Sunday, March 6, 2011

There's a little problem gambler in all of us

It is a frequent observation that abnormal psychology reflects on "normal" psychological functioning. In other words, understanding people with mental illness helps us understand the minds and behaviors of people without psychological problems. Addiction is one example. There has been an explosion of recent research on behavioral addictions. In fact, this explosion has been so pronounced, that in the popular mind anyone can be "addicted" to virtually anything. Shopping addictions and Internet addiction share equal standing with alcohol and drug abuse. However, restrictive technical definitions exclude these behaviors as addictions. In particular, behavioral addictions often lack strong characteristics of tolerance and withdrawal involved in chemical addition. I have a sense of unease as to whether these properties are absolutely necessary to the concept of addiction; but also a reluctance to accept all behaviors as having the potential for being addictive - unless the term becomes meaningless.

Gambling is occupying a new and unique place, as it is now reified as an addiction in the Diagnostic and Statistical Manual of the American Psychiatric Association V. No other simple behavior is yet recognized as an addiction - outside of substance abuse. Pathological gambling, now called disordered gambling, has been reclassified from an "impulse control disorder" due to its growing commonality with substance abuse. For instance, most people with disordered gambling also have a lifetime substance abuse problem.

The growing acceptance of gambling as an "addiction" makes me wonder what other pure behavior will be the next to fall within the expanded definition. Is it simply the severity of harm that is caused by the behavior that uniquely qualifies a behavior as "addictive"? Internet addiction, for instance, is arguably less harmful than gambling addiction. Shopping addiction is likewise less harmful to most people. Addiction may therefore be a term that we use to recognize the more severe levels of harm caused by the various obsessions that grip all of us.

If I told you that a person engaged obsessively in a behavior that resulted in huge financial losses, alienated their family, and caused a disruption in their gainful employment : you might be tempted to conclude that this person was in the grips of a severe addiction. However, if I also told you that this person was a track-and-field star and that their "behavior" was obsessive training to excel in their sport, suddenly their behavior no longer qualifies. What obsessive behaviors we see as "normal" are bound by cultural expectations and past definitions of what classifies as an addiction. These definitions, however, are evolving.

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