THE GOLD RUSH

Victor Bloom MD

Gambling is making its mark on Detroit's downtown city-scape, and so far business is booming. Nice to be able to take away some business from Windsor. But many people find themselves fixated at the one-armed bandit, appropriately named. They may not be fully aware of the fact that modern slot machines are electronically designed to increase the rate of speed in which your coins go to the management and eventually to the coffers of the city and the state. We fondly hope to improve things with that money, provide jobs, clean up the city and improve essential services.

The down side is that most of the gambling money will come from people who can least afford to throw their money away. Yet another down side is that most of the additional jobs will be entry level, minimum wage. Still, a job is a job.

The most serious down side is that many gamblers are addicts and cannot control themselves. They are not necessarily drug addicts, but they are addicted to the 'rush' of taking a chance, hoping to get lucky, risking their money. The true gambler cannot stay away, cannot quit while he is ahead, ultimately throws good money after bad. A common consequence is that the family may not have enough money for food, rent or house payments and car payments.

Watching slot-machine addicts in action reminds me of the experiments with rats. Psychologic researchers learned much about humans from observing rat behavior. In one experiment, the rat learned to press a lever and get a pellet of food. Once the lever-pressing was reinforced, the rate of pressing increased. The rats got fat. A more difficult and sophisticated experiment had an electrode in the rat's pleasure-center in its brain. Whenever they pressed the lever they would get a rush or a thrill of endorphins. This is not just a theoretical prediction, but an observable fact, as it was recorded that the rats would keep pressing the lever at a greater rate than they did for food. The kicker was, they kept pressing the lever and did nothing else till they died of starvation.

Now these rats represent an extreme case, and people are not rats, but you wouldn't know it watching the slot-machine addicts. They would deposit a bunch of coins, enabling them to press the button to get the three wheels to spin, not wasting any time with a lever. The electronic button and reserve of deposited coins and/or bills facilitates the transactions, usually leading to the customer being fleeced at an ever increasing rate, a wonderful example of 'efficiency.'

The addictive personality, which is often accompanied by manic-depression, if attuned to gambling, if that is where the thrill is, is very susceptible to the gambling casino's wiles. The neon signs, the impressive architecture, the ease of parking are all inducements to come and blow their money. There are usually temptations of cheap food, though not yet the girlie shows. They want to keep you there as long as possible. They want you to have such a good time you hardly realize you have lost a hundred dollars and rationalize it as 'entertainment'. I suppose it makes some sense to stay in Detroit instead of having to go to Las Vegas or Atlantic City.

The phenomenon of gambling addiction has several notable and definitive qualities. There is a strong, almost overwhelming attraction to the activity. It's what turns the person 'on.' The activity is exciting, producing endorphins (a brain manufactured opiate) and includes an adrenalin rush, as if there is danger. The excitement may produce palpitations of the heart, rapid breathing, a flushed face, and maybe dry lips and a lump in the throat. There may be butterflies in the belly.

These psychophysiologic phenomena are triggered off by various fantasies, among which is the thrill of being 'lucky' and the expectation of getting rich. How people can delude themselves in the face of reality is hard to understand. These fantasies are delusional, but usually not of sufficient degree for the gambler to be labeled mentally ill or require hospital treatment. The depressed person is looking to win and feel better, the manic person may have delusions that he is going to win a fortune and be on easy street.

Gambling addiction is difficult to treat, as the person usually resists thinking he is mentally ill, and really does not want to give up his habit. The same is true with drug addiction, alcohol addiction and nicotine addiction, but there are support groups of experienced people to help those in need of it. Gamblers Anonymous does exist.

One of the reasons gambling is difficult to treat in psychotherapy is shown by the following vignette. A man comes to a psychiatrist for treatment of his gambling addiction, hoping to use insight to change his ways. The psychiatrist explains that adequate treatment necessitates coming three times a week and the treatment may take several years. The patient says OK, fine, only consider this. The psychiatrist asks what. The patient says if I get well I pay you double, and if I don't I pay you nothing.

Dr Bloom is Clinical Associate Professor of Psychiatry, Wayne State University School of Medicine. He is a member of the American Academy of Psychoanalysis and on the editorial board of the Wayne County Medical Society. He welcomes comments at his email address--- vbloom@comcast.net.