Robert Custer redefines pathological gambling as a medical addiction
In the 1970s, psychiatrist Robert Custer observed a disruptive behavioral pattern in some patients. He perceived that their inability to stop gambling went beyond a simple habit, generating devastating consequences. Custer proposed that this compulsive behavior resembled a chemical addiction, a paradigm shift that transformed how psychiatry classifies this disorder. 🧠
From moral vice to diagnosable disease
Before Custer's work, the predominant view blamed a character flaw or lack of willpower. He argued that there was a specific medical condition, which he termed compulsive gambling. This approach enabled the creation of objective diagnostic criteria, laying the foundation for the disorder to be included in the DSM-III manual as "pathological gambling."
The three phases of Custer's model:- Winning phase: The individual experiences wins that reinforce the behavior.
- Losing phase: Losses begin, but the person gambles to recover what was lost.
- Desperation phase: The behavior accelerates to pay debts, leading to personal ruin.
By classifying gambling as an addiction, therapies similar to those used for alcoholism can be applied.
A legacy that endures in the digital era
Custer's clinical perspective paved the way for structured treatments. By equating pathological gambling with other addictions, it validated the use of support groups and justified investigating its biological causes. His conceptual framework is crucial today for understanding the addictive mechanics in video games and online betting.
Impact on modern treatment:- Allows the use of behavioral therapies and twelve-step groups.
- Encourages research into the neurobiological bases of addiction.
- Provides a model for identifying risky behaviors in new digital formats.
Pioneering vision for a contemporary problem
Robert Custer's foundational work changed the approach forever to problem gambling. Decades before loot boxes and online betting, his model already described the cycle of behavioral addiction. His legacy demonstrates that recognizing when gambling stops being fun is the first step to treating it as the real disease it is. ⚕️