Dr. Robert L. Custer, a psychiatrist who in 1974 established the nation's first clinic for treatment of compulsive gambling, died of lung cancer Tuesday at his home in Bethesda. He was 63.
Dr. Custer launched a treatment program for compulsive gamblers at the Taylor Manor psychiatric center in Ellicott City in 1983.
He was widely recognized as a pioneer in helping compulsive gamblers.
At a time when out-of-control gambling was widely considered to be merely aberrant behavior, he came to regard it as a disease that should be treated as such.
Dr. Custer rejected the Freudian theory that people gambled compulsively as a substitute for sex. Addicts gamble excessively, he believed, not for pleasure or self-punishment, but to escape pain.
In 1980, largely as a result of Dr. Custer's efforts, the American Psychiatric Association classified compulsive gambling as a psychological disorder.
Dr. Custer, who was born in Midland, Pa., was a graduate of Ohio State University.
He received his medical degree from Case Western Reserve University in Cleveland.
After practicing general medicine for a decade, he took psychiatric training at the University of Missouri.
He joined the Veterans Administration in 1968 and established the first clinic for compulsive gambling at the VA hospital in Brecksville, Ohio.
In 1974, he moved to Washington, where he became director of '' patient-treatment services for mental health.
He retired in 1986 but continued in private practice until his final illness.
In 1987, he established a treatment program for pathological gamblers at Charter Hospital in Las Vegas, Nev.