Stung

by Gary Stephen Ross

  Dostoevsky was himself ruinously drawn to the roulette wheel. The story he eventually wrote about a young man addicted to gambling was churned out in a month to avert financial disaster. Had he failed to deliver the manuscript on deadline, all his writings would have become the property of the conniving publisher Stelovsky. While writing The Gambler, Dostoevsky was also working feverishly on Crime and Punishment, contracted to another publisher. He lived daily with risk, pressure, and insolvency, and his character sketch seems — in light of what we now know about the compulsive gambling disorder — particularly astute.

  Walt Devlin’s therapist, Dr. Robert Custer, is the pioneer in this field; more than anyone else’s, his work enables us to say who compulsive gamblers are. Five times in six, they’re men. They tend to be friendly, sociable, and generous. Easily bored, they crave stimulation and excitement. They’re persuasive, assertive, outwardly confident (inwardly the opposite), and highly competitive. They thrive on challenge, risk, and adventure, channelling their superior intelligence and high energy into work. If the profile seems that of the successful executive, well it might: many compulsive gamblers work in business or the professions and have a record of consistent achievement. Along with brokers, lawyers, and accountants, bankers are inordinately represented. Most come from a background of traditional family life; few encounter legal difficulties prior to the onset of the gambling compulsion.

  Therapists explain the compulsive gambler much less confidently than they describe him. Speculation about the psychological foundation of the disorder extends back to Freud, who analyzed Dostoevsky’s passion in an essay called “Dostoevsky and Parricide.” Freud saw Dostoevsky’s gambling as “a form of self-punishment” and speculated that he enjoyed debasing himself in an orgy of contrition after losing at the casino. More generally, Freud saw the gambling urge as a “repetition of the onanism compulsion.” The compulsive drive to gamble was a translation of the child’s compulsive drive to masturbate; the consequent losses were a form of self-punishment necessitated by the child’s unconscious guilt at his wish to replace his father as his mother’s mate.

  Because the compulsive gambler never wins — because he cannot quit if he gets ahead — he is widely viewed as a compulsive loser. Freud’s idea of self-punishment recurs in other interpretations. Edmund Bergler believes the disorder begins when the blissful self-centredness of infancy is destroyed by the parents. The compulsive gambler, he theorized, is rebelling against the people who robbed him of his omnipotence. By inflicting on himself financial loss and humiliation, he also alleviates his guilt. Ernest Simmel believed the compulsive gambler to be someone who felt deprived of parental love. This feeling creates a neurotic hunger for pleasure and gratification. The excitement of gambling and the anticipation of winning dull the hunger and promise to appease it entirely. Like all neurotic yearnings, however, it can never be satisfied; no matter how often the deprived person gambles or how much he wins, his endless hunger compels him to continue gambling. Wilhelm Stekel saw the compulsive gambler as someone frightened by adult responsibility and incapable of dealing with it; he flees by regressing into child-like fantasy and play. Ralph Greenson suggested that gambling was oral, anal, Oedipal, masochistic, and latently homosexual — take your pick.

  Robert Custer’s view is more empirically based than most; he has treated or evaluated more than 1,000 compulsive gamblers. Rejection, he believes, is the most painful human experience, and the low self-esteem of compulsive gamblers is often the result of rejection in childhood. A child reacts to rejection in one of three ways: he develops anxiety, sometimes to the point of phobia; he becomes withdrawn and isolated; or he becomes angry. The anger may be denied and suppressed, but sooner or later it seeks expression. Custer believes compulsive gambling is usually the expression of this buried anger.

  In evaluating Molony, Custer felt he saw someone who had struggled for his father’s acceptance. The father’s lifelong devotion to work had brought financial success and a respected career. The son learned to equate success with diligent application and financial achievement. He strove to succeed on the father’s terms and was succeeding brilliantly. Yet the father’s acceptance remained out of reach. It was not deliberately withheld; the father’s emotional repertoire simply did not encompass the bestowing of affection on his children. He was busy with work; nurturing of the children was left to the mother and the housekeeper.

  Stimulating as all the various explanations of compulsive gambling may be, they have in common a failure to explain why the root cause manifests itself in a gambling compulsion rather than in alcoholism, kleptomania, or any other expression of psychological ill health. They also fail to explain why, in a family such as the Molonys, one son would fall victim and six others not. Custer is convinced the brain chemistry of compulsive gamblers differs from that of non-gamblers. Molony was not the first person to describe to him the volcanic, almost orgasmic sensation that sometimes rose up from the back of his neck and spread through his head, glazing his eyes and turning the casino into a slow-motion enchantment. Custer wonders whether endorphins come into play, as they do when marathoners experience “runner’s high.”

  Other signs steer Custer to the biochemical hypothesis. The stamina of compulsive gamblers defies explanation. A gambler Custer treated once played poker for five days and nights without missing a hand, eating at the table and going to the washroom when he’d folded early. Molony went sleepless to work without any letdown in performance and often spent two and three weeks without more than a couple of hours’ sleep here and there. Custer himself enjoys the racetrack, where he bumped into a compulsive gambler he knew well. Not three feet away, the man failed to return his greeting. Custer would have sworn the man was gone on alcohol or drugs if he hadn’t known the man never used alcohol or drugs. Perhaps the most telling sign of all, however, is that many gamblers who quit cold turkey exhibit withdrawal symptoms remarkably similar to those of alcoholics and drug addicts — chills, tremor, headache, insomnia, abdominal pain. If they resume gambling, the withdrawal symptoms disappear.

  So far Custer’s biochemical hypothesis remains unsupported. A study under way at the National Institute of Mental Health in Bethesda, Maryland, may change that. Compulsive gamblers without other addictions — those who were also substance abusers were weeded out — were put through several days of tests that included a spinal tap. The spinal fluid is being tested for, among other things, serotonin, dopamine, and norepinephrine. People who suffer from other obsessive compulsive disorders, such as repeated hand-washing, have been found to have unusually high levels of serotonin; Custer thinks compulsive gamblers will exhibit a similarly high level. If so, the study will have yielded the first hard evidence of a biochemical contribution to the disorder. The implications of such a discovery could be considerable. Foremost, perhaps, would be the development of a test to identify people at risk. Any number of institutions might use such a test to screen prospective employees — banks, for example, and casinos.

  Perhaps because the causes of compulsive gambling remain elusive and the explanations speculative, the treatment has been hit and miss. Aversion therapy has been used with some success, but critics argue that pairing electric shock or regurgitative drugs with undesirable behaviour merely suppresses the behaviour rather than confronting its causes, and that the underlying pathology will find some other form of expression. Intensive therapy seems the most effective treatment. Even so, the success rate is dismally low.

  In June, two months after his arrest, Molony obtained a variation in the terms of his bail — the surety was raised to $325,000 and he had to report regularly to the Metro Toronto Police fraud squad by phone — and flew to Ohio. Clearing U.S. customs, he was asked his destination.

  “Johns Hopkins University.”

  “Go ahead, doctor,” said the customs officer.

  In a Cleveland hotel room, Molony was evaluated by Dr. Julian Taber, an amiable, portly psychologist. Taber had grown interested in behaviour m
odification while working at the Veterans Administration Hospital in Brecksville, Ohio, near Cleveland. Like Custer, he found that some alcoholics were also compulsive gamblers. He became fascinated by compulsive gambling and eventually became coordinator of the Gambling Treatment Program at Brecksville.

  Taber interviewed Molony at length and administered the usual battery of tests, including the Minnesota Multiphasic Personality Inventory, the California Psychological Inventory, the Weschsler Memory Scale, The Shipley Institute for Living Scale, the Survey of Compulsive Gambling Questionnaire, and the Trail Making Test. Draw a line under the one word that comes closest in meaning to the word in capital letters. SMIRCHED: stolen, pointed, remade, spoiled. Compared to most people your age, how would you rate your present state of mind? (Molony checked “about as happy as most.”) Assuming the thrill you got from gambling rated 100 on a scale of 1 — 100, what numerical value would you give to the biggest thrill you’ve gotten since you stopped gambling? (Molony answered “20.”) After gambling, did you ever feel like you’d been in a trance? (Molony checked “frequently.”)

  The Gough Adjective Check List contained three hundred adjectives. Molony was asked to check off those he thought applied to himself. He checked “adaptable” and “adventurous,” bypassing “aloof” and “arrogant.” “Civilized” and “considerate,” but not “conventional” or “deceitful.” “Helpful” and “insightful,” but not “inhibited” or “intolerant.” He checked “practical” and “realistic,” skipped “selfish” and “sly.” As Taber pointed out in his report, Molony’s self-description was sometimes conflicting. He saw himself as both assertive and shy, easygoing as well as demanding, simultaneously wary and trusting.

  The next day Molony flew to Philadelphia, where he was met by Gerry Fulcher. Molony had flown many times to Philadelphia, of course, and said to Fulcher, “Just like old times.” On the drive to Baltimore they stopped at Howard Johnson’s. Returning from the washroom, Molony told Fulcher he’d thought of slipping out the window. A joke, but he seemed to Fulcher plainly anxious about what lay ahead.

  Mount Wilson is a hilly Baltimore suburb; stands of pine and oak, once abundant, are giving way to housing developments. In 1978 the Maryland state legislature had passed a bill authorizing treatment of compulsive gamblers. Four different agencies submitted proposals; Johns Hopkins University was awarded the grant. The treatment facility was on the grounds of an old Maryland state hospital. The grant money was used to restore and staff a two-storey colonial house that had been the home of a surgeon at the hospital; Hopkins turned it into an out-patient treatment centre. The original grant covered only residents of Maryland, but soon after the centre opened, in 1979, people from all over the country were calling for help, and an in-patient program was established. Molony was the first patient from outside the U.S.

  The third floor of the house had been turned into a dormitory. Molony found he would share the space with three other compulsive gamblers — an auto worker from Michigan, a butcher from North Dakota, and a stockbroker from Iowa. Immediately they had to come to terms with each other. Who would sleep where? Use the bathroom first? Take which dresser drawers? Their comfort would depend on mutual reliance and cooperation, and on mastering the skills of daily living. The staff consisted of a house manager, two peer counsellors (themselves recovering compulsive gamblers), and two professional therapists. Molony was given a schedule, telling him where he was expected to be for each session, and who would be in charge. Apparently there would be some sort of therapy all day, every day.

  The first night Molony said very little, listening to the others tell gambling stories. Much of what they said hit home — he’d had similar near-misses, dealings with bookmakers, heartbreaking, last-second losses. But he was appalled by their bravado and one-upmanship (“That’s nothing, let me tell you about the time I had fifty thousand on the Cowboys”), their almost swaggering way of recounting their experiences. He lay in the dark, half curious about what lay ahead, half afraid. He’d thought long and hard before accepting Brenda’s money to pay for this treatment; he wondered if he’d made a mistake. Jail had been trying enough. This was starting to look like it might be the longest two weeks of his life.

  “I remember Brian as being somewhat aloof,” recalled Joanna Franklin, an addictions counsellor at the Johns Hopkins clinic. “He was rather isolated from the group he was with. Just about everybody goes through that at the start. It’s very strange, a little scary, and you need time to come to the realization that you not only have to wear this bloody label for the rest of your days, you also have to do something about it. It’s not a pleasant thought. Usually when they hear each other’s stories — ‘That happened to you? Really? That happened to me, too’ — they begin to bond. I don’t recall seeing Brian do that. I don’t think he wanted to identify with these people. Even though some of what he heard may have clicked inside — ‘I felt that way, too’ — I don’t think he allowed himself to experience it in the therapy sense of sharing and catharsis and all that neat stuff.

  “Brian was an incredible intellectualizer. It’s a common defence, and he was very good at it, a very bright man. Our team would talk about him — ‘God, this guy has got a case of the head’ — meaning he was stuck in his head like nobody we had seen in a long time. He was particularly difficult in that respect. My feeling was that he was as introspective as the others, just not as disclosing. I don’t see how he could help but ponder some of the things being suggested, even if he didn’t share a lot of his views. He wasn’t one to say, ‘I’ve thought about what you said yesterday, and this is how I think it relates to me.’ I don’t believe he reached that level of trust while he was with us. He was willing to take in what he thought might be useful to him, and I’m sure he took in more than he realized, but it was not a two-way kind of exchange, as it usually becomes. You eventually click with them. Some of the defences come down and there’s an exchange, the emotional kind of exchange that therapy is about, sharing on that level.

  “Four or five hundred compulsive gamblers have now gone through this program, and I don’t remember anyone other than Brian bringing a briefcase to the sessions. He’d come down in the morning for breakfast with his briefcase. I think some of that symbolism represents how he felt. I’m here, this is something I have to do, I’ll work at it. He was determined to do it to the best of his ability, without having the hang of how you do therapy. You certainly don’t do it with a briefcase.

  “I think we may have been seeing Brian doing what his dad did. Work very hard at what you do best. Brian worked very hard at his job and he worked very, very hard at his gambling. The work ethic seemed deeply rooted in the family. If at first you don’t succeed, back you go, shoulder to the wheel. This do-do-do stuff works wonderfully well in the professional setting, but it doesn’t work with gambling. If at first you don’t win, bet again? You’re going against the laws of probability, and you can’t change those laws. But that’s not allowed to sink in. If I work hard enough and long enough with my brights — and I know I’m smart — I’ll beat this. Now we’re into magical thinking, the distortions people take across the line that separates the social gambler from the compulsive gambler.

  “To build a picture of who this was we were seeing, I’d start from the family history. I believe Brian is very much a product of how he was raised. I don’t mean his parents exclusively, but everything around him — siblings, friends, community environment, school experiences. When you treat those things as puzzle pieces, you begin to get a picture of someone who had a sense of responsibility within the family structure, responsibility to his parents and to his own sense of what a good boy should be. He had a very strict, internalized set of morals and ethics — if anything, a little too strict. Many years later, when he found himself violating his own ethical concerns, I believe he got very depressed. That begins the cycle. The violation causes pain. To get away from the pain, you gamble, which causes more pain, which you need to get away from. And so
on.

  “After the earliest stages, winning money disappears as the focus. Gambling becomes almost entirely an emotional experience. It triggers the competitiveness compulsive gamblers have in common. I refuse to be beaten by the cards, the horses, the casino, whatever it happens to be. As if willpower and tenacity will see them through, as they did in business settings. I’m down ten, I won’t be beaten, next time I’ll bring twenty. Now we’re into the chase, the beginning of the end. It’s a hopeless cycle because I can’t stop, can’t save the money without losing my sense of who I am — a person who succeeds, who sees things through. I couldn’t handle losing that, my self-esteem is already low. I’m in for the duration. That’s the only way I’m going to find the quality in myself that I value and I want everyone else to value.

  “When I met Brian’s father he seemed very one-two-three. Not cold, but undemonstrative in terms of affection and emotions. In that family I’d imagine that emotional concerns were rarely discussed, and when they were it would probably be around a critical issue — disappointment, pain, embarrassment. There would be more to hide than to put on the table and say, ‘Let’s look at this.’ I’d get the message I had hurt my parents by doing this or that, but it wouldn’t be communicated directly. I’ve been bad, that was bad of me, I’m going to have to make it up and also carry the guilt. I didn’t mean to do it, I care about my family very much. I must be a wormy person to have done that to such good people.

  “Brian was typical in coming from a large family with an absent father — be it by death, divorce, or workaholism — and having a lot of emotional needs that were not fulfilled at an early age. I assure myself I’m okay, but I don’t really believe that, and if you get to know me well enough you’ll see that too. I can’t let that happen, I have to remain at a distance from you. I need your acceptance, your love and care and attention, and I’m going to do what it takes to get those things. But I’m going to stay at a safe distance because you also represent a lot of potential pain. Gamblers have a notoriously poor tolerance for rejection. I’m going to give you enough to keep you around, but I can’t afford to let you get too close. I’ll do as little emotional investing as possible, which is what we saw when he was in treatment.