Gambling addiction – definition
= repeated and persistent gambling, although negative financial, social or psychological consequences are emerging or already exist.
Thoughts constantly revolve around gambling.
Control over the start, end and extent of gambling is limited.
Compulsive gamblers often play repeatedly in persistent phases, so that gambling ultimately dominates the lifestyle of the person concerned, and leads to the decline of social, professional, material and family values and obligations.
They jeopardize jobs, incur large debts, lie or act illegally to make money or to avoid paying debts.
Gambling addicts describe an intense, almost uncontrollable urge to gamble.
Intense thoughts and lively pictorial ideas encircle gambling and its accompanying circumstances.
The mental preoccupation and the urge often intensify in stressful life situations.
Gambling addiction: DSM-5
The current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5, Diagnostic and Statistical Manual of Mental Disorders) of the American Psychiatric Society (American Psychiatric Association, 2013, 2015) defines gambling disorders as follows: Persistent and recurrent problematic gambling behaviour leading to clinically significant impairment or distress, as indicated by the individual exhibiting four (or more) of the following in a 12-month period (criterion A):
- Needs to gamble with increasing amounts of money in order to achieve the desired excitement.
- Is restless or irritable when attempting to cut down or stop gambling.
- Has made repeated unsuccessful efforts to control, cut back, or stop gambling.
- Is often preoccupied with gambling (e.g., having persistent thoughts of reliving past gambling, experiences, handicapping or planning the next venture, thinking of ways to get money with which to gamble).
- Often gambles when feeling distressed (e.g., helpless, guilty, anxious, depressed).
- After losing money gambling, often returns another day to get even (“chasing” one’s losses).
- Lies to conceal the extent of involvement with gambling.
- Has jeopardized or lost a significant relationship, job, or educational or career opportunity because of gambling.
- Relies on others to provide money to relieve desperate financial situations caused by gambling.
The exclusion criterion is that gambling behaviour cannot be better explained by the existence of a manic episode (criterion B).
Gambling addiction: game – gambling – addiction
Playing is normal human behaviour. The normal, unproblematic play of children and adults allows us to leave reality:
- What happens in the game has no consequences or effects outside of the game.
- In the game we can forget our own limitations, we are »one« with the game.
- Mastering the rules and laws of the game increases our self-esteem.
- Rules of the game create security and unambiguousness. We can feel as part of a stable order.
Games of chance also do allow a distance from everyday life and immersion in a gaming world. In gambling, however, completely new properties are added, which in particular eliminate the freedom from consequences of gaming for areas of life outside of the game:
- Real money is used in gambling.
- The gambling result depends exclusively – or to a very large extent – upon chance.
- Winning is promised, but uncertain.
- By losing or winning real money, the outcome of the game has real ramifications beyond gambling. The risk of a real loss and the chance of a real profit create a specific tension that can become intoxicating.
- Increased immersion in the game, everything outside of gambling is hidden.
- Struggle to control the game.
The gambler lets chance decide about win or loss, the weal or woe. This is the »kick«, which can create an enormous bond to gambling, and leaves everything outside of the game irrelevant and bound to be forgotten. At the same time, the gambler maintains the illusion, that he can influence and control the game. He hopes to outsmart chance.
When gambling gets out of control, it is referred to as „pathological gambling“ or „gambling addiction„. Gambling then is often an attempt to avoid problems or uncomfortable feelings. It can become more and more self-perpetuating, and takes on an addiction-like character with:
- An overwhelming desire to leave reality and forget problems
- A feeling of power and control and the illusion of being able to control and control the game
- Inaccurate estimates of probabilities and chances of winning
- Seeking consolation in gambling in case of self-esteem problems, depression and anxiety
- Making excuses to keep gambling
- Use of funds that were originally intended for other purposes
- A compulsive desire to recover lost money by gambling again
- Appearance of cravings and withdrawal-like symptoms: The person concerned becomes nervous, restless and irritated at the prospect of not being able to play for the foreseeable future.
Gambling addiction: treatment
The therapy of gambling addiction begins with the person concerned finding out about the development of their own gambling behaviour, and then learning to develop alternatives to gambling. It clarifies the triggering conditions of gambling behaviour and clarifies individually why gambling is not abandoned, despite negative consequences.
It also includes developing a strategy for dealing with money and risk situations for relapsing into gambling. Additional topics can be added as required.
In parallel to individual therapy, it is essential to work in a disorder-specific therapeutic or support group. The discussion and exchange of experience with other gamblers offers the opportunity to recognize and question one’s own problematic behaviour when dealing with gambling invitations, and patterns within personal relationships. The aim is that each participant can develop a personal understanding of their problem behaviour and build realistic alternatives. In this way, each participant should become an expert in their own gambling problems. This strengthens the ability of the participants to take responsibility for their own actions and to bring about desired changes in behavior.
New behaviour strategies are checked for their feasibility and effectiveness. The transfer of the acquired knowledge into everyday life is planned and tested. This increases self-esteem and strengthens the conviction that one can make a difference oneself.
Premper, Volker. Pathologisches Glücksspielen (German Edition). Beltz. Kindle-Version.