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Like the drinking of alcohol, gambling is a complex activity, motivated by a variety of impulsions, and serving a wide order of needs.
Aware of this complexity, Dr. Niederland declares that he will limit himself to the so-called “gambling neurosis.” Unfortunately, he doesn't define the characteristics of this neurosis, and in his paper he speaks also of “the gambling addiction” and “the gambler.”
Addiction as such is not neurotic, and gambling can be a game, entertainment, and a congenial way of overcoming boredom and killing time.
From the psychiatric point of view, only compulsive gambling can be considered pathological, and the compulsive gambler presents a number of distinctive features which are in effect pathognomonic. The compulsive gambler cannot refrain from gambling and he cannot quit while he is ahead. He must continue to play until he loses, and in some cases even beyond that until his credit is exhausted.
The compulsive gambler is, in respect to his affect life, immature and masochistic. He is incapable of sustaining an effective heterosexual relation in or outside of marriage. I have encountered no homosexuals among compulsive gamblers.
In my experience with compulsive gamblers I find no support for Freud's formulation that compulsive gambling is a replacement for compulsive masturbation. This formulation of Freud's can make sense only in the deeper meaning that in the adult, both activities, masturbation and compulsive gambling, attest to the individual's failure to mature.
There are aggressive gamblers. They treat gambling as a competitive sport. Generally they play card games that involve skill and bluff. These may be addicted gamblers in the same sense that there are golf addicts. They are not compulsive gamblers.
The more interesting and significant part of Dr. Niederland's paper is that concerning his experience with the uprooted refugees of the Hitler atrocities. Here we encounter a very complex reaction phenomenon, part of which—and a small part at th