Tonight, in a classroom in Congregation Beth Chaim in Feasterville, Pa., within earshot of the trucks rolling north out of Philadelphia on Route 132, there are 14 men at the meeting. They are mostly middle-aged, and they are squeezed into desks meant for 10-year-olds. Everything is out of scale, incongruous, like the progress chart tacked to the classroom wall indicating that the race between Debbie and Glenn for the reading achievement prize is still too close to call.
During daylight this is a bright, cheerful place. The men now assembled have lived in a dark and tormented world, which, it is to be hoped, Debbie and Glenn will never know.
The 14 assembled here are compulsive gamblers, and they are representative of at least three million Americans with that affliction. The evil irony of the disease of compulsive gambling is that it seeks out those, like Debbie and Glenn, who are brighter than average, tenacious achievers and tough competitors. And it catches them young. Most compulsive gamblers are on a course to self-destruction by their mid-teens.
Any one of the little group now in session here in Feasterville could tell you that. Each is an expert on the subject, a member of Gamblers Anonymous. There are about 12,000 people in GA, divided up into some 700 chapters like this one. GA was founded in 1957, structured along the lines of Alcoholics Anonymous, the pioneer organization in applying group therapy to fight an addiction. Tonight Jim M., dark, heavy-jowled, 30ish, takes the leader's chair. This is an honor he has earned by going 90 days without a bet. "I am Jim M., and I am a compulsive gambler," he says.
At first, the tempo is slow. Jim M. speaks modestly about his achievement. He is followed by Bill T., a hearty fellow in a Dior leisure suit, gold chains and an out-of-season tan. He says that he has been clean since '83. It looks in the early going as if the evening may not be very harrowing at all. But now Bob T. is on his feet. His tan bomber jacket is a little jaunty for his 60-plus years, but he is starvation thin and his breathing is harsh and broken. "Oh, Jesus, it's hard out there," he begins. "I made my last bet five days ago. I...I'm sorry I haven't been coming to the meetings. My wife puts pills out for me. She should put out a knife.... My son took $50 off me, to keep it for me, so now I'm painting some cabinets in the house. He took my credit cards off me as well.... Oh, Jesus, I'm sorry, but I kicked him." Bob starts to sob. Then he controls it. "I want to tell you all, it's still rough, rough...rough...out there." He sits down to a burst of warm handclapping.
John B. is next. He has gone six years without a bet, and he tells us of a fearful thing that happened this week to him. He met an old friend who was still gambling. "We didn't get juiced," he says. "We just talked till 2 a.m. Then five in the morning I get a call. He's run his car into a tree. He's killed himself."
John B. pauses. The classroom is silent. "Listen, we got to see that his family gets his money," he says. "Screw the bookies!" John B. is becoming almost hysterical. "Oh, please!" he cries to the audience. "Please! I don't want to be back in the football crazies. Oh, please, I know I'm downhearted, but I'm not crazy!"
John B. sits down. In contrast, Donald D., neat and well turned out, keeps it humorous. "Good news all day today," he says. "I agreed to a restitution schedule that I would have to earn maybe a half million a year to cover. Also, my psychiatrist called to say he has bought my home, but he'll let me stay on paying rent." Donald D. claims to be the only man in America who owned a $6,000 truck with $10,000 worth of bodywork on it. That, he says, was because whenever he took the six-minute drive home from his club after phoning his bookie, he kept running his truck into walls and street lamps. "I had numbers on my mind," he explains. Even Donald D. can't stay light-hearted for long. He says, "Once I got home, I'd switch on the TV and wait for the pre-game trash to be cleared out of the way. Then, the moment the ball was kicked, I'd know I was a loser. It was always the same. I'd just sit there and wait for the play that I knew would break my back. I did that for 10 years, and then I was ready for the bughouse."
The only new man at the Feasterville meeting is Joe B. He is in his late 20s and shaking, eyes misty, features curiously blurred. He is asked to read through the 20 prescribed questions that determine, in GA's terms, whether one is really a confirmed gambler. He is barely able to read aloud, but to 15 of the questions he answers yes. Only seven yesses are needed to qualify. Then Joe B. mumbles his confession. "Uh, I took off from work, uh, spent all my savings, $15,000, uh, blackjack and slots," he says.
It sounds cruel, but none of this is either new or surprising. You could write the rest of the script for Joe B., who is easily recognizable as having already reached the third, or Desperation, phase of pathological gambling.
This instant diagnosis is the product of a small group of psychologists, psychiatrists, social workers and recovering gamblers who together run a gambling treatment program at a private psychiatric hospital called Taylor Manor. The place is sequestered above Ellicott City, Md., 10 miles west of Baltimore. It is one of only three hospitals in the U.S. that offer the public inpatient treatment for gambling addiction. The other two are the Philadelphia Psychiatric Center and South Oaks Hospital on New York's Long Island. Military veterans have a further choice: There are five VA hospitals that treat gamblers. The biggest of these is in Brecksville, Ohio. The compulsive gambling program there has a grand total of 10 beds. Nevertheless, it was at Brecksville, as recently as 1972, that Dr. Robert L. Custer, a psychiatrist who is now chief of treatment services of the Mental Health and Behavioral Science Service of the U.S. Veterans Administration, founded the world's first treatment center for pathological gamblers.
Most of the staff at Taylor Manor, originally hired at Brecksville by Custer, moved to Maryland in 1979 because of a state grant funding a gambling-treatment program at Johns Hopkins Hospital. In 1983, the program was discontinued at Johns Hopkins and moved to Taylor Manor. The director of the addiction program (including gambling) is Dr. Joseph Ciarrocchi, a clinical psychologist.
The nightmare life of the addicted gambler has been well charted. "The overwhelming majority of pathological gamblers," says Ciarrocchi, "start in their teens. At first, they will just gamble in a social setting, a Saturday night poker game with friends, a football pool at the office. They seem normal, often for a very long time. We call this the social phase...."
Phil L., a recovering gambler who is an alumnus of Taylor Manor, recalls the social phase: "When I was real little, eight or nine years old, my aunts would take me to the racetrack, give me a couple of dollars and buy my ticket. One of my grandfathers was a bookie. At home there would be card games going on all night. We were a real tight-knit family...."
Larry D., who is two years into the GA program, also on the social phase: "I used to look forward to Saturday morning, getting the lines for all the college games. We were kids, but we all had jobs and we were intelligent. Four or five of us would pick a game we all really liked. We'd call the bookie and get $10 or $20 down on maybe three games in a parlay early in the afternoon. Win or lose, by 3:30 p.m. we'd be picking the later afternoon games. Then Sunday morning at eight, we'd call the bookie again and bet our three best pro teams. Then we'd watch them all go to hell in the early afternoon. We'd bet three or four games at 4 p.m. But even then, if we lost, there was still Monday night to recoup. We didn't have to pay the bookie until Friday, and we weren't talking a whole lot of money, just $20 or $30 a game among us. We were working. We were intelligent...."
Most gamblers, fortunately, never go beyond the social phase. Those who do become pathological gamblers. As defined by Custer in the early 1970s, the disease has three stages. Almost always, the first stage of compulsion begins with a Big Win. Says Ciarrocchi: "He'll hit heavy on a bet, maybe for half a year's salary or more. The Big Win convinces the gambler that he's found a magic formula that is going to end his problems. It triggers a change in the gambling pattern. Gambling takes on a more frenetic pace. The quantity of gambling increases. This stage is called the Winning Phase."
Mike P., recovering gambler in the GA program: "When I was in high school, I started betting anything from $20 to $50, which was a lot for me. Then—in '76 was it?—on a dare, I took the Reds to beat the Yankees. I had no money, but I bet anyway. I'm just out of high school. I'm in a bar, and a guy says, 'Come on, big handicapper pro, who's going to win this?' And I said, 'Cincinnati.' There was some odds. Cincinnati was a real heavy favorite. I was betting something like $1,000 to win $850. But I did it. And, oh, when I came through, I was on top of the world."
As the phases are described, an image comes to mind of one of those dark, delicate Victorian engravings depicting the broad path to damnation. The second step is, of course, the Losing Phase. "Already small problems have emerged, even when the gambler was winning," Ciarrocchi says. "Principally, these occur in his relationship with his family. This is when the lies and deceptions begin. For a while, though, he can keep control, and his job, too. But once the Losing Phase really gets under way he'll start digging himself deeper and deeper in the hole. Usually, he's a socially pleasant, attractive guy anyway. So he'll start going to friends and family and saying, 'Look, I've been sick. I'm two months behind on the mortgage.' And he'll find somebody who'll cover his debts. In the Losing Phase, people come to his support. They like him. He's not a scoundrel. Not at this stage. And when he finds a victim, to him it's another magical solution, just like the Big Win. We call it the Bailout."
Nick B., a compulsive gambler who has been in remission for 11 years, lived through Stage Two: "I'd tell my wife I had a flat tire or I needed gas. You have to have time to sneak all these calls to the bookie. Always I'd have to get out of the house to call him around noon on Saturday.... I started to get money from my aunts who lived with us. I got about $12,000 apiece from them. I reckoned that when I won big, I would pay them back and quit. But I lost another $30,000 and I had to go to the sharks.
"One day my oldest son, Peter, grabbed me. He said, 'What are you doing, Dad? We've been talking to Aunt Mary and Nanna. You know you've taken $25,000 off them?' I broke down crying; then Peter said Nanna and Aunt Mary would pay back everything I owed if I quit. We added up everything I needed. It was more than $30,000. I paid off my debts.
"That didn't stop me betting, though."
"The last phase we simply label Desperation," says Ciarrocchi. "Everything is out of control now. The gambler is irrational, almost delusional. If he wins money, he simply pours it back in. There is no logic left in him, no awareness of the laws of probability. He has hit bottom."
Larry D.: "I was on a junket in Vegas, and I called up this special number and I got a hot word about the Jets. I bet $5,000 on that game, but I wasn't happy with just that bet. I teamed it up with eight other games on which I had no information at all, $1,000 on each game. I flew back that day. The Jets had won like they were supposed to, but the eight I'd parlayed with them had all lost. I was out of control. With what I lost in Vegas, I had just blown $20,000 of the company's money I had embezzled. I was wiped out. I called my wife, and I told her that I owed $150,000 altogether and that I didn't think I would ever be coming home again. I told her it was time to end it all because I had taken so many other people down with me."
One can sup full on horrors at any GA meeting or in any conversation with gamblers who have been through the Taylor Manor program. The ones who are able to bear witness to the nightmare are the lucky ones.
From The Press of Atlantic City, March 31, 1984: "A Hammonton businessman, about to be sentenced to a seven-year prison term for embezzlement, pulled a gun from his hip pocket...and killed himself in criminal court here Friday, officials said. [Ernest] DeMasi was charged with embezzling $416,000 from several trucking companies.... There were indications that the father of five sons and three daughters had gambled much of the money away."
In his recent book, When Luck Runs Out, a layman's guide to compulsive gambling, Custer, now 59, affirms that it is not merely a serious disease but potentially a life-threatening one. He says that 20% of gamblers in treatment have attempted suicide; this is perhaps 100 times the national average for suicide attempts. There is no way to gauge the number of gamblers in the Desperation Phase who have attempted suicide and not sought professional help. And, saddest fact of all: Professional help of any kind is very difficult to find. Taylor Manor has just 15 beds for gamblers, a four-week program costs $10,500, and many gamblers lose their hospital and psychiatric insurance coverage when they lose their jobs.
In advanced cases of compulsive gambling, the inpatient route seems the best. It gives the gambler four weeks in which his life may be restructured. This is a major therapeutic challenge. The typical gambler is often very intelligent, full of energy and macho big talk, although by now he may be somewhat subdued because of deep depression. "Even so, these guys can talk their way up, down and around anybody," says Joanna Franklin, director of training at Taylor Manor. "They have solid defenses that we have to penetrate."
A day of treatment at Taylor Manor often starts at 8 a.m. and goes on to 10:30 at night. Treatment includes group therapy, assertiveness training ("Behind the macho talk, they tend to be very passive people," Franklin says) and visits to the biofeedback lab, where gamblers learn to measure their tensions and control them. There is also art therapy. Franklin pulls a gambler's picture from a file. It shows a horse and jockey on a track. "Look, there are no people, no grandstand. It means that when this man gambles, nobody else exists for him." She adds sadly, "We're about where the treatment of alcoholism was 30 years ago."
Custer has observed a number of changes since his original research in the '70s.
"We're getting a younger person who is more distraught, more restless, more hyperactive, typically a kid in his early 20s," he says. "In 1974 the average age was 39.5. Now it is less than 32. We're seeing more and more women also, though they start to gamble at a later age, by and large. They are just starting to come out of the closet, as women alcoholics did 20 years ago." Indeed, only three women have gone through the Taylor Manor inpatient program (out of a total of 125 patients). Now, though—especially since New Jersey has joined Nevada in legalizing casino gambling, more and more women are showing up at GA meetings.
Another big shift, says Custer, is the growing involvement of compulsive gamblers in betting on football, basketball and baseball. However, the other major gambling categories—horse racing, casinos, the stock market—also continue to pose problems. Custer says he has a "feeling" that more people are now moving into crime in the later stages of addiction.
Surprisingly, Custer does not condemn gambling as such. "The great majority of people aren't hurt," he says. "But if you decide to head out skiing in a dangerous place, you should take out insurance in case you break a leg. My feeling is that a half of one percent of gambling revenue—especially from legal sports gambling—should be set aside to pay for treatment for the unfortunates who develop a destructive addiction and as funds to finance new research and treatment."
There are some fascinating theories to be explored as to why some people become so addicted to gambling. One of Custer's is something of a bombshell.
"We have no proof," he says cautiously. "We have made no clinical tests. But I have a very strong notion indeed that there may be a biological factor involved. This is the hypothesis we are working on now at the National Institute of Mental Health [in Bethesda, Md.]. The project is headed by Dr. Alec Roy—he's the researcher and I'm the clinician. We're asking, 'Why are pathological gamblers so impulsive, so psychotic, so wildly overactive?' We suspect that it must have something to do with brain chemistry. These are biochemical symptoms—the energy, the brightness, the failure to learn from experience. I talk to parents and ask them to compare kids who eventually became compulsive gamblers with their normal siblings. It turns out that, though they weren't always clinically hyperactive, they were inclined that way. There may be a genetic factor to this.
"I'm really excited about this," says Custer, "because it means that one day there could be a drug treatment."
But for the moment there is no chemical cure, no medical treatment for a gambling addiction. The best medicine is still the kind of hands-on, human-to-human help that Gamblers Anonymous offers. There are GA hot lines in 45 big cities. Taylor Manor, closely linked with GA, has a statewide hot-line number—1-800-LAST-BET—in Maryland. (There is also a statewide number in New Jersey, 1-800-GAMBLER.) Much of the time the phone is answered by Jean Richardson, director of voluntary services at the Manor, who is a model of calm. One recent morning a call came from a public defender in Chicago. "Sure," says Richardson, "we can send somebody round to the prison to evaluate him, or you could remand him for treatment here." She smiles as she hangs up the phone. People involved with the legal system, she observes happily, "are beginning to recognize this disease."
Richardson says that 85% of hot-line appeals come from spouses or other relatives—"after they've been to the family doctor and he's put them on Valium." But now the hot line rings with the real thing. Jean is alarmed. "Do you know where he went?" she asks. "Did he take anything with him? We're going to have to find him and bring him back to the hospital." She turns from the phone and says, "It's a triple on a suicide trip." By "triple" she means someone who is triply addicted—to drugs, alcohol and gambling. This is by no means a rare combination, especially in youngsters. She says, "We cannot imagine the pain these people are in."
Some non-gambling sufferers seek relief from a different kind of pain through an organization called Gam-Anon, which works in parallel with Gamblers Anonymous and offers help to families victimized by pathological gamblers. Often, and obviously, this help has to do with money. "Have you ever had to chose between buying peanut butter or toilet tissue for your kids?" one woman asked bitterly at a recent Gam-Anon meeting. Even those enlightened enough to recognize that addictive gambling is as much a disease as alcoholism or narcotics addiction often forget that gambling carries a staggering extra penalty: the terrifying mountain of debt built up over the years, the thousands upon thousands of dollars owed to sharks and bookies.
And these debts must be paid. Restitution is a central part of the GA creed, and one of the organization's main functions is offering what it calls pressure relief. This does not mean direct financial aid. At Feasterville, the GA veterans indicate how pressure relief might be used in the case of the chapter's newest member, Joe B.
"He'll have to put all his financial details on the table, and for the first time in years, probably, the guy is going to be honest," says Angelo S., a member of nine years' standing. "Otherwise he might as well walk out the door and forget it. After that, the family gets taken care of first. Any money left over, we distribute evenly to the other creditors. Joe will have to go to them and say, 'I can afford $5 or $10 a week.' Maybe he'll have to take a second job. Suppose this guy owes a shark $1,000. He goes to him and says, 'Look, I'm not gambling anymore. I'll pay you this much a week.' Now, a shark will accept that. He's human. But if he hears that you go on gambling, making a fool out of him, who the hell knows what'll happen to you."
Someone mutters something about broken legs, but that makes Angelo laugh. "Broken legs?" he scoffs. "Never. How can you work to make money for a shark with a broken leg?"
The little group of gamblers in Feasterville is breaking up now. They extricate themselves from the child-sized desks, slowly drift outside the school and move off into the dark. "It doesn't sound like much, a little coffee and cake together every week," says Angelo. "But it means a hell of a lot to me."