The medical model of pathological gambling is coming to dominate the public image of the problem gambler. The new image is replacing the previous one of sinner or criminal. This article traces the roots, causes, and phases of pathological gambling. The sociocultural roots of pathological gambling are seen as distinct from gambling itself. The work of sociologists, psychologists, psychiatrists, and others is summarized herein, and different types of pathological gamblers are examined. Three phases of the career of the pathological gambler are outlined: the adventurous, or winning phase; the losing phase; and the desperation phase. The gambler's career progresses with increasing problems in all spheres of life, including relations with family members and friends, gambling associates, employment, and finances. Eventually the gambler has reduced life options, which include suicide, imprisonment, running away, and seeking help. Two major sources of help, Gamblers Anonymous and professional counseling, are examined, and their prospects and difficulties are revealed. Projections are made for future developments in the area of pathological gambling.
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