You’d think that because compulsive gambling has been in the current diagnosis manual professionals use diagnose people, it would be fairly well-understood and professionals would be agreement about some of the basics about this disorder.
And you would be wrong.
Earlier this week, Mind Hacks had a thoughtful entry about how even gambling addiction professionals are still learning what makes a behavior an “addiction.” Vaughn also rightfully points out how ridiculous it can get when the media just tacks on “addiction” to any behavior done more frequently than “normal” (whatever that is), and voilà! — a new diagnosis is born:
Not a single one of these is based on research. It’s just people announcing a new form of addiction. That’s all you have to do and you can get international press.
For extra bonus points you can mention dopamine, and it sounds like science.
We know dopamine is involved in drug addiction, but we also know that anything we enjoy, ‘addictive’ or not, also engages the dopamine system. So saying that the activity is addictive because it engages the dopamine system is an empty statement.
This of course has been my concern with “Internet addiction disorder” from Day One. If you use terms with little agreed-upon meaning in science, you’re bound to wind up with a fuzzy disorder that has few boundaries and little usefulness.
Read the full entry: Loaded dice in gambling addiction research
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4 Comments to
“Questions about Gambling (and Other) Addictions”
Dr. Grohol,
I sometimes wonder if we really don’t know as much as we claim we know in this profession of the mind and emotional disorders. I often see doctors being quite sloppy in diagnosis. I can think of one case where one diagnosed a young man who was accepted to the Annapolis Military Academy but at last minute he was rejected. Never mind that his Congressman backed him totally and that he was at the top of his class. It was later found out that the Navy dug up obscure insurance based diagnosis from a doctor when the graduate was a small child. It was then called A.D.D. He was eliminated immediately from his dream of being a Navy Cadet.
I wonder if this kind of sloppiness is what gets Dr. Thomas Szasz irked: http://youtube.com/watch?v=Lk4hWWPv9EY
Samuel Lopez De Victoria, Ph.D.
http://www.DrSam.tv
I think there’s a difference between calling something and addiction and calling it addictive behavior. It may very well be that people are exhibiting addictive behavior in respect to the internet or emails. The big question though is: “Is it causing them distress or affecting their lives (mental, physical, social) in a destructive way”? Because if so, something likely needs to change. This is where I believe social support, education, and mindfulness can play a key role.
Elisha Goldstein, Ph.D.
http://www.drsgoldstein.com
Dr. Grohol, I agree with your take without a hint of a “but.” (Dr. Goldstein’s as well.) I had read your other articles about this already. I think the subject needs a lot more visibility, so I’m very glad to see it here.
So many OCD behaviors fit within the criteria and definitions being bandied about in the attempt to make addictions out of actions. I truly believe that plopping compulsive behavior under the umbrella of addictions will jumble the treatment options and make a mess of trying to treat both of them at the patient’s expense.
Overuse and misuse of the word addiction has already diminished the social attitudes, seriousness and consequences of true addictions. (Maybe it will influence insurance coverage of treatment as well?) Working with an addict to get off crack is not even in the same neighborhood, never mind ballpark, as working with someone to get off the Internet.
I mean no disrespect or dilution of what people with OCD and other behavioral challenges face. The intrusion on lives must be terrible and life altering. But you don’t die, destroy your liver or get brain damage from betting the bank account dry.
Dr. Grohol, I hope your common sense and professional premise reign in the end. Thanks again.
In regard to wordmeister’s statement that one does not die from betting the bank account dry is not true. Thousands of people commit suicide for that very reason. Any addictive behavior that causes a person to completely disregard their personal welfare is devastating and should not be treated offhandedly. Many people consider gambling a character defect but for many it is something that they cannot control without some kind of a medical intervention. I have known people who go for days without eating or drinking because they cannot leave the slot machines. There are people who gamble their entire salaries and have no money for food or rent or bills - who are left homeless, not because they want to be in that situation - but because they literally cannot stop the behavior. They are in an emotional war with their own hearts and finally choose to end their lives because that is more possible then stopping the behavior. They are ashamed and guilt-ridden but cannot stop and definitely in danger of losing their lives. So, please do not be so quick to say that these people are not as in trouble as a crack addict or a heroin addict — they most definitely are and need help.
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Last reviewed: By John M. Grohol, Psy.D. on 21 Jun 2008
