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Pathological Gambling

Understanding the mind of a high roller

16076514_xxlGambling behavior exists on a continuum, ranging from social gambling to problem gambling and to pathological gambling (which is gambling addiction). The features of each stage may be classified as below:

Social Gambling

  • • Similar to social drinking
  • • Fun, relaxation, leisure
  • • Sets monetary limit
  • • Does not bet more than he can afford to lose
  • • Losing is “part of the game”
  • • Gambling does not cause problems to home, work or social life

Problem Gambling

  • • Similar to drug abuse
  • • Gambling behaviour interferes with personal life, studies or work, or affects family
  • • Gambling behaviour causes problems or negative consequences
  • • When a person bets more than he can afford to lose

Pathological Gambling

  • • Most severe pattern of excessive gambling behaviour
  • • The person loses control over his gambling
  • • Has great difficulty stopping gambling
  • • Gambling behaviour has become destructive
  • • Personal life, work, studies, family suffers severe damages

Reasons Behind Gambling Addiction

Some may ask why many pathological gamblers continue to gamble despite experiencing negative consequences, which can be severe (e.g. wiped out savings, a mountain of debt, and strained family relationships). There may be several factors perpetuating the gambling behaviour. One is due to the fact that addiction is related to the imbalance of chemicals (neurotransmitters) and abnormal circuitry of the brain, as shown in studies. After a period of engaging in the addictive behaviour or substance, there is a loss of control, and impulsivity develops or worsens.

Additionally, research has found that cognitive distortions, or thinking errors, play an instrumental role in the maintenance of gambling behaviours.1,2 A common theme underlying all these distortions is the failure to recognise or appreciate the independence of events in the world of gambling.

People, in general, are uncomfortable with the unknown and would try as best as they can to derive reliable patterns and trends to make sense of things that are happening around them. This usually works in the real world as one can quite accurately and reliably predict an outcome based on another event (e.g. if the sky is darkening, it is probably going to rain). Some distortions (especially superstitions) may also be rooted in one’s cultural beliefs.

Common Cognitive Distortions

Besides prolonging the gambling behaviour, research has also indicated that pathological gamblers experience and endorse more cognitive distortions than non-pathological gamblers.2 It is also important to note that it is usually not the type of games per se that directly causes the distortions but the gambler’s perception towards gambling. Most games, however, do give gamblers an impression that it is possible to predict or control outcomes, and most people (even social gamblers) who gamble do, to a small degree, have such distortions. The main difference is that the pathological gamblers would usually experience more of them and endorse them more rigidly and passionately compared to the non-pathological gamblers regardless of the types of games they play. Some common cognitive distortions would include:

1. Illusion of control:

the belief that one has the ability to predict outcomes and that skills and experience improve one’s chances of winning A punter at the race course may think that he/she can predict the outcome of horse races by studying the terrain, weather, jockey or the form of the horse. A casino gambler may believe in the utilisation of certain strategies (e.g. predicting future results based on the observed “patterns” of previous outcomes, doubling up, etc.) to enhance their chances of winning. The underlying belief is that gambling is a game of skill rather than a game of chance.

2. Superstitions:

the belief that rituals, number combinations or special objects can improve luck in gambling A gambler may believe that his luck will improve eventually, and that he needs to continue gambling or risk losing out if his/her luck comes. Other examples are the belief that some number combinations (e.g. birth dates, number plates of vehicles involved in accidents) are particularly lucky, or the belief that luck in gambling can improve if certain items (e.g. lucky charms, lucky t-shirt, etc.) are worn or brought into the gambling venue.

3. Misinterpretations:

where losses are perceived as near-misses and a sign indicating that a win is coming soon When a jackpot player gets, for example, two apples and a banana, there may be a strong belief that the third apple is coming soon if he/she gambles “a little longer” or “a little more passionately”. Another example is when someone who bet on 1233 but 1243 came out as the winning number for the lottery draw.

4. Other distorted beliefs

Other distorted thinking/beliefs in gambling could include the belief that chance is self-correcting, meaning that a win is definitely in the pipeline because it has not happened for a long time. An example is a gambler who believes that the likelihood of winning from a “hungry” slot machine (a slot machine that has just paid out a huge amount of money) is a lot lower than the likelihood of winning from a full machine (a slot machine that has not paid out for a long time). In truth, however, there is no way to predict when slot machines will give one winnings. Winnings are determined by a Random Number Generator, which creates thousands of random pictures per second.

Treatment of Pathological Gamblers

Treatment at the National Addictions Management Service (NAMS) is based on an integrated, multi-disciplinary approach which combines medical and psychosocial therapy to guide the problem/pathological gamblers and their families through the journey of recovery.

Comprising psychiatrists, counsellors, medical social workers, nurses and psychologists, the NAMS multi-disciplinary team works together to render help from various angles. Individual as well as group therapy sessions are available to the patient as part of treatment. To address gamblers’ cognitive distortions, cognitive-behavioural therapy (CBT), an evidence-based psychotherapeutic approach, has been shown to be particularly effective. Family and friends can help the problem/pathological gamblers by making information and resources related to treatment readily available. They can also provide healthier support by being emotionally present for the gambler (e.g. care about how he/she is feeling), rather than provide financial bailouts, which may perpetuate the gambling behaviour. They can also call the Problem Gambling Helpline at 1800-6-668-668 to speak to NAMS paracounsellors for advice and support on a confidential basis. In conclusion, it is important to note that problem and pathological gambling are treatable and that one should not hesitate to seek professional help.

References 1. Okuda M, Balan I, Petry NM, Oquendo M, Blanco C. Cognitive-Behavioral Therapy for Pathological Gambling: Cultural Considerations. Am J Psychiatry. 2009 166:1325-1330 2. Myrseth H, Brunborg GS, Eidem M. Differences in Cognitive Distortions Between Pathological and Non-Pathological Gamblers with Preferences for Chance or Skill Games. Journal of Gambling Studies. 2010 26 (4): 561-569

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Mr Lawrence Tan is a Senior Psychologist at the National Addictions Management Service (NAMS), Institute of Mental Health.
Posted by ezyhealth on Jun 6 2013. Filed under Mental Health. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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