At about the same time last week that I was writing a column about compulsive gambling, two smart people were addressing the same subject in print.
Richard E. Vatz of Towson State University and Lee S. Weinberg of the University of Pittsburgh were moved by doctors' descriptions of quarterback Art Schlichter as a "pathological" gambler to explore the nature of his "disease" for the Los Angeles Times. Their analysis was a revelation.
Vatz and Weinberg point out that the categorization of gambling as a disease is not just a harmless slight of the millions of people who are sane, self-controlled bettors. It raises some serious questions of social justice and public policy.
I have always harbored some vague doubts about the psychiatrists who talk about gambling as a sick, uncontrollable compulsion. I know plenty of gamblers, and yet I don't know any who seem afflicted with the kind of disease the supposed experts talk about.
The people who have allowed their gambling to hurt their lives are ones who would surely find other outlets for their self-destructive impulses if they weren't gamblers. I don't know any who would be normal if they could only be "cured" of their gambling addiction. But I assumed that trained psychiatrists must know a lot more about the problem than I do.
Vatz and Weinberg, however, are not so charitable in their view of psychiatrists. They are the authors of a recent book about Thomas Szasz, the country's foremost critic of the psychiatric profession, and they wrote, "There is not the slightest shred of evidence that gambling can be pathological, or actually disease-related. Moreover, there is no evidence that it is any less controllable than any other human temptation. How can psychiatrists persuade the public that gambling is a disease when it isn't and why would they want to mislabel it in this fashion?"
If gambling is viewed as a disease, the authors point out, public money will be channeled into the study and treatment of it. Several states are moving toward the establishment of state-supported facilities such as the one pioneered at Johns Hopkins. Health-insurance programs are started to pay for the treatment of "sick" gamblers. So there is plenty of incentive for the medical profession to promote the idea that gambling can be a disease.
And, of course, there is plenty of incentive for organizations like Gamblers Anonymous and individuals like Art Schlichter to support this notion, to relate horror stories of how the gambling addiction held them powerless in its clutches, for it relieves them of the responsibility for their own actions. Schlichter has earned widespread public sympathy for his gambling activities, and will probably gain forgiveness from the National Football League, because of the belief that he had no control over what he was doing.
Vatz and Weinberg are cruel enough to ask how, if he had no control over his actions, he was able to restrain himself from betting games involving the Baltimore Colts, which probably would have gotten him banned from the sport. But there aren't many people asking such questions and challenging the psychiatric profession, and so its view of compulsive gambling is becoming widely accepted. As a result, gamblers are getting state-sponsored help and support even in an era when other government services are being cut back.
This is what most troubles Vatz and Weinberg. "Are citizens whose habits leave them destitute as worthy of help as the unemployed or disabled?" they ask. "These 'sick' beneficiaries are hardly the most worthy recipients of such funds, and their attending physicians are performing no medicine, only persuasion--on their 'patients' and the public."