Pathological Gambling in Montreal’s Chinese Community: …archives.cerium.ca/IMG/pdf/Papineau_2005.pdf · Pathological Gambling in Montreal’s Chinese Community: An Anthropological

Pathological Gambling in Montreal’s ChineseCommunity: An Anthropological Perspective

Elisabeth Papineau

Quebec National Institute of Public HealthNational Institute of Scientific Research

Si sheng you ming, fu gui zai tian,(Life and death is a matter of fate; riches and poverty depend on Heaven. Analects,Confucius)

Pathological gambling has been identified as a major issue in Montreal’s Chinesecommunity. A variety of sources attest to the fact that, though we live in an increas-ingly heterogeneous society, the services provided to minority communities for pre-venting and treating pathological gambling are inadequate. An anthropologicalapproach that takes into account cultural characteristics of one’s community couldlead to better strategies for acknowledgement, definition, diagnosis and treatment ofpathological gambling among culturally different communities. Research paths thatcould help to provide effective treatment and services to specific populations are sug-gested. An overview of the way the Chinese view gambling, pathological gamblingand treatment is presented. The concepts of fate, destiny and luck in Chinesethought, as well as Montreal’s Chinese community social norms related to gamblingare then described. The incorporation of those cultural understandings in futurestudies and treatment attempts is suggested.

KEY WORDS: pathological gambling; treatment; prevention; Chinese community;anthropology; cultural foundations.

Please address correspondence to Elisabeth Papineau, Quebec National Institute of PublicHealth (Researcher), National Institute of Scientific Research (Associate researcher), 4835,Christophe-Colomb av., bureau 63, Montreal (Quebec) H2J 3G8. E-mail: [email protected].

Journal of Gambling Studies, Vol. 21, No. 2, Summer 2005 (� 2005)DOI: 10.1007/s10899-005-3030-y

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1050-5350/05/0600-0157/0 � 2005 Springer Science+Business Media, Inc.

PATHOLOGICAL GAMBLING, ANTHROPOLOGY ANDCULTURAL COMMUNITIES

This paper examines the characteristics of Chinese culture thatmay play a role in the understanding, prevention and treatment ofcompulsive gambling in Montreal’s Chinese community.1 A clinicalanthropology approach, which is ‘‘oriented towards the use ofanthropological knowledge in diagnosing and resolving health prob-lems’’ (Tremblay, 1990, p. 125), could help treatment providers bet-ter serve an increasingly heterogeneous society in general, and theChinese population in particular.

In the case of the Montreal Chinese community, a few eventscovered by media have recently drawn attention to pathological gam-bling in the community. The Chinese Family Service of Greater Mon-treal (CFSGM, 1997) reported a higher prevalence of compulsivegambling in the Chinese population it studied than for the Quebecpopulation as a whole, 3.0% vs. 2.6% respectively. Notwithstandingthe methodological limits of that study (i.e., non-representative sam-ple, low response rate, social desirability effect), it indicates thatproblem gambling is as important or more important a problem inthe Chinese community than in the Montreal community as a whole,estimated at 0.9% by Chevalier and Allard (2001).

Although some members of Chinese community authorities pub-licly recognize and fight pathological gambling, most Chinese gam-blers tend to under-evaluate the problem, avoid seeking advice andrefuse to seek therapy: ‘‘A majority of respondents (78.6%) thoughtthat there should be service particularly for Chinese problem gam-blers and their families. [. . .] 55.4% of the respondents ‘‘stronglyagreed’’ and 36.0% ‘‘agreed’’ that the worker who provides servicesto the gamblers needs to understand Chinese culture, while theother 8.0% do not think so’’ (CFSGM, 1997, p. 40).

Those findings are corroborated by Blaszczynski et al. (1998), whobased his views on an in-depth review of the literature and on a studyon pathological gambling conducted in one of Australia’s Chinesecommunities. That study places the incidence of pathological gam-bling at 2.9% within the Chinese community, which is more than dou-ble the general Australian prevalence rate. Blaszczynski writes: ‘‘It isreasonable to expect that pathological gambling in the Chinese Com-munity will remain hidden and/or under-reported for these and a

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number of other reasons. These other reasons relate to the desire toconceal problems because of the stigma associated with mental illness(Lin, Kleinman, & Lin, 1980) and the fear of losing face in public(Lewis-Fernandez & Kleinman, 1994). In addition, there is also amarked reliance on family support and management in preference toconsulting professional organizations (Tseng et al., 1995), a disposi-tion towards the use of personal control in overcoming excessivebehaviour (Luk & Bond, 1992), and a reluctance to approach main-stream health services because of language and cultural differences(1998, p. 363)’’.

These researchers’ findings are consistent with the study con-ducted by the Conseil des Communautes culturelles et de l’Immigra-tion (CCCI, 1987) on cultural community access to health and socialservices. Their report concludes that cultural and linguistic fac-tors—and the cultural communities’ lack of familiarity with existingresources—constitute major barriers to the use of treatment services.The report favours establishing ‘‘an information and training pro-gramme on cultural minorities for service providers in the network’’(Helly, 1997, p. 61). In a document entitled ‘‘Culture, sante et ethni-cite’’, Gravel and Battaglini (2000) raise similar issues. They concludedit is necessary to transform social and health services so that they meetthe needs of a pluralistic society, that is, taking into account the diversestandards and cultural attitudes of the ethnic communities whorequire use these services. In addition to changes affecting Local Com-munity Service Centres (CLSCs) and hospitals, they suggest publichealth prevention and information programmes must be established.

In the field of pathological gambling, health researchers andplanners have overlooked the following trend: between 1981 and1996, the number of immigrants as a proportion of Montreal’s totalpopulation rose from 21.1 to 26.5% (Direction de la sante publiquede Montreal-Centre, 2000). Thus, any re-thinking of the state ofresearch and services provided must take into account that fully aquarter of the population of Montreal is affected (For Quebec as awhole, the proportion is 9.4%, Gouvernement du Quebec, 2000).

Lesieur (1989), one of the few proponents of a cultural approach,suggests: ‘‘[w]hile providing an ethnographic base from which a bio-psychosocial theory may be developed, the sociocultural orientationholds future promise. At present no studies compare the experiencesof different ethnic groups with gambling and pathological gambling in

159ELISABETH PAPINEAU

particular. Folk wisdom has it that Chinese–Americans are heavy gam-blers, yet there is no research on problem gambling among membersof this ethnic group to my knowledge’’ (p. 284).

While there is very little research on Chinese perceptions ofgambling, the Chinese relation to gambling will be explored througha review of literature and personal fieldwork. This literature review ismeant to facilitate the creation of more culturally appropriate treat-ment programmes that may prove attractive for Chinese communi-ties. In a broader perspective, the lack of Chinese communitycultural specificity in problem gambling services is only one exampleof the dearth of culturally sensitive approaches in the field of preven-tion and treatment.

HOW THE CHINESE VIEW GAMBLING AND PROBLEMGAMBLING

North American and Asian cultures represent problem gamblingin different ways. Since 1980, problem gambling has been classifiedin the United States under the heading of ‘‘Impulse Control Disor-der Not Elsewhere Classified’’ (APA, 1980). While most caregiversaround the world rely on this nomenclature for diagnosis and ther-apy, for fundamental cultural reasons, it is not necessarily adapted tothe needs of Asians.2 Gabb (1998) explains: ‘‘In problem-gamblingterms, there may be very different traditions and belief systems influ-encing your behaviour and your thinking about games of chanceand the unseen forces that control life’s outcomes’’. Indeed, Chineseculture (and more broadly Asian culture), notwithstanding internaldiversity, has distinctive notions of fate, chance, luck, probability, riskand control.

Given the existence of cultural differences, the Chineseapproach toward problem gambling might be different from that ofother cultures, and Chinese approaches may provide us with clues ashow to deal with the issue of pathological gambling in communitiesaround the world. In fact, it is impossible to speak of just one Chinesesociety. Taiwan, Hong Kong and the People’s Republic of China, thethree most important Chinese population concentrations in Asia,have a common cultural base, but their social and political systems


differ. As a result, neither their respective lawmakers, theoreticians,caregivers or populations view excessive gambling in the same way.

China

In the People’s Republic of China (PRC), gambling is well spread,though viewing the excess of gambling as a medical problem is consid-ered taboo. The numerous works on betting habits (and bettingdevices) throughout the ages place gambling in the field of criminol-ogy, though there are also those that discuss it from a historical or anec-dotal perspective, or that link it to eccentric behaviour (Ge, 1995; Gu,1989; Guo & Xiao, 1995; Luo, 1990; Luo & Xu, 1994; Ma, 1990, 1993).There are regular propaganda campaigns in China, often accompaniedby dramatic, larger-than-life accounts in the press that attempt todenounce and eradicate gambling. However, few sociologists, philoso-phers or psychologists have examined this phenomenon, and academicinterest in the subject is virtually non-existent. The PRC does not recog-nize excessive gambling as a mental health problem: ‘‘The negativeperception toward pathological gambling is further reinforced by thereluctance of the psychiatric profession to recognize the behaviour as amental health problem as evidenced by its decision to exclude patho-logical gambling from the Chinese Classification of Mental HealthDisorders (CCMD-2-R, 1995)’’ (Blaszczynski et al., 1998, p. 363).

The PRC views excessive gambling from an ideological perspec-tive: as the product of a sick, dysfunctional, individualistic society.According to this logic, excessive gambling cannot arise in a ‘‘socia-list society’’. In propaganda campaigns, it is generally tarred with thesame brush as the ‘‘plagues’’ of prostitution and drug use. If excep-tions to this rule exist, they preclude attenuating circumstances, suchas mental illness, that would explain the affected individual’s margin-alized behaviour. In this view, undesirable social influences alone areat the root of deviant behaviour. Thus, the only way to fight crimeassociated with gambling is to condemn and punish it: in fact, thequestion of treatment has not yet been raised. As Lee (1996, p. 447)remarks, in Chinese society, ‘‘people who gamble immoderately andruin their life are considered bad rather than mad’’.

Another element comes into play in the problem of identifyingexcessive gambling. According to Wei Shujie, a Shanghai psychologistspecializing in cross-cultural research on mental illness, the game of


majiang (mah-jong), when used as an outlet for gambling (with rela-tively large bets) is so widespread that only very extreme addicts areidentified (Personal communication, 2000). In his view, a large pro-portion of the population is in the very high-risk category—if they arenot already problem gamblers according to Occidental standards—butare unaware of their problem. This bears out the views of the CFSGM,which observed that a major methodological difficulty of the studystemmed from the fact that playing majiang, buying lottery tickets andstock-market speculation are so pervasive that ‘‘people who participatemay not see themselves gambling’’ (CFSGM, 1997, p. 9).

Hong Kong

In Hong Kong, very little research has been conducted on theprevalence of pathological gambling (Foo, 1984 Unpublishing Mas-ter’s Thesis), or on the relationship between ‘‘the gambling personal-ity’’ and the illusion of control (Chen, Lo, & Wong, 1986(Unpublished Manuscript); Hong & Chiu, 1988). There is emergingrecognition here that problem gambling is an addiction, similar toalcohol or drug addiction. In their study on the mental health of theShatin community of Hong Kong, Chen et al. (1993) acknowledgethat, after substance abuse (addiction) and general anxiety disorders,the third most important problem in the community is pathologicalgambling. To demonstrate this, the Hong Kong psychologists work-ing on the Chen study made use of the diagnostic tool commonlyemployed in the West, namely DSM-III.3 More recently, the HongKong Polytechnic University (2001) conducted a survey on the HongKong people’s gambling habits, using the DSM-IV and the Americanconceptualization of pathological gambling. In so doing, thoseresearchers set themselves apart from their colleagues in the PRC byrecognizing excessive gambling as a mental health problem.

The ritual of the bi-weekly horse races, the permissiveness associ-ated with the majiang gambling culture, and the great accessibility ofgames in Macao, have together allowed excessive gambling tobecome a much greater problem in Hong Kong than in the PRC.The existence of these activities may also account for Hong Kong’searlier recognition of the problem and the adaptation of DSM-III(APA, 1980) and DSM-IV (APA, 1994). In addition, given theirEnglish-colonial history, Hong Kong scholars have had a strong tradi-


tion of academic exchanges and co-operation with the Anglo-Saxonworld; it was therefore natural to incorporate the concept of patho-logical gambling.

While medical authorities are starting to view gambling as apathology, the population as a whole sees it differently. GracemaryLeung (Personal communication, 2000) confirms that the Chinese,wherever they live around the world, have difficulty acknowledgingproblem gambling: ‘‘In HK this would be more difficult to convincethem that excessive gambling is a problem and it is impossible for themto construe or accept it as an illness concept. Saying that the social andcultural acceptance of gambling as a hobby and as a way to make aquick buck has not stopped the Chinese from acknowledging thatsome are bad gamblers and are struck with loads of debts. [They adopta] ‘that only happens to them, not to me’ type of reasoning. Once aperson is labelled as a heavy and bad gambler, he is being despised.Thus, all heavy/compulsive gamblers tend to deny they are one and liesand lies more to cover up (. . .)The DSM IV took years until recentlybefore including compulsive gambling, so HK and China may takeanother 5–10 years before acknowledging the need to do so’’.

Taiwan

In Taiwan, problem gambling is a somewhat more recent; someobservers do not hesitate to characterize it as an epidemic. With bet-ting illegal, limited issue government lottery tickets seem to generateextraordinary excitement among the population. Illegal gamblingseems to be flourishing; the authorities frequently talk about relaxingthe laws, on one hand to raise funds for the government and on theother hand to reduce illegal gambling. A study of the mental health ofTaiwan residents supports the view that there is a high incidence ofpathological gambling, especially among the male population (Hwu,Yeh, & Chang, 1989). The diagnostic instruments employed by thestudy include the Mini Mental State Examination (MMSE, Folstein,Folstein, McHugh, 1975), while the criteria for diagnosis are deter-mined by the DIS-CM-III [Chinese modified, Chinese University ofHong Kong (CUHK), 1984]. Thus, Taiwanese psychologists, too, haveadapted certain instruments to local conditions; their adaptations gobeyond linguistic considerations, and include disorders considered tobe of particular importance to the population of Taiwan.


HYPOTHESES ABOUT CHINESE PSYCHOLOGYAND GAMBLING

Though there are only a handful of studies of gambling in Chi-nese populations, those that do exist confirm that if we wish to helpChinese pathological gamblers, we need to consider alternativeapproaches. Other Chinese studies dealing with Chinese psychologyin general, rather than with pathological gambling specifically, pro-vide a basis for understanding the incidence of problem gamblingin the Chinese community; they support the contention that cross-cultural psychological differences may be decisive in identifying andtreating gambling. However, the link between general psychologicalcharacteristics and gambling has not yet been validated.

Individuals with an external locus of control are those whobelieve that rewards and events in their lives depend on externalforces, on individuals with personal power over them or on the pow-erful concept of luck itself (Yang & Ho, 1988). Research on patho-logical gambling has revealed a positive correlation between theproclivity for gambling and an ‘‘external locus of control’’. In variouscomparative psychological studies involving Anglo-Americans, HongKong Chinese and Sino-Americans, the standard results associate theconcept of an internal locus of control with Anglo-Americans andthat of an external locus of control with the Chinese (Hsieh, Shybut,& Lotsof, et al., 1969; Lao, 1977). It is likely that this proclivityreveals itself as an incentive to partake in excessive gambling, andcan be especially harmful to those Chinese who play in the hope thatchance alone will bring them economic prosperity.

In a similar vein, Yu analyzes the concepts of Social-orientedAchievement Motivation (SOAM) and Individual-oriented Achieve-ment Motivation (IOAM): ‘‘IOAM describes an individual’s motiva-tions in terms of an internally determined goal or standard ofexcellence achieved through acts which contain a degree of uncer-tainty as to the outcome’’ (Yu, 1996, p. 229). IOAM describes thecultural values of middle-class America, while SOAM more closelydescribes values based on the concepts of family and community,which are found in China, or in Confucian societies generally.The results of the study show that in allocating failure, ‘‘[i]n thecase of SOAM, the dominant subsequent attributions are social ori-ented, and they include a lack of necessary social connections, poor


supernatural precondition such as bad fate (ming), bad luck (yun),and bad predestined interpersonal affinity (yuan)’’ (ibid). Individualfree will in determining destiny seems to give way to a fatalism thatmight unconsciously justify resorting to gambling.

Lastly, the Hong and Chiu study, Sex, Locus of Control and Illusionof Control in Hong Kong as Correlates in Gambling Involvement, con-ducted with 158 Hong Kong adults of all social origins, focuses, as itstitle suggests, on the relationship between the locus of control andthe illusion of control in gambling and betting. Based on the resultsof their study, the authors advance the following hypothesis: giventhat the average Chinese person lacks effective control over certainaspects of his or her life: ‘‘[t]he feeling that major reward allocationdecisions are left in the hands of other powerful persons is frustrat-ing and more likely to trigger the motivation to regain illusory con-trol experienced in gambling’’ (Hong & Chiu, 1988, p. 671). Thus,in this interpretation, gambling allows the individual to experiencethe liberating feeling of interacting with, and perhaps even affecting,events and destiny.

Thus, the propensity to attribute life-change events to externalcauses is fairly well documented. Although, generally speaking, theChinese associate success with hard work, they may also link manyevents to a lack of necessary social connections, poor supernaturalpreconditions such as bad fate, bad luck and bad ‘‘predestined inter-personal affinity’’. This predisposition might explain the incidenceof pathological gambling in the Chinese community, though this hasnot yet been documented. We need to more carefully define the con-cepts associated with luck and destiny, this time employing anapproach that is more anthropological than psychological. Theseaspects of Chinese world view may affect a person’s relationship togambling or the way he or she perceives connected problems; ineither case, it appears that they can provide gamblers with guidanceand a context for understanding.

THE CONCEPTS OF FATE, DESTINY AND LUCK IN CHINESETHOUGHT

Pathological gambling involves dependency on games of chanceand money. If we wish to explore Chinese attitudes towards chance


and money, we must also discuss their attitudes towards destiny, luckand work.

In Chinese thought, ming, or fate, is decided in heaven, and istherefore unavoidable (ming originally meant order or decree); itestablishes ineradicably the good or ill fortune that each personexperiences over the course of his or her life. When Steve Harrellasked his informants in a Taiwan village what the expression hao ming(favourable/fate) meant, he always got the same reply: ‘‘lots ofmoney and not too much physical labour’’ (Harrell, 1987, p. 95). Itis quite understandable in a traditional peasant society that a favour-able destiny should be associated with prosperity and a light work-load. That said, the Chinese have a reputation as a hard-workingpeople; wherever they settle in the world, their entrepreneurial ethicgenerally contributes to their success. For the Chinese, therefore,fate is not synonymous with passivity. In fact, the Chinese have theirown equivalent of the proverb: ‘‘God helps those who help them-selves’’, expressed as follows: ‘‘If man works hard, the land will notbe lazy’’ (Arkush, 1984).

The Hidden Gifts of Destiny

At the same time, the concept of ming (also known as mingyun)explains why two people, both of whom are born and raised in simi-lar circumstances, work equally hard and exemplify community val-ues based on an entrepreneurial ethic, will not necessarily meet withequal success. People will say that the first individual has a goodmingyun, while the second has a bad mingyun. Mingyun is also equiva-lent to fate in the broad sense; that is, it includes events over whichpeople have no influence, and spans their entire lives.

It is sometimes said that everything has already been decided,but what has been decided may hold some surprises: ‘‘Fate is alife-long thing, and thus can both be immutable and encompasseswhat are sometimes wild shifts in fortune’’ (Harrell, 1987, p. 100). Itis precisely those possible reversals in fortune (but that already formpart of the person’s fate) that, as life progresses, make the Chineseseek the advice of fortune-tellers, astrologers and palmists. Since timeimmemorial, people have been asking heaven to reveal its intentions.They believe that heaven replies through unexpected signs on tor-toise shells and on bones, via geophysical and epidemiological


events, or when the petitioner counts yarrow stalks. Gambling playssomething of a similar role. As Neveux remarks, ‘‘As a bettor, thegambler is a vehicle of Providence; as a soothsayer, he is a vehicle ofprecognition. At first, therefore, his gambling seems to consist of anambiguous combination of prediction and prayer’’ (Neveu, 1967,p. 459). Gamblers thus have a double-pronged relationship withluck.

Dice Speak

There are those who believe that through gambling they canreveal their concealed destiny. Therefore, the Chinese use gambling,among other means, to inquire about their destiny. Just as suppli-cants in ancient times used yarrow stalks and dice to read omens andmake decisions, gamblers of today may try to interpret the results ofa game in a similar way. Once the game is over, they extrapolatefrom their success or failure; that is, they interpret the outcome ofthe game as boding well, or ill, for their entire destiny, includingtheir business prospects and their love life. They assume that there issymmetry between the cosmic order as revealed in the outcome ofthe game and the way their lives are turning out.

Two Australian researchers, Duong and Ohtsuka, raise two otherbeliefs that may affect Asiatic gamblers’ perceptions of destiny andluck: ‘‘. . . Vietnamese Australian gamblers do use culture specificschemas in explaining and reinforcing their theories regarding gam-bling. Qu bao (repayment) is clearly based on the traditional Viet-namese beliefs in justice and retribution influenced by Buddhism.Similarly, wins and losses being seen as the Yin-Yang in life is defi-nitely influenced by Asian philosophy. (. . .) [C]ulture-specific beliefsmight contribute to reinforce the maintenance of illusion of con-trol’’ (Duong & Ohtsuka, 2000, p. 10).

The Power of Numbers

Another Chinese belief, numerology, is thought to be highlyinfluential as an oracle and, therefore, is linked to gambling. Tradi-tionally, the Chinese have believed that numbers symbolize power,are linked to natural phenomena and influence a variety of dimen-sions in their lives. There is a correspondence between numbers on


one hand and seasons, directions, elements, colours, flavours, etc.,on the other hand. By extension, some numbers are considered tobe lucky, others harmful. What Needham (1995) calls ‘‘numerologi-cal mysticism’’ has such a strong following that the so-called partici-patory lotteries, in which players themselves choose their numbers,were for a long time avoided in Asia, since the players all tended tochoose the same numbers. Games such as roulette, Blackjack and pa-chinko are extremely popular with the Chinese, who, when they playthese games, may attribute divinatory power to numbers drawn atrandom, or believe that they themselves influence the outcome whenthey draw the numbers.

Honouring the Gods

Lastly, in the pantheon of popular Chinese religion there arenumerous divinities to whom it is customary to make offerings. In astudy on economic practices and betting in a Chinese community inMalaysia, Nonini (1979) observes that minor gamblers ask the gods, byway of a medium, to provide them with the numbers that will appearon winning lottery tickets. By contrast, wealthier gamblers considerthat the money they spend on public gambling rituals (at casinos andmajiang tables) carries just as much weight as an offering to Buddha;gambling, in this respect, allows them to conspicuously and publiclyhonour the gods, who are then obligated toward them. Their money istherefore not wasted, it is a symbolic investment in the future prosper-ity of their business, their clan or their descendants.

SOCIAL STANDARDS AND PATHOLOGICAL GAMBLINGIN MONTREAL’S CHINESE COMMUNITY

Cultural patterns, social standards and attitudes, immigrant sta-tus and the realities of belonging to an ethnic community (NationalResearch Council, 1999) may affect the practice of sustained prob-lem gambling, and problems involving its identification and treat-ment. In order to highlight the ways that specific gamblingbehaviour reflects the importation of general social beliefs or struc-tures to a new environment, we now take a look at some social stan-dards within the Montreal Chinese community.


The State and the Father: Two Figures of Authority

Gabb (1998) quite rightly points out that the State’s almost totalmonopoly on the legal commerce of games of chance and gamblingmay seem puzzling to some Chinese and Vietnamese. While gam-bling has just as wide an appeal in societies with a Confucian heri-tage as elsewhere, only rarely has it been legalized in these societies,and even then not until quite recently. Gambling is generally allowedduring New Year festivities, and tolerated in private circles. Public lot-teries are permitted when it is clear that the funds raised will go tosports or humanitarian causes. We might suspect that upon arrival inQuebec the widespread availability and accessibility of gambling con-fuses many immigrants. What kind of message are they getting froma society in which the State not only sanctions gambling but also pro-motes it for profit, from a society in which an authority figure, thegovernment, employs every possible means of communication to getpeople to play? The dangers inherent in the accessibility of gamblingare obscured, so that the new found permissiveness, which stands instark contrast to what they experienced in their homeland, may con-stitutes an additional risk factor for new immigrants. This is anhypothesis that needs some testing.

On another level, gambling could affect two enduring founda-tions of Chinese society, family cohesiveness and filial respect, whichare Confucian in origin and inescapable; their steadfastness in Chi-nese life is very well documented. Ladouceur reports that out of apopulation of 1612 adolescents in the Quebec City region, not lessthan 7% felt that their parents gambled excessively (Ladouceur,1988). There is every reason to believe that this proportion is thesame or higher in the Chinese community. This raises the problemof the ‘‘gambling parent’’. The effects of gambling on family life arewell known (see Jacobs, 1989; Lorenz, 1987): the children are wit-nesses to quarrels, excuses and lies, and promises are not kept, theybecome hostages to both parents. The bankruptcy and unemploy-ment that can ensue accentuates the social ostracism and isolationexperienced by the family. In many cases, the gambler does not gettreatment, and the story ends in divorce, with the non-gambling part-ner assuming sole responsibility for child support. The child of gam-bling parents, placed in a conflictual family relationship, often losesboth self-esteem and esteem for the gambling parent. However, in


Chinese society, Confucian family values are extremely important,and respect for the father is immutable: ‘‘Responsibility towards thefamily, the interdependence of family members, and respect for par-ents are still key themes among Chinese populations around theworld’’ (Goodwin & Tang, 1996, p. 303). Thus, we suggest pathologi-cal gambling could affect the bonds of Chinese family and social life,harmony between the generations and respect for elders.

There is evidence for the argument that the prevalence of path-ological gambling among adolescents is three times as high as that ofthe adult population (Gupta & Derevensky, 1998a,b). We do notknow if a comparable level exists within Montreal’s Chinese commu-nity, but Chinese youth are already reporting their problems to theCFSGM. When Chinese children and adolescents have gamblingproblems, it is them (rather than the adults) who could have a dis-ruptive effect on family values.

It is often remarked that the Asian community attaches great valueto studying. In Quebec, as elsewhere in Western society, people pointto the remarkable success achieved by young Asians in their studies(Methot, 1995). For the immigrant population, a child’s educationalachievements are the most likely path to social integration, upwardmobility, an interesting career, and material security. This is why theyoung are encouraged to start studying early in life, and why success inschool is highly valued by the Chinese community; unfortunately, path-ological gambling is often associated with poor academic achievementor failure (Griffiths & Sutherland, 1998; Kaminer & Petry, 1999). Whenyoung Chinese people face a crisis because of an acquired dependenceon gambling, feelings of failure could be heightened by the gapbetween their level of achievement and the model validated by theirfamilies and communities. At the same time, they are violating ances-tral rules that place collective happiness and prosperity, both presentand future, before individual concerns. In that respect, for youngChinese–Canadian gamblers, the potential effects of their gambling onboth their self esteem and their family, as well as the potential effect ofparental gambling on children, needs further research and testing.

Honour and Entrepreneurship

How does the Chinese community handle the vicious circle ofgambling and economic hardship? The community has always had a


reputation for working hard, and is proud of its thrift and entrepre-neurship. Numerous anthropological and historical studies have doc-umented the idea advanced by Harrell that: [a]ll these traits(industry, frugality, planning) constitute what I have characterizedelsewhere as the Chinese entrepreneurial ethic, a cultural value thatrequires one to invest one’s resources (land, labour, capital, scholar-ship, whatever) in a long-term quest to improve the materialwell-being and security of some group of which one belonged andwith which one identifies closely (Harrell, 1987, pp. 93–94).

Closer to home, if we wish to confirm this cultural trait we needonly look to the entrepreneurial growth of Quebec’s Chinese com-munity since the arrival in the last century of the first Chinese immi-grants and workers (see Helly, 1987).

Thus, it is not hard to understand that for the gambler experi-encing economic hardship stemming from pathological gambling,including spending savings that according to tradition and ethics heowes to his family, the sense of failure is much more than economic;they are breaking with tradition, as well as failing to provide theirfamily with material well-being and security (Harrell, 1987). A gam-bling parent unable to provide support for family or clan loses facein the eyes of the community, which may help to explain many indi-viduals extreme reticence to openly acknowledge their gamblingproblem. If, moreover, the problem is identified as a ‘‘mental ill-ness’’ the failure is compounded.

Independence and Resistance to Help and Treatment

Our final point is that Montreal’s Chinese community has alwaysbeen fiercely independent in taking care of its needs; it has alsobeen studious, industrious and has demonstrated solidarity (Helly,1987). It does not have an established tradition of using social ser-vices. Montreal’s Chinese community has developed its own media,financial and social services, hospitals, and groups involved in net-working and co-operation. The resulting self-sufficiency has beensuch that those Chinese who need help will not spontaneously seekhelp outside of this network. Chinese pathological gamblers whoneed help have already ‘‘lost face’’ in the eyes of their community.Furthermore, the government support systems for pathological gam-blers that were set up a few years ago are inappropriate, not only for


this community, but for that of other culturally diverse communitiesas well; pathological gamblers simply do not use them.

The non-acknowledgement of the problem, and a sense of hon-our and decency could most likely account for avoidance of Gam-blers Anonymous as well. Indeed, Gamblers Anonymous is based onthe idea that the individual must first acknowledge that they have aproblem. Once gamblers recognize that they need help, they areinvited to take part in a series of steps to recovery, in which the pro-cess of self-help initiated by the individual is based on the principlethat there exists a ‘‘higher power’’. Meetings, not so anonymous, inwhich experiences are shared openly, are unimaginable for the Chi-nese, who by tradition do not verbalize their problems in the sameway as Westerners. In addition, the work involved in getting a Chi-nese gambler to acknowledge the existence of a higher power or of agod ‘‘as I conceive it’’, would be daunting. In contrast to the Gam-blers Anonymous credo, Taoism, Buddhism and Confucianism—theleading philosophical systems in Chinese thought—exclude the con-cept of god personified as a type of consciousness that enlightens.Chinese cosmology holds that there are diffuse forces that may inter-act with a person’s destiny; if a person knows how to handle the posi-tive forces, so much the better. However, these forces never serve asspiritual guides.

RECOMMENDATIONS FOR CULTURALLY SENSITIVEAPPROACHES

Due to the methodological limits of the CFSGM study specifiedabove, the prevalence of pathological gambling in Montreal’s Chi-nese community is probably underestimated. Moreover, the rise ofpathological gambling (and popularity of video lottery terminals)among adolescents as a whole, ought to be detectable in Montreal’sChinese community. For reasons raised in this paper—the commu-nity’s social standards and the specific cultural characteristics of theirbeliefs—it seems clear that culturally sensitive approaches to detec-tion, sensitization and treatment must be established.

The Chinese community is not homogeneous; treatment involvestwo types of clientele: recent immigrants who are concerned aboutsettlement issues, and established immigrants. We have seen that


Quebec’s standards and policies on gambling leave recent immi-grants in a somewhat weak position. Those in a position of financialand statutory instability, or who are unemployed or hold only casualemployment, may be more vulnerable to the allure of gambling; theymay be susceptible to the illusion it offers of regaining control oftheir lives, to the mirage of getting rich quickly, or simply to theprestige that their peers associate with going to the casino. The lackof language ability may contribute to their isolation and vulnerability,and tendency to depression. According to Chevalier and Allard(2001), those playing in slot machines at least five times a year, orthose buying lottery ticket at least five times a year whom nativelanguage is neither French or English are not more inclined towardplaying, but they appear more at risk of developing problemgambling.

Problems such as the lack of services in Chinese or of confi-dence in institutions outside of the Chinese community, which affectthe more established section of the Chinese community, will have tobe examined in future studies.

Overall, broader prevalence studies surveying the prevalence ofpathological gambling in the Chinese population generally (includ-ing youth) are called for. This research should delineate the scopeof the problem, canvas gamblers’ motives, and detail strategies forprevention and treatment. We strongly recommend such survey beconducted by or in close collaboration with researchers from theChinese community, who share not only the language but also acommon cultural background with the respondents.

On a cognitive level, special attention should be paid to reveal-ing gamblers’ beliefs regarding fate on one hand and illusion of con-trol on the other. In fact, current therapies often try to correct amisconception nurtured by gamblers regarding their chances of win-ning and probabilities. Try as we may to convince gamblers of theindependence of the events and the negative probability of gains(Ladouceur, 2000), they hold on to the belief that in the cosmicorder it is precisely because fate is not foreseeable that it may havepositive changes in store for them. This particular world view mayeven increases the vulnerability of the Chinese to the insidious, entic-ing and extremely efficient message: ‘‘One day your turn will come’’.In this view, these beliefs are all the more insidious since their adher-ents view them as sacred rather than as profane; they form part of an


established religious heritage that is a syncretism of Buddhism, Tao-ism, Confucianism and popular religion. Yet the Chinese maintainthese beliefs informally, so that it is only with tremendously difficultythat they are able to admit, systematize or verbalize them. In the con-cept of ming, an individual may be earmarked for a daxi, an unfore-seeable ‘‘major stroke of good luck’’, daxi, which belongs to therealm of world view rather than to logic, is a belief whose effect ongambling is certainly very difficult to either channel or, inversely, toneutralize by traditional therapy. The concept provides fertile terrainfor anthropologists and psychologists to work together, and as a firststep, any social representations map or attitude scale that would beused should be validated in and by the Chinese community.

As for offering adapted treatments and for modifying behaviourlinked to gambling, it is imperative that we take into account andmake full use of Asian attitudes toward family, clan and community.Asians place great value on maintaining social and emotional stabilityin the family and this is why an approach based on family dynamicshas to be tested. ‘‘Among other things, this would have the effect ofpromoting a climate of trust between social workers and Asian fami-lies’’ (Gravel & Battaglini, 2000, p. 61).

Finally, the question of diagnosis is raised by the reluctance ofChinese to define themselves as ‘‘pathological gamblers’’. Furtherstudy should be done on the intercultural limits of the diagnosis(and tools used for the diagnosis) of pathological gambling, which isitself a cultural category.

METHODOLOGICAL LIMITATIONS

This paper, being preliminary theoretical research, does notinvolve field work. It is therefore mainly based upon hypotheses thatstill needs to be tested. It will be followed by a qualitative surveyamong Montreal’s Chinese community which, we hope, will helpconfirm or refute the multiple hypotheses proposed here (Papineau& Fu, 2004).

We acknowledge that this task of outlining and defining thespecific Chinese cultural norms and views on gambling is incompleteand may never be complete. Due precisely to the lack of theoreticaland practical research on this topic, we are in danger of over gen-


eralizing what cannot be a single and unique point of view. TheChinese community, or should we say Chinese communities, is com-posed of many linguistic, religious, social, migratory, and politicalexperiences that shape individual experiences of gambling. However,while not pretending to enter this other field of research, Sinology,we assume there is something called a Chinese identity, that makesmany Chinese share a series of common beliefs and attitudes. Thesociocultural approach that would inspire the research proposalslisted above might still be the best way to avoid ‘‘overgeneralization’’.Those researches would eventually benefit from closer collaborationwith psychologists and anthropologists from mainland China as wellas with representatives of Chinese diasporas around the world.

On another hand, this paper would benefit from the points ofview of treatment providers, in order to measure their understandingof the cultural gaps they encounter in their own clinical practice andthe perceived needs for a more culturally oriented approach. Thismay as well be the subject of further research.

CONCLUDING REMARKS

With the rise of the ‘‘luck industry’’, and the ever growing visibilityof games such as video lottery terminals, pathological gambling willmost likely continue to become more common, and not only in thewestern world. Those most vulnerable to pathological gambling arethe populations at risk: immigrants, families living below the povertyline, the unemployed and the retired—all the more reason to callupon therapists and researchers to devise treatments that are betteradapted to the needs of ethnic communities or specific populationsand are balanced by an appreciation of cultural factors. Philosophers,sociologists, anthropologists and psychologists agree that playing is auniversal phenomenon; but sensitisation programmes and treatmentto overcome the excess of play cannot be universal.

NOTES

1. The following article is a synthesis of fieldwork done in China in 95–96 (Ph.D. thesis, U. deMtl. Published under the title ‘‘Le jeu dans la Chine contemporaine: mah-jong, jeu de go etautres loisirs’’. Paris: L’Harmattan, 2000), and of readings, observations in the Chinese


community and correspondence with Chinese scholars for a postdoctoral research (INRS-Urbanisation, culture et societe, 2000–2002; see also Papineau, 2000, 2001).

2. In our view, the cognitive behavioural perspective is closest to the anthropological perspectivein that it excludes universal psychological explanations and, in its understanding of individ-ual predisposition toward pathological gambling, ultimately allows taking cultural and envi-ronmental factors into account (see: Ladouceur et al., 2000; National Research Council,1999).

3. They also use the SRQ-32 (Self-Reporting Questionnaire) and DIS-III-CM (Diagnostic Inter-view Schedule, version III, Chinese Modified). The latter, which was developed by Robinset al. for the American Psychiatry Association (APA), remains a Western tool. It was translatedinto Cantonese for this study.

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