Treatment of compulsive gambling and other non-substance addictions

Two elements define an addiction: Loss of Control and Dependence.

• Losing control means that a person cannot abandon the habit by his own means, despite having tried to do it on several occasions and being aware of the damage his behavior is inflicting upon himself and his loved ones.
• Dependence is the increasing need for the habit that gradually involves more time, energy, money, etc. and starts to take priority over other needs, even those that were basic to the person (family, work, etc.)

The addiction develops slowly without the person’s awareness initially. Krych masterfully described the various stages of development of addiction (Abnormal consumer behavior, a model of addictive behavior, 1989):

• 1º. The activity is pleasurable
• 2º. There is an increase in preoccupation when the individual is not performing the activity
• 3º. There is an increase in the frequency of the behavior and the person progressively loses interest in other activities that were also satisfying before
• 4º. The individual tends to downplay his interest in this activity
• 5º. He experiences an intense desire to engage in this activity
• 6º. Behavior is maintained despite the increasing negative consequences. The person begins to justify and try to convince others because he is incapable of coming to terms with reality
• 7º. As the negative consequences increase, the person begins to realize this and makes attempts on his own to control himself
• 8º. Here, the activity is performed not for pleasure but for the relief of discomfort. This relief becomes less intense and shorter in time
• 9º. The person has less and less capacity to cope with negative emotions and frustrations of everyday life. This stressful state becomes more acute and the addictive activity becomes the only way to ESCAPE from stress
• 10º. The addictive behavior worsens and an external crisis (a breakup, the discovery of a large debt, a layoff, etc) leads the person/ family to seek treatment.

When a person begins to bet more money than planned, prefers to play alone, goes to betting centers to try to recover lost money and starts to lie, we can say he is getting to the point of compulsive gambling and may need treatment. Immediately important prejudiced thoughts show up in different areas of life:

• In the personal area, the individual is stressed, sad, anxious, and has a low self-esteem. The feeling of guilt for spending too much money and the debts make the person lie to family, friends, employers…
• At work, performance decreases by the constant thoughts about the games, unexcused absences start to happen and the person may even leave his job. The person could be laid off for attempting to steal, although this does not always happen.
• The family particularly suffers the consequences of gambling. A significant loss of confidence (after lying, petty theft, broken promises…) is added to financial difficulties. The person is not reliable and can’t carry out his responsibilities for his partner, children, parents and the guilty feeling makes him distance himself.

The psychological treatment has the following objectives:

• Regaining self-control over gambling behavior (minimize the impulse or excitement).
• Build a new lifestyle that is satisfactory without the presence of the game.
• To develop effective strategies to be able cope with life’s problems (including financial problems) without resorting to gambling.
• Discover the real and rational functioning of games of chance (such as slot machines, bingo, casino games, etc.) and the mechanisms that cause the addiction.

• Addiction to work is a maladaptive and excessive involvement in work activity and a loss of control of the work limits. This “obsessive” dedication causes family and social relationships to deteriorate and usually affects health as a result of physical stress, lack of sleep and the frequent consumption of alcohol and stimulants. The psychological treatment is directed towards building a balanced lifestyle in which work satisfaction is combined with personal, family and social well-being.
• An addiction to Shopping is defined as an uncontrollable urge to acquire desired objects. The satisfaction comes from the act of buying rather than the object bought (they are usually superfluous things that are not really necessary) The level of consumption breaks the level of economic stability giving way to debts, the deterioration of family relations and guilt… Psychological problems are frequent: depression, anxiety, food disorders that result in low self-esteem and impulsiveness. Counseling will help define the severity of the problem, identify its causes and teach the person to regain control.
• Addiction to sex is not exclusively the result of a high desire for sexual activity but the decrease of personal distress through sex; hence it becomes an obsession the person is unable to control. Among the negative consequences are the possibility of transferring the obsession to the partner as well as feelings of guilt, shame or reduced self-esteem. The psychologist can help identify and resolve internal unrest, satisfy unmet needs or gaps through healthy strategies and help control the obsession with sex.
• Addiction to Internet and New Technologies involves time spent on this activity that is out of proportion in relation to other leisure activities and obligations that often leads to the deprivation of sleep, and the neglect of other activities and important relationships. A person who struggles with this will continually receive complaints from those around him, constantly thinking of going online and trying to control the time spent online without any success are unmistakable signs. Psychological treatment is a useful tool to restore balance in our lives.