George lost his job and can’t afford a vacation, but says, “I have $40 so I may as well gamble – I might win thousands and be able to go on vacation.” These economic times are challenging all of us to make different financial decisions.
During the Great Depression, gambling was up and last year lottery sales were up in 42 states. (McMahon) Calls to the 1-800-BETS OFF helpline increased 41 percent from FY 2002 to FY 2008. McMahon notes a very serious side effect for gamblers is that “suicide rates among compulsive gamblers are more than 20 times higher than in the general population, according to the crisis center.”
Furthermore, suicide rates are between two and four times higher for people who can’t find a job than for people who are employed, according to the American Association of Suicidology. Hence, we really need to help the unemployed gambler, George, get out alive.
Pathological gamblers, like George, and other addicts may not be gambling or using drugs to feel good but “to stop feeling bad.” Gambling is a financial anomaly where one tries to gain wealth by engaging in a behavior that decreases wealth. Some of my recovering gamblers chuckle that “gambling is for those who are poor at math” and later learn that the only guarantee with gambling is that “the more you gamble, the more you’ll lose.”
Gambling often involves escaping from work, stress or family and “playing” the slots or other “games” of chance. In economic hard times, George may not be able to afford a vacation, but he can afford a chance at winning a trip to Hawaii. Other “action” gamblers are excited to bet with peers on sports or craps as they feel the neurotransmitter “highs” and forget their daily troubles.
A wonderfully prolific researcher and writer, Nancy Petry, has identified several major precipitants of potentially hazardous gambling behavior: “a lot of free time, unstructured time; available cash (though not necessarily wealth), adverse moods, such as depression or loneliness; family conflict … and a trauma.” (Buck) When our clients are going through tough economic times, the stress and Petrie’s precipitants noted above can easily trigger gambling behavior.
The loss of a job or home foreclosure can be traumatic and again trigger a gambling or addictive episode. I call gambling treatment “Addiction Plus” because it has all of the attributes of addiction plus other concomitant stressors or psychiatric disorders. Other Axis I and Personality Disorders are often present in problem gamblers that seek treatment. I often ask myself, “Which of the four presenting issues shall I start with?” knowing that I often will need to deal with all four simultaneously.
If sport betting, cards and casinos weren’t bad enough, along comes Internet wagering. Gamblers do not have to plan ahead, get dressed or drive, they can just impulsively log on. Underage, minorities, disabled and non-English speaking patrons can easily access gambling sites 24/7. “A recent report released by Ernst and Young indicates that online casinos are faring far better than their land-based counterparts during the world economic slow down.” (Royal Casino Guide)
Treatment and recovery for the problem gambler starts with at least a partial recognition of the problem and willingness to do something different. As therapists successfully treating problem gamblers, we need to employ all that we know about addiction, plus include treatment for impulsive and co-occurring disorders.
Pathological Gambling in the DSM-IV is an Impulse Control Disorder and requires knowledge of dealing with behavioral patterns similar to treating impulsive adolescents. Most problem gamblers are actually being treated by individual psychotherapists because there are very few gambling treatment centers and the gamblers may not live near one or have any financial means to travel or admit themselves.
Outpatient gambling treatment, according to experts like Robert Ladouceur (2007), should involve at least 12 structured sessions with specific homework assignments. The “softer” intervention techniques allow these clients who have atrociously poor stress management skills to stay aware of options.
GamBlock.com is an easily downloadable and very helpful tool that will block new online gambling sites and software.
The more we can help our clients to have abundant coping and supportive options, the less we’ll have to worry about clients like George considering suicide and resorting to gambling as a way of coping with negative economic pressures. Of course we do want him to get out alive.
Gary Lange, Ph.D., is a licensed marriage and family therapist in private practice in Rancho Mirage, Calif. He is one of the first to be nationally certified as a gambling counselor in California and is chair of the Training Committee for the California Council on Problem Gambling. He may be contacted by e-mail at: email@example.com or by telephone at: 760-773-1014.