And these hooks work on casual casino-goers just as well as they do on problem gamblers. Uncertainty as its own reward in the brain. One of the hallmarks of gambling is its uncertainty – whether it’s the size of a jackpot or the probability of winning at all. And reward uncertainty plays a crucial role in gambling’s attraction. 12, 2003 - Pathological gamblers have decreased brain activity in areas that monitor impulse control, according to a new study. Pathological gambling is considered a major psychiatric. Ongoing research is helping illuminate the biology of risky behaviors—studies that may one day lead to interventions for vices like compulsive gambling. The recent results show an explanation is.

When Shirley was in her mid-20s she and some friends road-tripped to Las Vegas on a lark. That was the first time she gambled. Around a decade later, while working as an attorney on the East Coast, she would occasionally sojourn in Atlantic City. By her late 40s, however, she was skipping work four times a week to visit newly opened casinos in Connecticut. She played blackjack almost exclusively, often risking thousands of dollars each round—then scrounging under her car seat for 35 cents to pay the toll on the way home. Ultimately, Shirley bet every dime she earned and maxed out multiple credit cards. “I wanted to gamble all the time,” she says. “I loved it—I loved that high I felt.”

In 2001 the law intervened. Shirley was convicted of stealing a great deal of money from her clients and spent two years in prison. Along the way she started attending Gamblers Anonymous meetings, seeing a therapist and remaking her life. “I realized I had become addicted,” she says. “It took me a long time to say I was an addict, but I was, just like any other.”

Ten years ago the idea that someone could become addicted to a habit like gambling the way a person gets hooked on a drug was controversial. Back then, Shirley's counselors never told her she was an addict; she decided that for herself. Now researchers agree that in some cases gambling is a true addiction.

In the past, the psychiatric community generally regarded pathological gambling as more of a compulsion than an addiction—a behavior primarily motivated by the need to relieve anxiety rather than a craving for intense pleasure. In the 1980s, while updating the Diagnostic and Statistical Manual of Mental Disorders (DSM), the American Psychiatric Association (APA) officially classified pathological gambling as an impulse-control disorder—a fuzzy label for a group of somewhat related illnesses that, at the time, included kleptomania, pyromania and trichotillomania (hairpulling). In what has come to be regarded as a landmark decision, the association moved pathological gambling to the addictions chapter in the manual's latest edition, the DSM-5, published this past May. The decision, which followed 15 years of deliberation, reflects a new understanding of the biology underlying addiction and has already changed the way psychiatrists help people who cannot stop gambling.

More effective treatment is increasingly necessary because gambling is more acceptable and accessible than ever before. Four in five Americans say they have gambled at least once in their lives. With the exception of Hawaii and Utah, every state in the country offers some form of legalized gambling. And today you do not even need to leave your house to gamble—all you need is an Internet connection or a phone. Various surveys have determined that around two million people in the U.S. are addicted to gambling, and for as many as 20 million citizens the habit seriously interferes with work and social life.

Two of a Kind

The APA based its decision on numerous recent studies in psychology, neuroscience and genetics demonstrating that gambling and drug addiction are far more similar than previously realized. Research in the past two decades has dramatically improved neuroscientists' working model of how the brain changes as an addiction develops. In the middle of our cranium, a series of circuits known as the reward system links various scattered brain regions involved in memory, movement, pleasure and motivation. When we engage in an activity that keeps us alive or helps us pass on our genes, neurons in the reward system squirt out a chemical messenger called dopamine, giving us a little wave of satisfaction and encouraging us to make a habit of enjoying hearty meals and romps in the sack. When stimulated by amphetamine, cocaine or other addictive drugs, the reward system disperses up to 10 times more dopamine than usual.

Continuous use of such drugs robs them of their power to induce euphoria. Addictive substances keep the brain so awash in dopamine that it eventually adapts by producing less of the molecule and becoming less responsive to its effects. As a consequence, addicts build up a tolerance to a drug, needing larger and larger amounts to get high. In severe addiction, people also go through withdrawal—they feel physically ill, cannot sleep and shake uncontrollably—if their brain is deprived of a dopamine-stimulating substance for too long. At the same time, neural pathways connecting the reward circuit to the prefrontal cortex weaken. Resting just above and behind the eyes, the prefrontal cortex helps people tame impulses. In other words, the more an addict uses a drug, the harder it becomes to stop.

Research to date shows that pathological gamblers and drug addicts share many of the same genetic predispositions for impulsivity and reward seeking. Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire. And a few studies suggest that some people are especially vulnerable to both drug addiction and compulsive gambling because their reward circuitry is inherently underactive—which may partially explain why they seek big thrills in the first place.

Even more compelling, neuroscientists have learned that drugs and gambling alter many of the same brain circuits in similar ways. These insights come from studies of blood flow and electrical activity in people's brains as they complete various tasks on computers that either mimic casino games or test their impulse control. In some experiments, virtual cards selected from different decks earn or lose a player money; other tasks challenge someone to respond quickly to certain images that flash on a screen but not to react to others.

A 2005 German study using such a card game suggests problem gamblers—like drug addicts—have lost sensitivity to their high: when winning, subjects had lower than typical electrical activity in a key region of the brain's reward system. In a 2003 study at Yale University and a 2012 study at the University of Amsterdam, pathological gamblers taking tests that measured their impulsivity had unusually low levels of electrical activity in prefrontal brain regions that help people assess risks and suppress instincts. Drug addicts also often have a listless prefrontal cortex.

Further evidence that gambling and drugs change the brain in similar ways surfaced in an unexpected group of people: those with the neurodegenerative disorder Parkinson's disease. Characterized by muscle stiffness and tremors, Parkinson's is caused by the death of dopamine-producing neurons in a section of the midbrain. Over the decades researchers noticed that a remarkably high number of Parkinson's patients—between 2 and 7 percent—are compulsive gamblers. Treatment for one disorder most likely contributes to another. To ease symptoms of Parkinson's, some patients take levodopa and other drugs that increase dopamine levels. Researchers think that in some cases the resulting chemical influx modifies the brain in a way that makes risks and rewards—say, those in a game of poker—more appealing and rash decisions more difficult to resist.

A new understanding of compulsive gambling has also helped scientists redefine addiction itself. Whereas experts used to think of addiction as dependency on a chemical, they now define it as repeatedly pursuing a rewarding experience despite serious repercussions. That experience could be the high of cocaine or heroin or the thrill of doubling one's money at the casino. “The past idea was that you need to ingest a drug that changes neurochemistry in the brain to get addicted, but we now know that just about anything we do alters the brain,” says Timothy Fong, a psychiatrist and addiction expert at the University of California, Los Angeles. “It makes sense that some highly rewarding behaviors, like gambling, can cause dramatic [physical] changes, too.”

Gaming the System

Redefining compulsive gambling as an addiction is not mere semantics: therapists have already found that pathological gamblers respond much better to medication and therapy typically used for addictions rather than strategies for taming compulsions such as trichotillomania. For reasons that remain unclear, certain antidepressants alleviate the symptoms of some impulse-control disorders; they have never worked as well for pathological gambling, however. Medications used to treat substance addictions have proved much more effective. Opioid antagonists, such as naltrexone, indirectly inhibit brain cells from producing dopamine, thereby reducing cravings.

Dozens of studies confirm that another effective treatment for addiction is cognitive-behavior therapy, which teaches people to resist unwanted thoughts and habits. Gambling addicts may, for example, learn to confront irrational beliefs, namely the notion that a string of losses or a near miss—such as two out of three cherries on a slot machine—signals an imminent win.

Unfortunately, researchers estimate that more than 80 percent of gambling addicts never seek treatment in the first place. And of those who do, up to 75 percent return to the gaming halls, making prevention all the more important. Around the U.S.—particularly in California—casinos are taking gambling addiction seriously. Marc Lefkowitz of the California Council on Problem Gambling regularly trains casino managers and employees to keep an eye out for worrisome trends, such as customers who spend increasing amounts of time and money gambling. He urges casinos to give gamblers the option to voluntarily ban themselves and to prominently display brochures about Gamblers Anonymous and other treatment options near ATM machines and pay phones. A gambling addict may be a huge source of revenue for a casino at first, but many end up owing massive debts they cannot pay.

Shirley, now 60, currently works as a peer counselor in a treatment program for gambling addicts. “I'm not against gambling,” she says. “For most people it's expensive entertainment. But for some people it's a dangerous product. I want people to understand that you really can get addicted. I'd like to see every casino out there take responsibility.”

I’m a proponent of gambling for fun, but I’m not a fan of every single thing that people in the gambling industry do. The psychology of gambling is too often taken advantage of to the players’ detriment.

One example of this is the industry’s use of the term “gaming” to refer to “gambling.” The idea that they can just co-opt a term that’s used for different activities to try to make their business seem more legitimate is disingenuous at best and dangerous at worst.

But people like to gamble for fun, and I’m firmly in that camp. I’m not alone. I’ve seen estimates that suggest an overwhelming majority of Americans gamble. (The number of adults who never gamble is 20% or lower).

Some people, though, eventually start gambling compulsively. This makes gambling similar to other pleasurable activities like drinking or smoking.

And the psychology behind casino games and other gambling activities is based on selling a game that’s designed for the gambler to lose in the long run.

A cold, hard look at the odds behind most casino games would cause a sane person to fold their money in half and put it back in their wallet.

How the Brain’s Rewards System Works With Gambling

It would be hard to discuss the psychology of gambling without getting into some of the ideas about how the brain’s reward system works. If you didn’t get some kind of psychological kick out of gambling, you wouldn’t do it. Neither would anyone else.

Understanding this is a step in the direction of being a hard-nosed, realistic gambler.

The first aspect of gambling that seems obvious is that you don’t know what the outcome will be. Your brain is hardwired to enjoy activities when you don’t know what’s going to happen, especially if one of the possible outcomes involves a reward of some kind.

When you exercise, eat, drink alcohol, or make love, your brain releases a neurotransmitter called dopamine. This neurotransmitter is also released when you have money in action at the roulette table, or anywhere else in the casino.

In fact, psychologists have performed multiple studies and experiments measuring the brain’s release of dopamine when gambling. Not only does the brain release dopamine in the same way it would as if you were using drugs, but the brain physically changes when you’re gambling.

You can think of the dopamine that gets released in your brain as traveling through a road. That road becomes more sensitive with repeated use. Not only does gambling increase your craving for more gambling, it also increases your craving for other things that release dopamine (including alcohol, drugs, or any other activity that causes that dopamine release).

They’ve even done studies that demonstrate that gamblers who lose get the same hit of dopamine that winners get. Problem gamblers who chase their losses are living examples of this phenomenon in action.

How Gambling Changes Your Brain

Other Stimuli, Other Responses

The brain’s reaction to uncertainty when it comes to rewards and losses would seem to be enough to motivate gamblers, but casinos are in the business of maximizing profits. (All businesses are in the business of maximizing profits.)

The casinos use other stimuli to motivate their customers to gamble.

These stimuli include the sights and sounds of the casino. You can even see similar sights and sounds aimed at children. Notice what the game room at Chuck E. Cheese sounds like, then visit your local casino.

Live casinos, of course, have these sights and sounds in abundance, but even online casinos use the same stimuli. It would be dull to play at an online casino that didn’t include at least some of the flashing lights and music that you hear in a brick and mortar casino.

Scientists have done studies related to these stimuli, too, and they’ve come to the conclusion that the sights and sounds increase that dopamine release. In other words, the uncertainty of the rewards system combined with the music and lights have a synergistic effect.

A Skinner Box With a Lever

B.F. Skinner is one of the most famous behavioral scientists in history. Not all of his work relates to gambling, but some of it does. In particular, the Skinner Box applies directly to slot machine addiction.

Skinner did experiments with rats using boxes that dispensed cheese as a reward when the rats pulled a lever.

Obviously, the rats who got cheese every time they pulled the lever were more motivated to pull the lever than the rats who didn’t get cheese.

But there was a third box. This one dispensed cheese as a reward randomly. Sometimes, the rat got cheese, and other times, it didn’t.

You’d think that the rats who were certain of getting cheese would be the most motivated to pull that lever. But you would be wrong.

Now, let’s talk about slot machines. You’re the rat in the situation, the prize money is the cheese, and you have an uncertain result.

It’d be easy to say that people aren’t rats. But if you look at the research, this experiment relates to how the brain reacts to uncertainty.

And slot machines are the biggest moneymakers for the casino by far, even though they usually offer the worst odds in the casino. How else do you explain their appeal?

There’s a great book specifically about slot machines called Addiction by Design. It’s worth reading if you’re interested in the psychology of gambling.

The Gambler’s Fallacy

You’ll sometimes see this referred to by another name, like the “Monte Carlo” fallacy. Either way, it means the same thing.

It’s the tendency for a gambler to believe that if something happens more or less often than it should, the future results will even that out by having that something happen less or more often than it should.

In the case of random events that are independent of one another, this is a complete fallacy.

You have 18 black outcomes, 18 red outcomes, and two green outcomes at the roulette table. You’ve been betting on black, and black has hit eight times in a row.

Someone who believes in the gambler’s fallacy would think that a red or green result is now more probable on the next spin of the wheel. After all, the probability of black hitting nine times in a row is low indeed.

The problem is that you’re not betting on black coming up nine times in a row. You’re betting on the next spin, which is an independent event. The roulette wheel has no memory of what happened on the previous eight spins.

It still has 18 red numbers out of 38 total numbers, so the probability of a red result on that ninth spin is still 18/38, or 47.37%.

This is another example of a psychological shortcoming that causes gamblers to chase their losses. Even when you understand what the gambler’s fallacy is and the real odds, it’s tempting to bet the other way.

The gambler’s fallacy has been prominent in gamblers throughout history, but the most notable example happened at the Monte Carlo Casino in 1913. The roulette table saw an epic streak of black results, the ball landed on black 26 times in a row.

The odds of that happening are similar to the odds of winning the lottery, about 1 in 67 million.

The roulette players bet millions on red and lost. Their assumption that you’d see a streak of red results in higher proportion on the next batch of spins was entirely incorrect.

Applied Psychology in Gambling: The Game of Poker

Entire books about psychology and its application in poker have been written by psychologists. It’s impossible in the space here to provide anything like comprehensive coverage of the subject.

But I can provide an introduction to how psychology affects poker.

How Gambling Affects Your Brain

First, think about the concept of tells in poker. If you’ve seen many movies about poker, you probably already know what tells are. You might even have an inflated sense of their importance.

What Gaming Does To Your Brain

A poker tell is just a physical clue that a poker player gives when he’s about to do something. For example, a player might have shaky hands when he likes his cards. (This is a common tell, by the way. Excitement about a hand results in the release of nervous tension in the form of trembling hands.)

You can spend all day looking for tells and still lose at poker. You can’t replace an understanding of hand strength, pot odds, and outs with close observation of the other players at the table.

Another example of psychology at the poker table is the tendency for players to tilt. This is the phenomenon of getting angry because you feel like you’re not getting the results you should be and changing your behavior as a result.

I used to play with a guy who wore scrubs to every poker game. I didn’t know him. I just used to run into him at the cardroom at Choctaw Casino in Oklahoma.

His nickname was “Doctor Tilt.” He’d get mad after a bad beat and start betting and raising with all kinds of weak cards. All you had to do was be willing to fold for a little while until you caught some decent cards.

He’d angrily bet into you with some dumb hole cards, and you’d win money from him two out of three times. He racked up some severe losses.

This tendency to tilt, though, is also subject to psychology. Because the game of poker is random, someone who tilts sometimes gets paid off when he bets and raises with a lousy hand.

This reinforces his tendency to tilt.

How Does Gambling Change Your Brain

Conclusion

The psychology of gambling is a huge subject, too huge to cover in any kind of depth in a single blog post. The best I could hope to do is provide an introduction to some of the effects of psychology in gambling.

Were there better examples of the psychology of gambling that I could have used in this post? If so, please leave a comment and let me know what you think!