminded of the word “vice.” But vice is only a moral category, and ludopathy has long been on the World Health Organization’s (WHO) disease lists. Ludopathy was first listed on the International List of Diseases in 1992, but the American Psychiatric Association began to list it in its diagnostic manuals twelve years earlier. Time has passed and the means for treating pathology have been greatly improved and expanded. Living nailed to the game is always a dark tunnel, but the chances of getting out are more and more numerous.

We met in Bilbao with an anonymous association of players. Arriving before the date, we looked for a bar to have something to drink, and there, about 300 meters from the headquarters of the association, we found a gambling hall full of slot machines. “The gambling halls have to exist, of course,” says a member of the association a little later, “there are also diabetics and that is why we will not close the

sweets.” A player's relative is the one who has spoken so. “In our association we attach great importance to the participation of family members in therapy,” they explain. One of the reasons for this is that the player usually lies when he attends the association meetings, especially at the beginning. The relatives must be there, spokesman for the truth. “In fact, we players lie as easily as we breathe, how else can we maintain our hidden way of life?” However, when large amounts of money are involved, this lifestyle comes to the surface at some point. It's time to take action. And many then know that they are sick, or that they have a sick husband, or a wife, or a parent.

Despite the WHO lists, it is not yet sufficiently known that pathology is a treatable condition. “I was so relieved to hear that I was sick. When I started having problems with my family, I thought I was a vicious person, and then I realized it was a disease. How else could we do the stupid things we do? But when you’re immersed in the game you don’t realize that you have a problem, how can you think that this could be a disease?”

Money is not the only problem

Etymologically, gambling means “the evil of the game”, but official classifications – as well as collective imagination – associate it with a certain type of game, precisely those in which money bets are made. Large losses of money come to jeopardize the family economy, which is usually the stimulus that the patient needs to start seeking help if they are to seek it. But not all the damages of gambling are economic. Not only is money wasted, but a lot of time is wasted. Relationships with friends and family, left on the sidelines, become rusty, work performance declines, and overall one’s life becomes impoverished because there is nothing out of the game.

These mentioned effects are not limited to pathological gambling. In many bars, next to the slot machine, it is a video game machine, cheap, that can spend the whole afternoon with little money if you have some skill, and some do: they can spend the whole afternoon. They won't lose a lot of money, everything else will. If gambling has been on the rise in recent years, let alone this type of gambling hobby, the Internet has been added to the old video consoles. Almost anyone can navigate at home at any time and without feeling the sharp gaze of the neighbors behind their backs. We are in the era of new technology, where collateral damage is a concern: People who spend more hours on the Internet than they should, who live glued to their handheld phone... There is also growing talk of other problems with similar characteristics, even if they have to do with activities invented long before the Internet: sex or work addiction, compulsive buyers...

But are they addictions?

So far we have avoided the word addiction, because there is a debate in psychology and psychiatry about the use of this term to refer to the problems we are dealing with here. Gambling addiction is defined by many as gambling addiction, but for many professionals it is not a very satisfactory definition from a clinical point of view and the most important diagnostic guidelines do not include it. In any case, there are those who accept it. For example, Enrique Echeburu, Professor of Clinical Psychology at the UPV/EHU, is an expert in drug-free addictions.

Echeburu explains that it has always been thought that for addiction to exist, a chemical substance is mandatory to produce the characteristic inherent in addictions: dependence, that is, loss of control. “We have now seen that some people can develop an addiction to a behavior, such as playing or walking on the Internet, without the need for substance, and that the main characteristic of addiction, the loss of control, appears in

these pictures.” The psychologist Beatriz Alonso works in the association Action-dasalud of Gipuzkoa. Using their words, they treat people with psychological addictions, most of them ludopaths. There is no fixed terminology for naming these problems, as Alonso explains, “but psychologists know, regardless of the name – addiction or behavior disorder – what is at the heart of the problem: the person does not have the power to stop repeating a certain behavior over and over again.”

Party lines before, chat now

Action-dasalud was founded in 1994 to deal in principle with ludopaths. Immediately, other cases began to arrive, just a few isolated examples, as Alonso recalls: “At that time the party lines were very successful, that is, many people talking on the phone at the same time, and we could see some examples of addiction. Even with the phone.” The Internet was still not widespread in the Basque Country. In the US, however, people had far greater habits and means of navigating the web. The consequences came without delay: In 1998, Kimberley Young, an American psychologist, said that Internet addiction had become a problem. Young took advantage of the term coined by Ivan Goldberg, also a psychologist: IAD, Internet Addiction Disorder.

Young invented a test – where one can find on-line – to measure one’s level of addiction and founded the Center for Online Addiction, the world’s first residence specifically deployed to cure the “new pathology.” In 2003, another was broadcast in Germany, and the media around the world paid great attention to the fortunate IAD. The discussion was in full swing and continues: Internet addiction does not exist, say many professionals, and the same could be said for others who have names such as “non-drug addiction”, “psychological addiction”.

IAD, a term born from a joke

Helena Matute, Professor of Psychology at the University of Deusto, wrote an article on this subject that has been widely disseminated on the web. Matute compares spending too much time on the Internet with watching too much TV or spending too much time on any other hobby, and endorses the words of psychologist Leonard Holmes: how can we say what is the wrong use of the Internet if we still do not know what is the “normal” use? “In a few years, when we’re going to spend the same amount of time on the Internet as we do on television today, are we going to blame the mental disorders that already exist for Internet addiction?” Matute asks. And Kimberley Young uses the data she has provided to disrupt the IAD concept she’s deployed: those who spend the most time chained to the network are those who spend less time on the Internet. So to speak, the initial fascination causes us to spend many hours in front of the screen, but in most cases, over time things recover. By the way, Matute says that the term IAD was jokingly coined by Ivan Goldberg, although it was immediately taken seriously by many and, as you can see, even made a good profit.

However, neither Matute nor anyone denies that the misuse of the Internet or other technologies can cause problems, usually revealing pre-existing evils. The issue gets the attention of the media from time to time, and we are all disturbed by the most serious cases. Some people have been hospitalized for spending too much time playing online games, and the hobby of a young man who a week ago was too stubborn with video games – maybe hobbies better? – led to tragedy in Catalonia, where he killed the bride’s young son by beating him because he touched the mules and made him lose the game.

Therefore, it is clear that walking on the Internet causes behavioral confusion for some. Sometimes it is the network itself that fascinates: there is a need to look at the email over and over again, or to access the same website over and over again. The websites that offer interaction are those that have the greatest capacity to attract the user without reluctance, especially if they are people who have difficulties in the execution of relationships. The problem was ahead.

Other times, the net becomes a tool to acquire pornography, or to play it. Video games are now acquired on the Internet, and virtual casinos do not know, for the moment, what the crisis is. The Internet, therefore, can be a tool to satisfy other hobbies and not the hobby itself. To complete the set, we have mobile phones with their own paraphernalia. In many cases, it is the minors who end up in the clutches of these modern “neon lights”, something that is of particular concern to psychologists and psychiatrists, as Beatriz Alonso emphasizes.

Although the issue raises a certain social alarm – often related to these serious and rare cases – and although the problem is becoming more widespread, there are still few people who go to the specialist consultation with a disease like this. In the Action-dasalud association, for example, 90% of those who take them are ludopathic. Those who have a problem with the Internet or their handheld phone are not too many, and those who have gone through the past five years due to ailments such as sex or work addiction could be counted with the fingers of one hand. There’s not a lot of data, and it’s hard to know how many have such a disorder. The effects are less obvious than those of ludopathy, and the patient can maintain a dual lifestyle for a longer period of time. “Hidden addictions,” Beatriz Alonso calls them.

Every Disease Its Treatment

Professionals have experience in the treatment of ludopathy, and one might think that one should behave in the same way in the face of these “newer” ailments that are about to be classified for now, but it is not. When caring for the ludopat, the goal is to never act again, just as alcoholics never drink again. On the other hand, the solution to sexual addiction cannot be total sexual abstinence, and the compulsive buyer cannot be asked not to buy anything for the rest of his life. These are common actions and the goal is for the patient to be able to perform them normally. The same can be said