Change Your Gambling, Change Your Life

Strategies for Managing Your Gambling and Improving Your Finances, Relationships, and Health

Howard Shaffer

• Publisher: Jossey-Bass
• Year: 2012
• Print ISBN: 9780470933077
• eBook ISBN: 9781118171035
• Edition: 1
• Topic: Psychology
• Subtopic: Addiction in Psychology
• Index: Psychology

A research-based guide to controlling the destructive urge to gamble

From Howard Shaffer, PhD, a noted expert on gambling addiction, and Harvard Health Publications comes Change Your Gambling, Change your Life, a landmark new book which explains how gambling problems are related to other underlying issues: such as anxiety, mood fluctuation, difficulty with impulse control, and substance abuse problems. Dr. Shaffer offers a series of self-tests to help evaluate the degree of gambling problem and analyze the psychological and social context of the behavior, with specific strategies and approaches for ending the problems with simple tools that anyone can do.

• Explains why many people have a problem controlling their urge to gamble and how that can be corrected
• Includes a toolbox of resources for anyone who wants to stop the vicious cycle of gambling
• Offers advice for avoiding slips and preventing backslides and how to deal with the consequences

With candor and expert advice, Change Your Gambling, Change Your Life provides proven techniques for controlling the urge to gamble.

Part 1: How to Begin

1

Assessing Your Problems

What you’ll learn in this chapter: As you think about changing your life, the information in this chapter can help you start the process with some preliminary information about problems with gambling and the other associated mental health issues we cover in the upcoming chapters. It includes descriptions and some general assessment tools to help you figure out which potential problems you might be experiencing in addition to your difficulties with gambling.

WHAT DOES IT MEAN TO BE ADDICTED TO GAMBLING?

It comes as a surprise to some, but you can be addicted to gambling in the same way that you can be addicted to alcohol or drugs. You can be addicted either to a substance, such as cigarettes or alcohol, or to activities, such as gambling or sex. Although there’s no precise definition of addiction or single accepted standard of treatment, there are certain ways of describing the experience to help you gain a better understanding.

Certainly gambling problems aren’t anything new; people have been writing about these difficulties as far back as 1812, and, reaching even further back into history, there are cave drawings depicting gambling-like behaviors. However, the concept that gambling is more than just a moral defect is relatively new. Most experts and clinicians now consider gambling addiction a legitimate biological, cognitive, and behavioral issue, and problem gambling can both follow from and lead to mental disorders and other problems.

Gambling problems have many potential causes: genetics, erroneous thought patterns, impulse control disorders, poverty, life experiences—these are just a few. Not every issue will apply to your particular relationship with gambling; different gambling-related symptoms and consequences affect each gambler in different ways. An estimated 2 to 3 percent of the U.S. population has experienced some level of gambling-related problem during their lifetime, according to the ongoing National Comorbidity Survey Replication, among other sources. This means that about 2 million people in the United States have experienced some level of gambling disorder; another 3.5 million experience problems with gambling that don’t quite meet the “pathological disorder” threshold.

You might express your addiction in different ways depending on the circumstances. For instance, you might drink alcohol all the time or drink only when you go to the track. You might have some occasional difficulties, or you might gamble in a way that disrupts your life on a frequent basis. Some people need treatment to recover from addiction; others seem to recover on their own with no help from anyone. When mental health experts talk about addiction, they’re referring to addiction syndrome. This syndrome encompasses a cluster of symptoms and behaviors that stem from the same underlying conditions, but these symptoms are not always present at the same time. The risk factors for developing the addiction syndrome are a complex interaction of genetic, psychological, social, and other factors. For example, someone with a genetic predisposition to addiction who also grows up in an environment that includes available drugs and gambling would be at great risk for developing addiction.

Just like any other expression of addiction, gambling addiction has a recognizable course and typical stages of development that don’t necessarily follow the same order or manifest in the same way for everyone. To gain a better understanding of an entire time line of gambling addiction, let’s examine one person’s journey.

THE STAGES OF ADDICTION

When Courtney was sixteen, an older friend got her a fake ID, and they hit one of the local casinos. There she took her first sip of alcohol. Later that night, her friend urged her to try her hand at blackjack. She picked up the rules of the game easily and did pretty well. The experience made her feel very grown up, and because she didn’t get caught or feel sick afterward, she figured it was no big deal. In the language of addiction, this first introduction to the objects of addiction—in Courtney’s case, drinking and gambling—is called the initiation stage. As Courtney experienced, at this point the risks seemed few and far between and the pleasures obvious, making it all the more likely for her to continue this behavior.

Continue Courtney did. By the time she was of legal age, she was drinking and gambling on a regular basis. Her entire social life revolved around the casinos. She enjoyed both activities immensely, especially when she drank and gambled at the same time. She had entered what is known as the precontemplation stage, the point where the person feels pleasure as she continues her use of a substance or becomes more involved in an activity. Although Courtney occasionally gambled a little too much and sometimes ran low on cash, she didn’t mind asking her parents or her siblings for a loan to tide her over. She didn’t yet view her gambling or drinking as a problem, so why change?

Then one night, she had too much to drink, bet big, and lost more than a month’s salary. She woke up the next morning flat broke with a terrible hangover. This time when she asked her parents for money, they were furious. As her mother sobbed, her father lectured her that this would be the last time they would write her a bailout check. When she looked for sympathy from her brother and sister, she realized that they too were fed up. It felt as if her entire family had turned against her; this was both humiliating and terrifying.

As Courtney drove home from her parents’, it struck her that she had no money, had alienated her loved ones, and often woke up feeling sick and queasy. This certainly wasn’t how she dreamed her life would be. It was in this contemplation stage of addiction that Courtney realized she longed to change. She began to imagine what it would be like if she were to quit drinking and stay away from the blackjack tables. After several months of thinking about it—during which time she continued to feel even worse and lose even more money—she finally entered the preparation stage, when she began to attempt to get her life back under control.

Courtney eventually entered the active quitting stage: she began to put a lot of energy into quitting drinking and gambling. Besides going to group meetings, she set some concrete goals for herself, stuck to a strict schedule, and took up yoga to help her relax and get in shape. Any time she felt the urge to take a drink or take a run through the tables, she’d call a nongambling friend and invite her to a meal or a yoga class to help keep distracted. Sometimes her preventive strategies worked. Occasionally she slipped up. But she was determined to make improvements and, after nearly two years of hard work, she found herself in the maintenance stage, also known as relapse prevention. Finally her life seemed under control. She was out of debt. She felt and looked better. Her parents and siblings were proud of her progress, and her relationships with them had greatly improved. She honestly didn’t know that she’d never again take another drink or lay down another card, but she felt sure of her priorities now and knew she was better off for the changes she’d made.

Not everyone goes through every stage of addiction and recovery in exactly the same way as Courtney did. Some people never see their addiction as an issue. Some never try to change even after they begin to have problems. It’s also not uncommon for someone to try to quit his addiction several times before he’s successful.

ARE YOU STRUGGLING WITH GAMBLING ADDICTION?

As you begin to think about the process of change, you may find it helpful to get a feel for your own relationship with gambling. To do this, take out your journal and write down your thoughts about the following questions:

• Do you become restless, irritable, or anxious when trying to stop or cut down on gambling?
• Have you tried to keep your gambling a secret from your loved ones?
• Has your gambling resulted in financial problems?

If your answer is yes to any one of these questions, it’s likely that you have problems with gambling. Even if you answered no to all three questions, if you feel concerned about the consequences of your gambling and how it affects your life, you have a gambling problem.

Experts often rate health problems on a scale. For example, we use a 0–3 scale to assign levels to a gambling problem. Someone who is currently abstaining from gambling completely is labeled a 0. Someone who is gambling but isn’t experiencing any negative consequences because of it is labeled a 1. Someone who is gambling and experiencing some negative consequences but not enough to consider that she has a gambling disorder per se is labeled a 2. And someone who is experiencing sufficiently negative consequences to merit serious changes and possible treatment is labeled a 3.

Gamblers often transition back and forth between healthy and unhealthy levels of gambling. The length of time that someone stays at a specific gambling level varies, and level 2 is the stage where things usually either get better or worse; however, some people languish at level 2 and suffer with some gambling problems for an extended period of time.

Think about this scale for a moment. Ask yourself how you would label your difficulties with gambling at various points in your life. Where are you right now on this scale? Maybe you’ve tried to get your gambling under control before, transitioned up a level, but then reverted back to your current level. Write down your answers to these questions in your journal.

If you are at a level that describes your behavior as problematic, take heart. This book, as well as other recovery and change strategies, can help you gain control. If gambling or the consequences of your gambling are causing you to worry, think of this as an opportunity. Worry can be an engine that drives change.

WHAT OTHER PROBLEMS ARE YOU EXPERIENCING?

As we mentioned earlier, gambling can be a part of an addiction syndrome or be accompanied by a host of other mental health issues. You may have some symptoms that are associated with a particular problem, but perhaps these symptoms don’t reflect a full-blown disorder. It’s possible to experience some symptoms without suffering from the full expression of the illness. In fact, most people have some symptoms that are commonly associated with an emotional disorder at some point in their lives even if they can’t be clearly diagnosed.

To help you clarify what your issues might be, we’ve included some brief descriptions of problems and associated symptoms that commonly overlap with gambling addiction. All of them are described in greater detail in upcoming chapters along with some suggested strategies for helping you get them under control. It’s likely that you are experiencing one or two or even several of these issues, but don’t let that scare you. Knowing what you may be struggling with is a good thing: it allows you to understand your problems and your specific needs, and that brings you one step closer to finding a solution. When reading these descriptions, keep in mind that only a trained clinician can make a clinical diagnosis.

Anxiety Disorders

Anxiety is a sense of worry that doesn’t seem rational. When you are anxious, you feel concern that you’ll somehow lose control or that bad things are coming your way, but you don’t quite know why you feel like this. Because anxiety can be very uncomfortable, some people get involved with activities that distract them from these feelings. Gamblers often gamble when they feel the need to defuse a high level of anxiety. When you’re anxious a lot, doctors say that you have an anxiety disorder. There are many manifestations of an anxiety disorder, some of which are described in the next sections. If you’re concerned that you might have some issues with anxiety and that perhaps they are contributing to your problems with gambling, you may find the information in Chapter Five helpful. It provides a more in-depth look at anxiety as well as opportunities to learn more about getting anxiety under control.

Obsessive-Compulsive Disorder

People with obsessive-compulsive disorder (OCD) have repeated, frequent obsessions and compulsions that interfere with their ability to function normally. Obsessions are repeated and unwanted thoughts and impulses that cause distress or anxiety. For example, a person might be hyperfocused on germs for fear they might cause disease, or on the tangled fringe on the rug because it spoils the organization of the room. Compulsions are repeated behaviors or rituals that are diff...

Table of contents

• Cover
• Endorsements
• Title page
• Copyright page
• Dedication
• Preface
• Acknowledgments
• Introduction: How to Use This Book
• Part 1: How to Begin
• Part 2: How to Change
• Part 3: How to Stay the Course
• Resources and Further Reading
• References
• About the Authors
• About Harvard Medical School
• Index