On a recent Wednesday, my local paper, The Seattle Times, ran an article on the increase in gambling addiction in the state of Washington. The article highlighted three at-risk populations: older adults, young people and certain ethnic groups. A retired administrator was highlighted; an intelligent, articulate woman in her 50’s who gambled away an estimated half a million dollars of retirement.2
On Thursday, the same paper ran two stories – one on a young man who started gambling in high school and continued through college, losing thousands of dollars.3 The second story spoke of a new state treatment program to treat problem and pathological gamblers.4
On Friday, the paper’s headline heralded federal approval of a new gambling license for yet another Native American casino in Washington.5
Such is the time we live in. the state acknowledges the damage of pathological gambling but continues to use gambling revenues to build up its general fund. Net receipts in Washington’s legalized gambling industry have increased more than three-fold in the past 10 years, up to almost $1.7 billion. That’s a lot of money to the state.
It’s also a lot of money to individual gamblers. For the female administrator, it was $500,000. For the young man, it was his entire $1,500 bank account at the Chips Casino, trying to make a month’s paycheck in one night.
Recognizing this dichotomy, my state launched a program this year to treat pathological gamblers, after an assessment and means test, funded by the state’s gambling revenues and voluntary contributions from the numerous Native American casinos that dot the Pacific Northwest.
Brave New World
Prior to 1980, there wasn’t even a diagnostic code for pathological gambling. Since that time, gambling has moved in, facilitated by cash-strapped states, willing to overlook or compensate for the resulting devastation on an acceptable percentage of their citizens. Gambling has increased and so have the number of people falling under this new diagnostic code.
Pathological gambling, in the DSM-IV, “is characterized by recurrent and persistent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits.” The following is taken from the DSM-IV Diagnostic Criteria for 312.31 Pathological Gambling:
- Persistent and recurrent maladaptive gambling behavior that disrupts personal, family, or vocational pursuits as indicated by five (or more) of the following:
1.The individual may be preoccupied with gambling (e.g., reliving past gambling experiences, planning the next gambling venture, or thinking of ways to get money with which to gamble)
2. Most individuals with Pathological Gambling say that they are seeking "action" (an aroused, euphoric state) or excitement even more than money. Increasingly larger bets, or greater risks, may be needed to continue to produce the desired level of excitement
3. Individuals with Pathological Gambling often continue to gamble despite repeated efforts to control, cut back, or stop the behavior.
4. There may be restlessness or irritability when attempting to cut down or stop gambling.
5. The individual may gamble as a way of escaping from problems or to relieve a dysphoric mood (e.g., feelings of helplessness, guilt, anxiety, depression).
6. A pattern of "chasing" one's losses may develop, with an urgent need to keep gambling (often with larger bets or the taking of greater risks) to undo a loss or series of losses. The individual may abandon his or her gambling strategy and try to win back losses all at once. Although all gamblers may chase for short periods, it is the long-term chase that is more characteristic of individuals with Pathological Gambling.
7. The individual may lie to family members, therapists, or others to conceal the extent of involvement with gambling.
8. When the individual's borrowing resources are strained, the person may resort to antisocial behavior (e.g., forgery, fraud, theft, or embezzlement) to obtain money.
9. The individual may have jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
10. The individual may also engage in "bailout" behavior, turning to family or others for help with a desperate financial situation that was caused by gambling.
- The diagnosis is not made if the gambling behavior is better accounted for by a Manic Episode.
We now have a name for it, a diagnosis for it. What we don’t seem to have is a consensus against it. Twelve years ago, after studying the situation as it existed then, “The National Council on Problem Gambling… advocated a public health perspective, pointing out that pathological gambling is more prevalent where gambling is more available, and advocating a national a gambling policy to restrict the availability of gambling (National Council on Problem Gambling, 1993. 6
Yet since 1993, in my state (and in most others), the availability of gambling hasn’t been restricted, it’s expanded. Because gambling has expanded, so have the number of people and families caught in the downward spiral of its problem and pathological side. The state is willing to accept this collateral damage. As counselors, this is unacceptable. Our mission is to assist these individuals to put back the shattered pieces of their lives, families, finances and faith.
The Face of the Gambler
The faces of the gamblers stared out at me from the newspaper over my morning coffee – an older woman with rows of books behind her (I could relate because my home and office are full of books), a young man fully entering adulthood with drive and determination on his face (I could relate because I well remember being that young man).
I’ve also seen them fact-to-face, sitting in my office, overwhelmed by the consequences of their gambling addiction, often only sharing this secret part of their lives as a result of the emotional scorched earth it leaves behind. It has generally been my experience that gambling does not surface immediately as a primary reason for a person or a family to seek counseling. More often, I’ve seen gambling interwoven around other issues. One of the most common companions to pathological gambling is alcohol abuse and a current study suggests that those with problematic gambling behaviors should undergo a chemical dependency screening.7
What to do the faces look like? They are more likely to have problems with alcohol, drugs, smoking and depression. Serious gambling problems can lead to suicide. While the poor appear to be an at-risk population for pathological gambling (Ladd, Petry, 2002), in a study for Arizona’s state-run lottery, 60% of those identified as problem gamblers worked full-time, with only 10% disabled or unemployed, a rate half of that of non-problem gamblers (20%).8
The faces are your neighbors, co-workers, friends and family. According to research by the Barna Group, “Of the ten moral behaviors evaluated, a majority of A
Americans believed that each of three activities were “morally acceptable.” Those included gambling (61%), co-habitation (60%), and sexual fantasies (59%).9 Moral acceptability of gambling is currently directly related to age, according to Barna. For the oldest Americans, half find gambling acceptable, while the number jumps to three in four for those just graduating high school. This culture increasingly finds gambling an acceptable behavior, the more who engage in it, the more will become trapped and the gallery of faces will grow.
The Downward Spiral
Even with other issues present, it is imperative that gambling be addressed, because of the destructive and progressive nature of the disorder. What starts as a preoccupation with thinking about gambling can lead to criminal activity to obtain funds to gamble, the loss of family relationships, financial resources, and employment. Simply stated, pathological gambling wrecks lives and ruins families.
There are three distinct phases in the progression leading to pathological gambling. Counseling may be sought during any of these phases, although the financial, personal, and peer pressure to confront gambling consequences may increase in the later stages and motivate a person to seek help.
The initial phase is known as the winning phase. It is during this phase that the gambler does not perceive any negative consequences to the gambling behavior. On the contrary, this phase is characterized by a sense of excitement and even euphoria. (for this reason, a manic episode involving excessive gambling. It is important to differentiate whether or not the manic characteristics are sustained outside of the gambling behavior, hence item B in the DSM-IV criteria.)
About half those identified as compulsive gamblers begin with a big win early on. This early win is identified as pleasurable by the gambler, who then seeks to replicate the feeling. Even if there is not an initial win, the sheer excitement of the act of gambling is interpreted as pleasurable, enticing the person to continue the behavior.
The more the person gambles to replicate the pleasure, the higher the odds s/he will lose. In the losing phase, the person starts to increase the amount of gambling in order to recoup losses (known as “chasing” losses) to recapture that initial feeling of excitement. The magnitude of the bets and/or the frequency of the activity increases to produce the same level of thrill or financial windfall.
It is at this stage that the gambler will begin to alienate family and friends, jeopardize employment, and borrow money. Sometimes, the gambler will experience a win during this phase or be enabled by family and friends to continue. These events merely forestall the inevitable. However, the heavier reliance on gambling does not produce the desired results long-term and the gambler sinks into the final phase.
As the person continues to gamble, s/he enters the desperation phase, gambling has now taken precedence over other, important considerations such as family, friend, work, and finances. In a desperate attempt to gain funds to maintain or even increase the amount of gambling, the person may resort to unethical or criminal behavior. Family members or friends may be lied to about the true reason for needing money. The person may cheat or steal from employers. Gamblers have been known to embezzle funds entrusted to them. It is during the desperation phase that pathological gamblers will have increased incidences of suicidal ideation as a way out of their difficulties brought by gambling.
Warning Signs to Watch For
In some instances, a pathological gambler, realizing the devastation his or her compulsion is causing, will come in for counseling specifically on this issue. However, pathological gamblers are not always forthcoming about their gambling behaviors, so there are specific signs to watch for during counseling on other issues that may point to the existence of a gambling addiction.
- Unexplained withdrawal of personal or family funds
- Unexplained time away from school, work or home
- Heightened irritability and hostility over financial matters
- Increased signs of depression and/or anxiety
- Increased isolation from family members
- Withdrawal from previously enjoyed social activities
- Unexplained mood swings
- Selling personal possessions
- Unexplained gifts or excessive generosity
- Borrowing from family and friends
- Unexplained indebtedness to credit cards
- Associated disorders
Associated Disorders
In my research, I believe that people become trapped in gambling behaviors out of a desire to obtain a euphoric thrill, to gain control over their lives through money, or to provide an escape from uncomfortable feelings and/or situations. Where one disorder takes hold, another can follow.
A link appears to exist between gambling behaviors and substance abuse through alcohol or drugs. These are not the only companions to gambling. The DSM-IV identifies “Mood Disorders, Attention Deficit/Hyperactivity Disorder, Substance Abuse or Dependence, other Impulse-Control Disorders, and Antisocial, Narcissistic, and Borderline Personality Disorders10 as being linked to Pathological Gambling. In some cases, these associated disorders precede and intensify the gambling behaviors, making it difficult to identify which came first. At some point, the only effective treatment is to recognize all of the associated disorders and factor them into a comprehensive treatment plan. In the case of Substance abuse or Dependence, this would require treating the person under a dual diagnosis of mental health and chemical dependency.
Treating the Whole Person
It is my belief that recovery from pathological gambling is possible and best achieved through a whole-person treatment model. By whole-person, I mean addressing the emotional, relational, physical, and spiritual components contributing to the person’s compulsion to gamble. Apparently, my state agrees. Providers approved to participate in the new treatment program are required to look at the individual’s relationships and spiritual resources, as well as legal and financial issues.
As Christian counselors,, we are uniquely suited to provide whole-person care, especially when our work with the individual can be partnered with a Christina physician or healthcare professional. As counselors, we can address the emotional and relational factors involve in the individual’s slide toward pathological gambling. Through our training, we can address the cognitive and behavioral aspects of their addiction, leading to personal insight and practical steps to modified behavior. As Christians, we can encourage and support the person’s spiritual resources, not merely through their faith community, but also through personal belief and reliance on God and Christ. Our understanding of and empathy toward a spiritual answer to their addiction is the strongest weapon in our arsenal against this continued personal corruption.
Whenever possible, I find it of great value to work with a Christian physician. People with addictions; in general have legitimate physical concerns that impact their ability to recover. This is no less true when the addiction focused on impulse-control. Gambling tends to combine with other physical addictions, such as to alcohol, drugs or cigarettes. A recovery plan should include strategies for physical wellness, including screening for substance abuse and depression.
Recovery from pathological gambling requires a concerted effort not only b the individual but also by the community surrounding that individual. As a counselor, you can provide an important piece of understanding and clarity of the true nature of the disorder. You can assist the person to make positive behavioral changes. You can provide motivation for the person to assemble outside resources from family, friends, physicians, support groups, financial counseling, and churches. The truth is, you can’t do this alone. The more resources the person has, the greater the success in overcoming an inevitable relapse. As a counselor, you will not be available to this person 24 hours a day and a relapse could occur during non-business hours. The more community support, the better.
Unfortunately, resources on the issue of pathological and problem gambling are slim. However, as the number of pathological gamblers grows, the community-at-large will slowly begin to take greater and greater notice. Christian professionals have been among the first to sound the alarm of pathological gambling, from resources through Focus on the Family to my book, Turning the Tables on Gambling, available through AACC.
Unfortunately, without a cultural consensus to reduce or eliminate the number of gambling options, Christian counselors stand on the front lines, helping those caught in the snare of problem gambling. As in any battle, forewarned is forearmed.
Gregory L. Jantz, Ph.D., is the executive director and founder of The Center for Counseling & Health Resources, Inc., with five branch locations in the Puget Sound area near Seattle, Washington (888-771-5166). He is the author of numerous books, including Turning the Tables on Gambling. To access information from his website, including an on-line compulsive gambling questionnaire, please go to www.aplaceofhope.com or www.overcominggamlbing.com
