Compulsive gambling is a very addictive disease that can cost you more than its worth. So why do people become compulsive gamblers? In America 2-3% of adults are afflicted by this addiction. Four out of Five compulsive gamblers are men. Over 90% of compulsive gamblers have gambled since their mid-teens. There are many reasons why people become compulsive gamblers. Throughout my paper I will go over many types of research that have been done on this disorder and show you a variety of reasons why people subject themselves to this behavior.
Problem gamblers do not ingest, inject, or inhale substances as chemically addicted people do. Just what is it to which they become addicted? The answer to this question is action. Action is an aroused, euphoric state involving excitement, tension, and anticipation of the outcome of a gambling event. It is the thrill of living on the edge. Problem gamblers describe gambling as high similar to that experienced from many drugs. Some experience these sensations when just thinking about gambling, as well as when they are actually gambling. Action also has been described as a rush that may include rapid heartbeat, sweaty palms, and even nausea. It is not uncommon for problem gamblers to describe being in action as better than drugs and better than sex. When they are in action, they lose track of time and sleep; food, water, and using the bathroom become lower priorities than staying in action.
Some doctors believe that gambling is considered an impulse control disorder. Which means that the individual is incapable or resisting his impulses to gamble. Others believe that it is an obsessive-compulsive disorder or a non-pharmacological addiction. This means that they show an intense desire to perform a specific behavior preceded by an unpleasant feeling. An alternative model of compulsive gambling is as a heterogeneous disorder with different subtypes sharing certain characteristics.Compulsive gambling may not fit into one of the models mentioned above, but rather a mixed group with different subtypes that share certain characteristics.
Both biological and psychological factors play a role in compulsive gambling. Pathological gambling is a chronic and progressive condition that disrupts the life of the individual and those close to him. Not only is pathological gambling associated with financial problems due to the large amounts of money spent on the activity or the loss of a job, but this disorder increases the likelihood of other emotional and psychiatric problems, and general health problems in the individual or his family (Lorenz V, Yaffee, R. 40-49). Suicide is a possible consequence of pathological gambling. Other consequences might be mood disorders, schizophrenia and some neurological conditions.
The World Health Organization (WHO), as well as the APA, classified Compulsive gambling as an impulse control disorder, because the individual becomes increasingly incapable of resisting his impulses to gamble. All the impulse control disorders share the following characteristics: difficulties to resist an impulse, desire or temptation to perform some behavior that is detrimental for the individual or others; a progressive emotional discomfort or tension before performing the act; pleasurable or gratifying feelings while performing the behavior, which means that the behavior is egosyntonic; in some cases, negative feelings of guilt, remorse or shame when the act is over. All these characteristics are recognizable in a compulsive gambler.
Some doctors consider that pathological gambling is best understood as an obsessive-compulsive disorder. The term obsessive-compulsive disorder is used to describe a group of disorders with similarities that also share genetic and biological mechanisms. Patients that have obsessive-compulsive disorders show an intense desire to perform a specific behavior preceded by unpleasant feelings and physiological activation, all of which are relieved when the behavior is performed (Hantouche and Merckaert 393-408).
In addition, it has been noted that in a compulsive gambling creates a repetitive thought related to gambling that they cannot remove from their minds. This leads them to gamble against their will, especially in advanced phases of the disorder (Lesieur 79-87).
Another view of compulsive gambling is through a non-pharmacological addiction. The common elements to all kinds of addiction are an intense desire to satisfy a need, loss of control over the substance or behavior. Symptoms of abstinence and tolerance, thoughts about the use of the substance and performance of the behavior despite its adverse consequences (OMS, 1993). All these elements are present in compulsive gambling. Gamblers intense longing to bet is equivalent to the cravings experienced by substance abusers, a study done by Castellani and Rugle (1995).
Although problem gambling is similar to substance abusers in many ways, it is much more difficult to detect because there are no physical signs of it as there are with addiction to alcohol or other drugs. You cannot smell problem gambling on a problem gamblers breath. A problem gamblers eyes do not dilate. Dice, chips, and cards do not leave marks on a problem gamblers arms. Problem gambling does not make you walk funny, stagger, and fall down in a stupor the way excessive alcohol consumption can. Given all this, it is not surprising that problem gambling is a hidden, difficult to detect addiction.
The absence of physical signs of gambling addiction also makes it easy for the problem gambler to conceal and deny the problem. The closest people to a gambler are his or her family, friends, and co-workers who can be easily deceived by him or her. Problem gamblers are skilled liars, and are very clever at concealing their gambling activities and gambling related problems. The absence of physical signs of the addiction aids the problem gambler in maintaining the deception.
While psychiatrys official diagnostic manual classifies pathological gambling as a disorder of impulse control, like the need to steal or set fires, new data directly challenges that view. The first study of pathological gamblers to use sophisticated medical techniques has found that they may suffer from disturbances in their central nervous systems.
The study showed that the gamblers had lower levels than usual of the brain chemicals that regulate arousal, thrill and excitement. They may engage in activities in the noradrenergic system, which secretes them. Chronic gamblers like sky divers and those who take to other high-risk sports are more prone to thrill seeking than most people (New York Times, October 3, 1989). Pathological gamblers seem to be driven by the need for the thrill; it stimulates an under active noradrenergic system, said Dr. Alec Roy, a psychiatrist formerly at the National Institute on Alcohol Abuse and Alcoholism. Dr. Roy did the new study with the institutes co-director Markku Linnoila, a psychiatrist. It was published in the August issue of The Archives of General Psychiatry.
In the study, 17 chronic gamblers, many of whom were in legal trouble because of crimes they had committed to pay gambling debts, came for tests and observation at the institute. Using urine samples and spinal taps, the researchers determined that there was a significant deficit in levels of a byproduct of the brain chemical norepinephrine. Norepinephrine is secreted under stress, as in moments of great risk or intense excitement. Some brain researchers think such a deficit can lead to a need to engage in activities like risky, exciting games that will stimulate the brain to secrete more of it.
If gamblers have an abnormality of the adrenergic system, it could make them seek the excitement of gambling as a way to increase their norepinephrine levels, said Dr. Roy. He noted that chronic gamblers have told researchers that they gamble for the thrill, not the money (New York Times October, 1989).
Behavioral psychotherapy is an educational model of therapy; it is self-directed with the therapist acting as educator, adviser and coach. Outpatient management begins with two assessment sessions to set up the treatment, each taking one hour, with once a week therapist sessions of approximately half and hour. The main focus of therapy is homework between sessions, monitored on homework sheets by the client. Progress is monitored on homework sheets by the client. Progress is monitored every four weeks and if progress is not maintained, then therapy is discontinued. If outpatient therapy is unsuccessful, clients are offered an inpatient program.
In our own work with pathological gamblers, we have recognized similarities with anxiety disorders. The uncontrollable urge to gamble described by patients is similar to the compulsion felt by patients with obsessive-compulsive disorder. That a behavioral technique such as imaginal (systematic) desensitization was effective for anxiety disorders and pathological gambling, suggests that some aspect of the therapeutic response is common to both disorders.
There is growing evidence for using exposure in the treatment of pathological gamblers. In exposure, clients are asked to grade their gambling triggers from very difficult to relatively easy. They are then asked to enter the easiest of the situations and remain there until the urge to gamble habituates. This is repeated daily until they are able to move onto the next stage. While their in this situation, they are asked to resist the urge to gamble. Therefore the four principles of exposure are used with gamblers (graded, prolonged, repeated, and the person focuses on the task). Graded exposure differs from imaginal (systematic) desensitization in that the pairing of relaxation is not present. In treatment of anxiety disorders the need for relaxation has been shown to be largely unnecessary, with the habituation model employed by exposure providing the best results (Marks, 1987).
For my interview I went to Dr. Gene Atkinson a local physiatrist do discuss ideas about compulsive gambling and treatment plans hes used with patients. Here are some of the questions and answers is compulsive I received from him.
Compulsive gambling is a condition in which the patient doesnt have the ability to stop themselves from gambling. Due to the rush it creates.
Why cant a compulsive gambler simply use will power to stop gambling?Most people realize they have a problem, but are merely caught off guard under circumstances. Many can stop for long stretches of time, but the defenses that they relied upon gave way before some trivial reason for placing a bet. In most occurrences the will power of the individual is has no effect on their ability to stop gambling. Problems are typically solved with adherence to more spiritual principles. What is the first thing a compulsive gambler should to in order to stop gambling?The first step in recovery is facing the fact that they have a problem, and that they need to deal with it. This often times is the most difficult step. Treatment is almost always successful as long as the patient honestly has the desire to stop.
How can you identify a compulsive gambler?Many times it is very hard to identify a compulsive gambler. Often times they are very good at deceiving others. Most that are identified as compulsive gamblers have come forward, due to subtle deterioration in many aspects of their life. Can a compulsive gambler ever gamble normally again?No, compulsive gambling is very similar to that of alcoholism. Once a person becomes a compulsive gambler they no longer have the control to keep the habit within responsible nature. Dedication to abstinence is key, without it they will inevitability return to their destructive nature.What treatment plans are available to those who wish to seek help independently?Although in most occurrences this approach is unsuccessful. One can seek help from a local Gamblers Anonymous group. Spiritual and religious help as also been shown to be successful. Have people been shown to be genetically more susceptible to compulsive gambling?Yes, like many other disorders associated with excitement, compulsive gambling is caused by an addiction of many hormones, and chemicals secreted by the body into the blood stream during periods of excitement, or despair. So an individual genetically prone to releasing higher amounts of these hormones and chemicals would become more susceptible to compulsive gambling.
Are periodic binges grounds for treatment of compulsive gambling?Yes, during periods of time when the individual is not gambling, they are often irritable, frustrated, and indecisive, and their personal relationship continue to deteriorate. Typically the individual will progressively become more and more involved into gambling. Like drug and alcohol addicts, can intervention help them recover?In most cases no. It all goes back the same principle that the individual has to have the desire to stop from within. In fact in many cases the gamblers progress towards recovery is hindered by this unsolicited attention. In conclusion, compulsive gambling is an addiction many people do not understand or know about. Although no drug is consumed, there are still chemical dependencies present. This is why many people fail to identify the significance of the situation. Fortunately problem gambling has received a great deal of attention recently. As knowledge of the disorder spreads it helps individuals identify the symptoms of the disorder, and stop them before it can turn into a serious problem. National television shows have addressed these problems more frequently, this is important because many people limit their education to that of the TV. Further understanding of pathological gambling and addiction is guided by the development of better theory. Improved theory can guide research more effectively.
Bibliography:Goleman, D. (1989, October 3) USA: Biology of brain may hold key for gamblers. New York Times, p11.
Pavalko. (1999). Problem gambling. National Forum p28 (5p.). Available: Academic Search Elite http://ehostvgw18.epnet.com2002, April 10.
Lorez V, Yaffee R. (1986). Pathological gambling: psychosomatic, emotional and marital difficulties as reported by the gamblers. Journal of Gambling Behavior, p40.
Marks I.M. (1987). Fears, phobias and Rituals. Oxford University Press, London, p337.
