Compulsive Gambling

Overview

Just as it is possible to occasionally indulge in rich foods without developing an eating disorder, it is possible to occasionally gamble for fun and entertainment without becoming a compulsive gambler. Compulsive gambling is the inability to resist the urge to gamble. It can blossom unexpectedly from controlled recreational gambling, and its personal and social consequences can be severe. Often, compulsive gamblers in advanced stages indulge their compulsion to such a degree that their family and professional lives are seriously disrupted. Compulsive gambling is often accompanied by depression or alcohol addiction.

The number of Americans with gambling problems generally increases during periods of economic crisis, and it is now widely recognized as a psychiatric disorder. According to the National Council on Problem Gambling, nearly three million American adults are compulsive gamblers, including an increasing number of women. For economic reasons, African-Americans have a higher rate of compulsive gambling than Caucasians, and the rate of compulsive gambling is about twice the average among those who live within fifty miles of a casino.

Generally, gambling behavior progresses from occasional to habitual. As one’s gambling problem takes hold, the urge to gamble becomes so intense that the tension can only be relieved by further gambling. The stakes become higher, and other interests and responsibilities are increasingly neglected. Family problems and financial ruin are common results of a prolonged gambling problem, and the need for money to support a gambling habit can lead to criminal activity. No universal cause of compulsive gambling is known, but it is generally acknowledged that excessive alcohol use – which lowers inhibitions and impairs judgment – is a factor.

If it is not detected and treated early, a compulsive gambling problem can lead to estrangement from family and friends. Compulsive gambling is a chronic condition, and relapse after treatment is a serious risk. For the families of compulsive gamblers, life can be emotionally traumatic, as problem gamblers in advanced stages are likely to deceive loved ones. These lies and deceptions are usually not based in hostility, but in a desire to create the impression that no problem exists. Financial hardship, which is inevitable in long-term compulsive gamblers, can destroy family life.

Symptoms

Identifying a gambling problem depends on an accurate psychological evaluation, and an understanding of the patient’s history. Among the early signs of a problem is the patient’s loss of control over the amount of time he or she spends gambling. When recreational gambling evolves into a compulsion, the gambler tends to continue gambling, whether he or she is winning or losing, until all money is lost or the game is terminated. The accumulation of large gambling debts is an obvious sign, as is a general lack of concern for society’s expectations and laws. The compulsive gambler often feels that gambling is a way to “beat the system” which requires labor in exchange for money.

The problem gambler is preoccupied with gambling, which can include a self-glorifying need to relive past victories, or a tendency to openly “handicap” or plan the next “piece of action.” Often, problem gamblers spend a good deal of time thinking of ways to obtain money with which to gamble, and as the problem progresses, the stakes must be made higher and higher in order to provide the gambler with a sufficient sense of excitement.

Some compulsive gamblers may realize that they have a gambling problem, and take measures to combat it. Unsuccessful attempts can be devastating, leaving the gambler with the sense that gambling is his or her only possible hope to “get ahead” financially. In many cases, compulsive gamblers use gambling as a means of escaping from personal problems. By putting all their hopes for happiness on their chances of winning big, problem gamblers preserve self-esteem by developing unrealistic expectations about winning. This can often lead to unrealistic expectations in other areas of life.

The Three Phases

Some experts have identified three phases of long-term problem gambling. The first, known as “the Winning Phase,” can often last up to five years, and is characterized by good luck. If a compulsive gambler “wins big” early on, taking home significantly more money than they earn at work, the chances of developing a serious problem are greatly increased. Hitting the jackpot early can justify a gambler’s conviction that he or she has won by being smarter than others, or because of superior gaming skills. New gamblers during the winning phase often believe that gambling is the answer to their financial woes, or the key to a lifetime of wealth. They may begin to think of themselves as “professional” gamblers. As the first phase progresses, they usually spend more and more time gambling, and for larger amounts of money. Eventually, they begin to lose.

The second phase is therefore identified as “the Losing Phase,” and it generally lasts more than five years. While continuing to gamble more, and for higher stakes, the second-phase gambler does not fare as well as he or she expects. The gambler usually believes that the second phase is a temporary “losing streak,” and normally attempts to combat this development by “doubling up” on bets, and by refusing to fold. In the second phase, the gambler depends on improbable degrees of good luck, putting money on “longshots” which will pay big in the unlikely chance of victory. Frequent losses cause the gambler to gamble even more, in the interest of winning back lost money, which is known as “chasing losses.” The second-phase gambler usually begins to borrow money with which to gamble, and often must lie in order to secure loans from friends, family, and associates.

At some point during the second phase, there is usually a major setback, such as serious financial trouble or problems at home. Usually, the gambler is able to obtain the first “bailout” in the form of a concerned party’s loan – generally more than the gambler actually needed, so there will be money left with which to continue gambling. The compulsive gambler considers this “bailout” a win, and often returns to “the action,” gambling more feverishly than ever.

The third phase, or “Desperation Phase,” can last for a short time, or for several years. Now the majority of the gambler’s time is spent gambling or thinking about gambling, and the problem is now something he or she cannot control. The third-phase gambler knows that he or she will lose, but it doesn’t matter; gambling has become an irresistible compulsion. Deception of associates and loved ones reaches a crisis level, as the gambler must obtain gambling money no matter what, often through thievery or other illegal activity. The gambler thinks of stolen money as a loan, which will be paid back as soon as the next big win. The gambler in this phase is sometimes able to continue presenting an outward appearance of calm control, but his or her family life is often in shambles by this period. Rent, utilities, and other expenses are often unpaid, credit cards are “maxed out,” and inner feelings of self-loathing are common. If financial trouble has become very serious, the compulsive gambler may begin to blame it on losses, rather than on the gambling problem itself. Suicide is often contemplated during the third phase.

Women and Gambling

Until fairly recently, gambling was thought to be a male domain, and women were not considered to be at risk for gambling problems. However, with increased legalization and access, gambling has become one of North America’s fastest-growing industries. Male-dominated venues such as off-track betting establishments now share their business with family-friendly casinos inspired by theme parks. Gambling now engages a much wider spectrum of the population, and the number of women who gamble compulsively is increasing rapidly.

Often, women gamble for different reasons than men. Men are generally drawn to gambling for its elements of competition and “fast action” with “big money” stakes. Because a win is gratifying to the ego, male gamblers usually must believe that they win because of their intelligence and skill, and are therefore more drawn to sports betting and card games. Women are statistically more likely to engage in less competitive games with a larger dependence on luck, such as bingo, slots, and roulette. They are more likely to see gambling as a social activity, and as an initially inexpensive form of entertainment.

Social stereotypes of problem gamblers uniformly depict a gregarious, boastful male, who prides himself on his alleged success as a gambler. A female compulsive gambler is more likely to be a “closet” gambler, as women are less likely than men to repress feelings of shame and guilt. Because of the hidden nature of secret gambling, her problem is less readily identified, and she is less likely to seek support in overcoming it.

Treatment

A great many compulsive gamblers are able to regain control over their lives by undergoing treatment. Treatment for gambling addiction is quite similar to treatment for drug and alcohol addiction, and begins with recognition of the problem. Because compulsive gamblers, like alcoholics or drug addicts, are often in denial about their problem, the first step is often the most difficult. Most problem gamblers enter treatment only due to pressure from others; in many cases, a problem gambler may agree to undergo treatment because he or she has been told that there is no other way to maintain the trust and presence of their loved ones.

Individual and group therapy are often recommended, and twelve-step support programs have helped many compulsive gamblers overcome their addiction. The abstinence principles which apply to other types of addiction are also relevant in the treatment of gambling addiction. Recently, antidepressants and other medications have helped in some cases, but it is important to understand that gambling addiction is a psychiatric disorder, and effective treatment must derive from some form of therapy, even if it takes place outside the clinical context.

If you are living with a problem gambler, you too may benefit from counseling, which can help families to understand the issues and make healthy decisions about how to deal with them.

Prevention of gambling addiction is difficult because of the same challenges faced by gamblers seeking treatment. If a potential problem gambler realizes his or her high risk, he or she may seek “pre-emptive” counseling in order to avoid developing a problem. Men and women who know themselves to have “addictive personalities” should probably avoid recreational gambling, as they are more likely than others to develop a serious problem. As with drug and alcohol addiction, people who have close relatives with gambling problems should be particularly careful.

Recovery among serious problem gamblers is more likely when the gambler receives support through a professional provider who understands the psychology of addiction and compulsion. In most successful instances of recovery, the gambler’s family is involved in the treatment, and acknowledges that their loved one’s addiction is a disease. Because the compulsive gambler’s urge to gamble is so intense, and so laden with outward justifications, recovery is only possible through a genuine desire to overcome the problem.

Author: Noah Diamond

Links

Gamblers Anonymous: http://www.gamblersanonymous.org

National Council on Problem Gambling: http://www.ncpgambling.org

MedicineNet: http://www.medicinenet.com/script/main/art.asp?articlekey=31458

Henry Ford Health System: http://www.henryfordhealth.org/12611.cfm