Pathological Gambling: The Making of a Medical Problem [Paperback]

Brian Castellani (Author)

Book Description

ISBN-10: 0791445224 | ISBN-13: 978-0791445228 | Publication Date: February 29, 2000

Although pathological gambling has been a field of study and treatment for over forty years, its story has remained unwritten. That is until now. Brian Castellani is the first to write a book on its history and its medicalization. Drawing on five years of research, Castellani integrates the perspectives of Michael Foucault and Anselm Strauss to provide a unique view into the history of pathological gambling. He also combines rich descriptions of court cases and historical documents along with his own clinical experiences and first-hand accounts from gamblers and their families. Together, these stories - which range from the gambling industry and treatment to the government and research - tell us how pathological gambling became a major social problem in the United States, how it was made into a medical disorder, and the impact its legalization and medicalization have had on our current society and gambling culture.

Editorial Reviews

From The New England Journal of Medicine

Gambling has always existed, but only recently has it taken on the colorful and highly accessible forms we know today. Essentially, gambling stakes something valuable -- usually money -- on the outcome of an entirely unpredictable event. In other words, gambling is governed by events that occur by chance -- hence the term, "games of chance." A gambler's main task is to use any information available to predict the outcome of the game (although it is, of course, unpredictable). We might wonder why anyone would risk his or her financial security on such a dubious venture. But most gamblers behave as though the outcome of their gambling depended on their personal skills and on the exercise of those skills at the appropriate moments. In the gambler's world, skill can influence chance. In reality, however, chance has the last word.

More than two thirds of adults gamble on a regular basis. For most of these people, gambling is a relaxing activity and has no negative consequences. For others, however, gambling becomes a disorder, characterized by an irrepressible urge to wager money. It ultimately dominates the gambler's life and has a multitude of negative consequences for the gamblers themselves and their friends, families, and employers. Experts agree that the social costs of pathologic gambling are enormous.

It is estimated that 1.5 percent of the adult population gambles excessively. Given that the prevalence of gambling is related to the accessibility of gambling activities and that new forms of gambling are constantly being legalized throughout the United States and in most other Western countries, this figure is expected to rise. Pathologic gambling is currently one of the fastest-growing mental health problems in these parts of the world.

Surprisingly, it was only two decades ago that pathologic gambling was first recognized as a mental disorder. Some may wonder why acknowledgment of the psychiatric aspect of this disorder was so long delayed; others, however, may wonder whether gambling merits recognition as a disorder at all. In many ways, gambling seems fairly harmless. In fact, it is not the act of gambling itself that is harmful but, rather, the vicious cycle that is set into motion by gamblers' attempts to recuperate their losses. This cycle begins when a gambler wagers money he or she cannot afford to lose and then, through a fault of logic, continues to gamble in order to recuperate the loss. The gambler fails to understand that gambling is governed solely by random events. He or she attempts to control the outcome of the game by concocting strategies to "beat the game."

Pathological Gambling: The Making of a Medical Problem, which is divided into 14 chapters, presents a unique and refreshing perspective on its subject. Castellani begins by tracing the history of pathologic gambling and proceeds with an articulate, integrated, and complete description of the first formal treatment unit, created by the late Dr. Robert Custer. Castellani goes on to describe some of the sticky social controversies surrounding the legalization of gambling. In particular, he criticizes the dual role adopted by government, which attempts to protect the public by regulating gambling while simultaneously encouraging this lucrative activity. Castellani concludes, "We cannot continue to have government and business working hand-in-hand. Government needs to re-establish its role as government and initiate regulations that will protect the public."

Castellani also describes and appraises the pioneering work of eminent scientists and clinicians (such as Lesieur, Lorenz, Rosenthal, and Taber) who made substantial contributions to the recognition of pathologic gambling as an independent disorder. More important, Castellani provides convincing evidence that pathologic gambling is a complex disease with numerous causes. Indeed, in order to have a comprehensive and comprehensible body of knowledge about gambling, we must look to many disciplines, including sociology, psychology, psychiatry, economics, and social work, while also remembering moral, political, and legal issues. Castellani has provided us with just such a broad, comprehensive view of gambling in his brilliant, elegantly written book.

This book is an indispensable resource for both advocates and opponents of the biologic and psychosocial perspectives it discusses. It presents readers with new perspectives on the important social problems posed by pathologic gambling. Experts and laypeople alike will find food for thought in this book. The epilogue alone makes the book worth reading; it contains more than 30 recommendations that, according to the author, must be implemented if we are to move beyond current limitations of thinking about and caring for persons affected by pathologic gambling. As Castellani eloquently states, "The lives of those we care for -- from pathological gamblers and their families to the communities in which we live -- are at stake."

Robert Ladouceur, Ph.D.
Copyright © 2000 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.

About the Author

Brian Castellani is Assistant Professor in the Department of Behavioral Sciences at Northeastern Ohio Universities College of Medicine.

Product Details

• Paperback: 232 pages
• Publisher: State University of New York Press (February 29, 2000)
• Language: English
• ISBN-10: 0791445224
• ISBN-13: 978-0791445228
• Product Dimensions: 8.9 x 5.9 x 0.5 inches
• Shipping Weight: 10.6 ounces (View shipping rates and policies)
• Average Customer Review: 3.0 out of 5 stars  See all reviews (2 customer reviews)
• Amazon Best Sellers Rank: #1,042,397 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

4 of 5 people found the following review helpful:

5.0 out of 5 stars A reviewer from Duluth, May 23, 2000

By 

Fred Hafferty "FWH" (Duluth, MN USA) - See all my reviews
(REAL NAME)   

This review is from: Pathological Gambling: The Making of a Medical Problem (Paperback)

This is an informative and interestingly written book about a little discussed problem. Castellani opens his book with a dialogue between two individuals, a friend of the author who is about to treat her first compulsive gambling patient and the author himself, who has experience and expertise in this area. It is within this dialogue that we are introduced to pathological gambling as a social problem, the therapeutic challenge it represents, and the theoretical and methodological approach taken by the author as he attempts to tackle this topic. The author then moves to a seminal court case (United States v. Toriero) and structures the rest of the book around this trial. As we are introduced to the major arguments put forth by the prosecution and defense, we encounter a wealth of information about how gambling is framed from a variety of vantagepoints (the government, the gambling industry, medicine, therapists, and special interest organizations). Each of these entities represents a "voice" (a "discourse") with each discourse having its own history, agents, and social dynamics. The various intersections of these discourses--how they compliment and conflict with one another--takes us to the heart of this study. Castellani ends his book with a series of policy implications and recommendations

The book itself is very well written. It is a quick and "clean" read. The three hours I spent with it (reasonably slim at 222 pages) was enjoyable and educative. I learned a lot about how pathological gambling came to be viewed as a disease rather than a failure of character and (God forbid) a little social theory along the way.

2 of 12 people found the following review helpful:

1.0 out of 5 stars Speechless, May 13, 2000

By A Customer

This review is from: Pathological Gambling: The Making of a Medical Problem (Paperback)

I thought sexist comments and introductions such as the one in this book went out with the buggywhip. If you like books that are me. me followed by I, I. you'll enjoy this one.