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Dr. Niederland sees the psychopathology of compulsive gambling as emanating primarily from pregenital roots, although he feels that oedipal elements may contribute to the guilt which causes some gamblers to punish themselves by losing. On a clinical level, he sees the need to run away from incipient depression as a precipitant for sprees of gambling often combined with traveling.
As Dr. Niederland mentions, the analytic literature on compulsive gambling is meager, partly because few compulsive gamblers are motivated to seek treatment. Their disorder is ego-syntonic, and for them the wares the analyst has to offer in the way of insight and change toward pursuit of long-term goals are an unattractive substitute for the heady mirage of instant satisfaction if only the right card turns up or the right horse wins.
Under the compulsion of approaching financial and marital ruin, a pure culture gambler once consulted me, and, fascinated and affected by his crazy optimism, I attempted to treat him for a few months until it became clear that I was to be paid for my efforts neither in money nor in productive work on his part.
He was the most oral character I have ever seen. Puffing at three to four packs of cigarettes a day, and in the face of all proof to the contrary, he reiterated his conviction that only good things could happen to him. However, even with him, there was reason to believe that his ego structure was a fragile one, and that a commitment to self-exploration might have led to the kind of depressive reaction that Dr. Niederland describes.
This was also apparent in another patient for whom gambling was an important but subsidiary symptom and whose trips to the tracks to play the horses were often also motivated by the need to run away from depression just as the manic patient runs away from depression through denial. However, in this case, and also in some other more casual experience with gamblers and gambling (including some of my own), it seems to me that explanat