OVERCOMING GAMBLING ADDICTION
CONTENTS:
1. What is Gambling Addiction?
Pathological/compulsive/problem gambling is an addiction similar to chemical addiction and can result in the gambler experiencing a ‘high’ similar to a cocaine addict receiving an infusion of cocaine. Gambling whether, bingo, the lottery or a visit to the casino, is physically arousing.
Gamblers are highly motivated to gamble and pressure to stop is usually external. You need to admit that your gambling is a problem to both yourself and others close to you, in order to be on the road to recovery.
There are four legal categories of gambling:
Gaming (card games, fruit machine, casino games such as roulette).
Betting (horse races).
Lotteries (raffles and bingo).
Speculation (gambling on insurance, business or stock markets).
Not all forms of gambling cause problems – it is when there is an opportunity to place large and/or frequent bets that addiction tends to occur. Examples are horse races, lotteries and fruit machines.
Easy access to gambling is also likely to lead to compulsive gambling.
Excessive gambling can lead to depression, anxiety, and alcohol and drug misuse. The stress of financial pressures may result in the person committing a crime to provide for their debts or further gambling.
See Program 4: Overcoming Addiction.
There is also emotional strain due to the fear of discovery and interpersonal relationships and performance at work suffer as a result of gambling addiction.
See Program 1: Coping Strategies Counselling Advice – Troublesome Emotions, Forgiveness, Program 6: Overcoming Anger, Program 8: Overcoming Anxiety and Program 12: Overcoming Depression.
Gamblers often experience a craving for gambling and are preoccupied with gambling to the exclusion of everything else. They fantasize about winning and are irrationally confident. They become irritated if anything hinders their gambling. On winning there is a sense of elation and on losing there is remorse and worry about how to cover living expenses, which can lead to alcohol and drug misuse to forget problems.
Gambling addiction develops from gambling at acceptable levels to losing control at some point due to not being able to resist the chance to gamble or from not being able to stop gambling. Loss of control may be rapid or it may be gradual but progressive. Some may proceed to sudden prolonged sessions of gambling – a binge.
There are three phases of pathological gambling:
The winning phase – marked by ‘beginner’s luck’ leading to initial excitement and fantasies about winning more and more.
The losing phase – the longer one gambles, the more likely one is to lose. Chasing losses begins and the gambler starts to gamble secretly.
The desperation phase – a vicious cycle is set up of chasing losses, winning occasionally and suffering more losses and so on. Irrational gambling begins often leading to serious consequences such as court convictions.
2. How Does Compulsive Gambling Affect the Gambler and Others?
Those on low income and unemployed persons are more susceptible to gambling problems than those on high salaries. Impulsive gamblers tend to start gambling at a younger age and have more financial difficulty. For some gamblers, gambling is a form of emotional escapism to evade their emotional problems via the distraction of excitement.
Depression can cause problem gambling and equally compulsive gambling can result in depression – about 75% of compulsive gamblers suffer from symptoms of depression.
See Program 12: Overcoming Depression.
Distress about financial problems, fear about being discovered to be gambling or to have committed a criminal offence as a result of gambling, as well as the low mood of depression – all lead to despair and put strain on interpersonal relationships. 60% of compulsive gamblers contemplate suicide and 20% have attempted suicide during a crisis.
Gamblers suffer from anxiety and tension due to the stress associated with compulsive gambling, leading to irritability and outbursts of anger. Disturbed sleep causes fatigue and exacerbates bad mood.
See Program 1: Coping Strategies Counselling Advice – Problem-Solving, Program 22: Overcoming Stress and Program 23: Overcoming Stress At Work.
Excessive gambling may lead to an alcohol or drugs problem where the gambler tries to escape their worries by drinking or taking drugs. Alcoholism can lead to the alcoholic losing control over gambling – they may find it hard to stop gambling once started or go on a binge and lose a large amount of money.
Gambling interferes with the gambler’s capacity to do their work effectively and often results in resignation or termination of employment – the former usually to avoid detection of criminal activities undertaken to secure money to gamble.
Lying becomes a way of life for gamblers and you need to open up and admit the urge to gamble to someone close to you who can support you in your goal to overcome gambling addiction. Admitting to the urge to gamble often curbs the desire to do so.
The stress of gambling can affect concentration and the ability to make decisions. Gamblers tend to suffer from stress-related physical problems such as headaches, muscular aches, pain and high blood pressure.
Couples argue frequently about financial difficulties and the gambler withdraws from family excursions due to conflict with gambling opportunities or lack of funds, resulting in loss of friends. Gamblers become irritable and moody when social functions interfere with gambling. They are often abusive to their children and wives. The result can be periods of marital separation and divorce.
See Program 15: Overcoming Grief And Bereavement.
Spouses react with confusion about what has happened; guilt that they did not realize earlier; anger at what their partner has done to the family; loss of trust, uncertainty, insecurity and fear; worry for the future.
See Program 13: Overcoming Destructive Relationships.
3. Treating Compulsive Gambling
Aversive therapy can be used to treat gamblers, where a new association is formed between gambling which was previously seen as pleasurable, and an aversive or unpleasant stimulus such as electric shocks to the fingers when playing slot machines.
A highly effective alternative is cognitive behavioual therapy. Gamblers have distorted or irrational ways of thinking which need to be identified and corrected if compulsive gambling is to be overcome.
See Program 1: Coping Strategies Counselling Advice – Modifying Maladaptive Thinking.
Gamblers often believe they have some skill in chance events. They tend to focus on wins and discount losses. Some gamblers may be superstitious and be over confident in their own luck.
Pathological gambling may be treated with drugs which improve mood or reduce impulsivity but medication treatment is best combined with psychological approaches such as cognitive behaviour therapy – CBT.
Depression associated with compulsive gambling can be treated with anti-depressants such as tricyclics (e.g. imipramine, amytriptyline) or monoamine oxiadase inhibitors (e.g. phenelzine) or selective serotonin re-uptake inhibitors (e.g. fluoxetine). SSRI's may be used and work either by reducing depression or acting on lowering impulsivity.
There are two principles of treatment - ‘abstinence’ (no gambling whatsoever), and ‘controlled’ gambling (gambling at reduced levels has benefits despite the continued presence of gambling).
Abstinence is advocated in the first instance and once control over compulsive urges is demonstrated, controlled gambling can be considered. However, the best advice is always to avoid gambling.
It is necessary to have a relapse prevention strategy to ensure you do not fall back into old habits of gambling.
Take care of your health.
See Program 1: Coping Strategies Counselling Advice – Nutrition, Exercise, Managing Your Time and Sleep Management.
Improve your social network.
See Program 1: Coping Strategies Counselling Advice – Social Skills Training, Communication Training and Negotiation Training.
For some further helpful coping strategies:
See Program 1: Coping Strategies Counselling Advice – Competitiveness and Perfectionism, Frustration, Procrastination, Problem-Solving and Persistence.
4. Motivating Yourself to Stop
If you are in a crisis situation and likely to self-harm consult your doctor immediately. Once you are no longer in danger of harming yourself you can continue with this advice.
See Program 1: Coping Strategies Counselling Advice – Criticism, Countering Self-Criticism, Improving Your Self-Image and Combating Self-Harm and Coping with the Need for Approval.
First you need to decide if your goal is to become completely abstinent and never gamble again, or to control your gambling to acceptable levels.
List reasons for and against complete abstinence and controlled gambling, to help you decide on your ultimate goal.
You need to be honest to your partner, about your level of debt and perhaps seek financial assistance.
If you are committing offences to support your gambling habit:
Stop any further offences immediately.
Take responsibility for your actions – accept the consequences, with legal help.
Discuss your actions with your partner.
Avoid drinking before or during gambling. Talk to your partner rather than drowning your sorrows in drinking after losing. If you are dependent on alcohol and/or drugs, consult your doctor. In a crisis seek help immediately rather than turn to alcohol or drugs which can increase your risk of self-harm.
Marital problems are caused by the financial strain of gambling and you may want to consult a marital counsellor.
Exposure to gambling can lead to the development of a gambling habit. Gambling has many similarities with substance abuse and may be treated effectively using addiction treatment strategies. Emotional responses such as stress, anxiety and depression may cause increased gambling behaviour.
Keep in mind that overcoming gambling will considerably improve your quality of life. Perhaps you feel ambivalent about giving up gambling – it is necessary for you to understand your motivation. Write down at least ten reasons to stop gambling and list them starting with the most important. Do the same for reasons to continue gambling.
Compare the two lists – can you see that your behaviour is affecting not only you, but also others close to you? Your gambling arises from selfish reasons and causes problems in all aspects of life. Your stress levels would be much lower if you stopped gambling.
Is your self-aim, abstinence or controlled gambling? If it is the latter you need to review your motivation. You will have to specify how much time and money you can allow yourself each week and stick to the plan. You should involve someone close to monitor your gambling each week, as well as seeking support from an external professional. If you are reluctant to do this and feel you can monitor yourself alone, you need to seriously reconsider your motivation to overcome your problem gambling.
Others can help motivate a gambler by:
Not pressurizing the gambler to seek help, since nagging tends to lead to resistance to help.
Ensure the gambler takes responsibility for action to stop gambling.
Provide them with information on what help is available.
Do not keep the problem hidden from others.
Protect yourself against any debts the gambler may incur and remove you from being responsible for these debts.
Do not pay off the gambler’s debts – they need to learn to be responsible for any problems caused by their gambling.
The gambler should not be seen as suffering from an illness and unable to control themselves – rather they fail to control themselves.
Consider the benefits for yourself and others if you stop gambling. Determine your level of motivation – are you realistic in your goal?
Monitoring your gambling will make clear any patterns in your gambling. You will notice the change in your level of gambling from following this advice and your motivation will increase. Also, you will become aware of exactly how much money you are gambling.
Use a separate sheet for each day and record gambling details immediately rather than rely on your memory later.
Make eight columns:
In column one: Record the time and place you gambled.
In column two: Write in detail your specific thoughts and feelings that made you decide to gamble. Rate your level of anxiety/depression 1-10 (1 is no anxiety/depression and 10 is extreme anxiety/depression) before gambling.
In column three: Note any money borrowed for gambling, from whom and the total amount of money owed to that person.
In column four: Record cash you actually have at your disposal before gambling, not that which has been borrowed in any manner (e.g. withdrawn from a savings account or used instead of paying the rent or bills).
In column five: Record cash remaining at the end of a gambling session.
In column six: Record your winnings.
In column seven: Record your losses.
In column eight: Note in detail your thoughts and feelings at the end of a gambling session. Re-rate your anxiety/depression 1-10 (1 is no anxiety/depression and 10 is extreme anxiety/depression).
At the bottom of the sheet total column three to see how much borrowed money you are risking.
Total column seven (losses) and subtract this loss total from the total of column six (wins). If this figure is negative you have lost. You will need to record this figure on another sheet as explained below:
Make three columns with seven rows – one for each day:
In column one: Record the date for each day.
In column two: Record the total winnings for the day.
In column three: Record the total losses for the day.
Total the loss column and subtract from the win column total to get the overall loss or winnings for that week.
Review your monitoring sheets regularly. Consider any patterns in your gambling (e.g. are there particular times, specific emotions or regular venues associated with your gambling?) Does a particular emotion or reference to gambling trigger your urge to gamble? How do you feel when you lose and what effect does this have on your gambling?
6. Using Relaxation Techniques to Control Your Urge
You may feel that the urge to gamble is overwhelming and beyond your control. Your mistaken confidence and tension grow until the urge is finally satisfied through gambling.
Imaginal desensitization is a relaxation based technique which reduces the urge to gamble and the tension produced in resisting the urge to gamble. Physical relaxation is combined with mental images of being confronted with the chance to gamble but not doing so.
Write down in detail a typical example of your pattern of gambling then break this down into six scenes, from the instructions to imagine the start of the urge to gamble, to successfully not gambling despite the opportunity.
Read out loud and tape record the following:
Relaxation instructions, scene 1
Relaxation instructions, scene 2
Relaxation instructions, scene 3
Relaxation instructions, scene 4
Relaxation instructions, scene 5
Relaxation instructions, scene 6
Each scene should take about five minutes to complete.
Formulate relaxation instructions for imaginal desensitization using the method of PMR.
See Program 1: Coping Strategies Counselling Advice – Controlled Breathing and Relaxation Techniques.
As you listen to the imaginal desensitization tape follow the relaxation instructions then imagine each scene remembering to relax during each scene.
The more you practise, the more skilled you will become in applying the technique efficiently. You will need to listen to the tape 2-3 times a day for a week then once a day until you have mastered the technique. After that, you may use the tape as required.
The first tape is sequence 1 – write two other such sequences describing your thoughts, feelings and behaviour prior to, during and after successfully not taking the opportunity to gamble.
Eventually you should be able to apply the technique whenever you experience an urge coming on.
Deal with your distress in situations you fear by exposure – FEAR (face everything and recover).
See Program 1: Coping Strategies Counselling Advice – Controlled Breathing and Relaxation Techniques, Eye Movement Technique (EMT), Mood Induction Procedure, Rational Emotive Imagery (REI), Imago Graded Exposure and In Vivo Graded Exposure.
7. Handling Triggers Associated with Gambling
You become conditioned so that certain cues or triggers activate gambling related thoughts and feelings which can be so strong that they have been described as being similar to a drug ‘high’.
Triggers include emotions, times and places as well as cues directly related to gambling.
Review your monitoring sheet and write down any situations you notice that lead to increase in your gambling urge (e.g. seeing a betting office as you pass it or a lottery broadcast on television).
In order to control your urge it is necessary to avoid any situations that remind you of gambling. Realistically you will not be able to avoid every cue but you can try to:
Avoid reading the race results in the newspaper and switch off the television or radio when results are being broadcast.
Decline any social gambling activity – you will not lose any friends worth keeping. Ask for your friends’ support in helping you.
Avoid gambling on the way home by changing your route or having company with you.
Arrange activities with others at high-risk times so that you are distracted and do not dwell on your urge to gamble.
As a cue sets off your urge to gamble, use imaginal desensitization to relax and release tension so help you control your urge.
On a flashcard write the four most negative consequences of acting on your urge. On the other side write: How will I feel when I lose? Keep this card close at hand to read frequently and whenever you feel the urge to gamble.
For many people gambling reduces their level of tension so when they are stressed they gamble to lift their mood, evade worries and cares or ‘take-out’ their anger by gambling. Review your monitoring sheet to see if unpleasant mood states are associated with your gambling. Write down the emotions that trigger your urge to gamble. List situations that remind you of gambling and write down strategies to avoid these situations.
8. Identifying Irrational Beliefs
Your attitudes and belief structures related to gambling influence your behaviour. Write down your beliefs and attitudes about gambling (e.g. ‘I am skilled at gambling and can be a winner’).
Consider some common erroneous beliefs:
Gamblers mistakenly believe that gambling is a source of income rather than a costly form of entertainment.
The most erroneous belief among gamblers is that they can win at gambling. This fantasy is encouraged by the media. Next time you win, note how much money you have lost trying to gain that win. Start to focus on your losses rather than emphasizing your wins.
Gambling is a game of chance but many gamblers are deluded that they have special skills to influence the outcome of chance events.
Write down the strategies you use and determine which ones are based on real skill and which are just superstitious beliefs.
Biased thinking leads gamblers to take credit for winning and boasting of their skills whilst when they lose they dismiss the losses, blaming external causes. Write down the last three times you won, how much each time and where. Next, write down the last three times you lost, how much each time, where and why in each case. You are likely to find it harder to remember your losses than your winnings. Near-wins are almost as exciting as actual wins but you need to realize that the end result is you lost and the near-miss has no bearing on the next event.
Many gamblers mistakenly believe gambling can solve their financial problems. Since gambling got you into debt in the first place, it is illogical to believe gambling will solve your financial problems. Moreover, gamblers tend to prefer to keep their winnings for further gambling rather than pay off debts. Even if debts are paid off, continued gambling results in more debts.
Gamblers often use the excuse that gambling is an illness over which they have no control but the truth is that they choose to gamble despite the harm to themselves. In order to regain control over your life you have to take responsibility for your actions.
9. Challenging Irrational Beliefs
Write down a few thoughts you have when you feel the urge to gamble. For each thought: Look closely at and challenge the evidence you think supports your belief. Is your thought rational? If not, why not? What is a more realistic view? You need to challenge that you are under an irresistible urge over which you have no control, and realize that you are in fact making a voluntary choice. Replace irrational thoughts with rational, positive thoughts that give you confidence and self-control.
Improve your self-confidence.
See Program 1: Coping Strategies Counselling Advice – Assertiveness Training, Neuro-Linguistic Programming (NLP), Building Confidence I, Building Confidence II, Building Confidence III, Building Confidence IV and Program 16: Overcoming Low Self-Esteem.
Practise writing down the situation, your irrational thoughts, challenging thoughts and positive thoughts.
See Program 1: Coping Strategies Counselling Advice – Modifying Maladaptive Thinking.
Learn to plan ahead and avoid risky situations that may lead to a relapse. You are bound to struggle on your path to recovery. Do not dwell on lapses – you need to be more careful in the future. Re-read this advice and renew your efforts. For additional problems (e.g. depression), consult your doctor or a counsellor.
Unpleasant moods and emotions, interpersonal conflicts and social pressure can singly or in combination contribute to the appearance of an urge. Note down a list of positive strategies you can apply to overcome these factors. Write the most useful strategies on an index card to keep close at hand.
Do you try to justify approaching a gambling situation? If so, think of alternative action that avoids exposure to gambling cues, for example, instead of playing the slot machines to relax, after an argument with your partner, try resolving the conflict.
Write down on index cards alternative actions to avoid exposure to gambling cues in all circumstances you face.
On a flashcard write down three good reasons why you should not continue to gamble and keep it close at hand, with the card on which you have written: ‘How will I feel when I lose?’ When you feel a lapse is impending take these cards out and read them to remind you to avoid gambling.
Practise declining invitations from others to gamble and make a habit of discussing your urges with your partner. Immediately inform your partner if you gamble any amount of money. Do not hold back your emotions. Ask for your family’s support. Work out a budget with your partner and limit your access to cash. Accept that your family are concerned about you and are trying their best to help you overcome your gambling addiction and move forward.
See Program 1: Coping Strategies Counselling Advice – Relapse Prevention.
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