Compulsive Gambling and the Medicalization of Deviance

Abstract

This paper describes the process whereby excessive gambling is being defined as both a disease and a serious social problem. Gamblers whose repeated losses lead to serious financial and psychological difficulties are increasingly being labeled or pathological. I use a model advanced by Conrad and Schneider (1980) to delineate this process. Clinicians developed the prevailing illness model from accounts of those seeking treatment to stop gambling. Although researchers working in gambling settings have found little empirical evidence of compulsive behavior, various clinicians and non-medical help groups staunchly advocate a medical model. The latter groups, aided by an increased middle-class awareness, have gained public support and currently control the maintenance of therapeutic programs. Since this control Is based more on political dominance than on scientific achievement, the efficacy of prevailing treatment programs can be questioned. Sociologists are showing renewed interest in the historical development of social problems (Blumer, 1971; Kitsuse and Spector, 1975; Lopata, 1984; Spector and Kitsuse, 1977; Wiener, 1981). This work follows Fuller and Myers' (1941) recommendation of the natural history approach as a valuable technique for studying social problems. An historical perspective emphasizes the dynamic role of claims-making groups in defining deviance and other social problems (Kitsuse and Spector, 1973). This perspective is well suited to an analysis of the factors involved in the medicalization of deviant behavior (Gusfield, 1981). The term medicalization refers to the process whereby certain behavior becomes defined as a disease-a condition that warrants therapeutic intervention (Pfohl, 1977; Pitts, 1968; Schneider, 1978; Szasz, 1970; Zola, 1972). Working within an historical framework, Conrad and Schneider (1980) traced the sociohistorical factors involved in the medicalization of such categories of deviance as homosexuality, alcoholism, mental illness, child abuse, and child hyperactivity. After analyzing the empirical data from their individual studies, they advanced a five-stage sequential model of the medicalization of deviance: