Throughout recorded history, people have placed wagers on all manner of unpredictable outcomes. For many, the roll of the dice and the outcome of the race are adrenaline-fuelled elements of their everyday lives. But in some cases, this perpetual thrill-seeking becomes an obsession, the characteristic buzz of anticipation as symptomatic as any other addiction (Constable, 2003, p.202).
Facts and findings suggest that gambling has been around for thousands of years and Schleifer (2009) believes that “the earliest evidence we encounter is a series of painted pebbles found in the French caves Mas d’Azil. This pre-dates recorded history and is pegged during the stone age” (p.13). Modern day gambling is a recreational activity which is commonplace in society, however, for some it is a form of escapism or a coping mechanism that can develop into a full blown addiction. This addictive behaviour is commonly known as compulsive or problem gambling and it has been defined as,
An addictive illness in which the subject is driven by an overwhelming uncontrollable impulse to gamble. The impulse progresses in intensity and urgency, consuming more and more of the individual’s time, energy and emotional and material resources. Ultimately, it invades, undermines and often destroys everything that is meaningful in his life (Custer & Milt, 1985, p.22).
In Ireland, it is estimated that gambling is a €5bn industry with online gambling accounting for a large percentage of its business. In 2016, one of Ireland’s leading bookmakers revealed that online delivered 80% of its revenue and 87% of its profits.
In the modern age of computer technology a large proportion of business is being conducted online, however, bookie offices are still very prominent in our towns and cities. In the Talbot Street area of Dublin alone, there are five Paddy Power bookmaker offices within a few hundred metres of each other, such is the demand for their services.
This advancement in technology over the last decade has made gambling more accessible, with smart phones, tablets and laptops providing 24 hour a day access to gambling websites and betting markets. Modern day gambling has extended beyond the stereotypes of gender, age and socio-economic status and has taken advantage of a multimedia society to become an omnipotent reality amongst the populace.
In a Sunday Times investigation, Ungoed-Thomas (2017) stated that “Some of Europe’s biggest gambling operators are targeting children with their favourite cartoon and storybook characters in online betting games” (p.1). A separate article in the Irish Independent in 2016, reported that “women are becoming prime targets of gambling websites, luring them into a web of potential addiction and despair” (p.10).
“Ever since Adam and Eve rolled snake-eyes with the apple, gambling has been a part of man’s journey” (Schleifer, E., 2009, p.13).
In Ireland, gambling is a big part of our society and is an activity enjoyed by many. The racing industry and bookie offices have long been a normalised part of our culture. Gambling has changed dramatically over the last number of years in line with advances in technology making it easier to place a bet and on a larger amount of betting markets. Fulton (2015), in her report on the impact of gambling on society in Ireland stated that,
Gambling is a socially embedded activity in Irish society and in cultures around the world. In Ireland, gambling is socially ingrained in everyday life activities. For example, gambling is strongly associated with sport, particularly with horse racing and sporting events (p.10).
The most pragmatic statistics available are taken from The UK Gambling Commission’s prevalence survey of June 2015 – June 2016. The study showed a 75% increase in problem gambling rates within this time period, and of the participants surveyed, 53% of men and 44% of women questioned, stated that they gambled in the previous 4 weeks. As a corollary to this, the figures from the UK NHS show that only 5% of problem gamblers seek help, with only 1% of this minority receiving treatment for their gambling addiction. Due to the socioeconomic similarities between Ireland and the UK, it follows that gambling, as a recreational outlet with the potential to be harmful, can be statistically comparable.
In Ireland there is a sizeable cohort of people for whom gambling is developing into a serious problem. The medium through which gambling is practised has evolved alongside advances in technology. As Barrault & Varescon (2016) assert, “There are many reasons why online gambling has gained popularity for some over conventional gambling, such as permanent availability, anonymity and speed of play” (as cited in Columb & O’Gara, 2017, p1). Modern gambling practices have accelerated to the same rate as the mind of the problem gambler, however, research and treatment have not advanced in tandem.
A 2017 report in the Economist shows that Ireland has the highest gambling losses per resident adult in the EU and the third highest globally. The figures also show that Ireland has the highest online gambling rates in the world (Appendix A). These statistics not only highlight how popular online gambling has become in Ireland but how it may be a growing problem. It is only recently that Ireland has produced any limited research in the area of gambling behaviours. In 2017, under the auspices of St John of Gods (A primary Irish addiction rehabilitation centre), Columb & O’Gara conducted a study on a sample of two hundred and eight online participants. The results showed a noticeable similarity between the behavioural profiles of gamblers in both the Irish and UK’s online market. They concluded that “The majority of participants in this research have been adversely affected from both a mental and financial perspective due to their gambling behaviours” (p.1).
From an Irish healthcare perspective, Drugnet Ireland (2014), in an article about gambling estimated that in 2012 “64% of adults played the National Lottery” and “according to the Institute of Public Health, up to 1% of the Irish population have gambling problems” (p.16). The most recent legislation for the governance of the gambling industry in Ireland dates back over 70 years and is not applicable to the modern incarnation of gambling in Irish society.
Drugnet Ireland (2014) highlight that the,
Regulation of gambling in Ireland is governed by the Betting Act 1931 and Gambling and Lotteries Act 1956. Under current legislation the maximum stake allowed in a licensed amusement hall or funfair is 6d a player and the maximum prize is ten shillings, rendering this law unenforceable (p.17).
The deficit in up-to-date regulation and legislation has resulted in little or no restrictions on the volume of advertising by gambling operators on television and social media sites. This status quo has increased accessibility and has normalised gambling within our generic society. A 2016 report in The Irish Independent stated that four major bookmakers allowed new online unverified account holders to bet and deposit money for at least 72 hours before personal details were verified. Children under 18 were joining, gambling and in some reported instances were clearing out parents’ credit cards before it was noticed by gambling firms. They also reported on high profile cases involving fraud in the workplace which included instances pertaining to prominent Irish sportspeople. This exposure contributes in highlighting the growing gambling problem in Ireland. However, the problem runs a lot deeper than the ones that make the newspapers.
Unlike other addictions which exhibit more prevalent and obvious signs, gambling addiction usually manifests itself when the person in difficulty is at rock bottom. The problem gambler may be in extreme financial difficultly, distress, have committed fraud and in numerous cases has contemplated suicide. Fulton (2015) writes that “The lengths to which a gambler may go to hide gambling and the outcomes of gambling can lead the gambler to make socially and legally flawed decisions” (p.18).
The biological, psychological and social effects of a gambling addiction can be long lasting and detrimental on the individual and their families. Due to the fact that research and regulation are continually ‘playing catch up’, there is a resultant shortfall in treatment practice to address this constantly evolving issue. Irish treatment protocol at present finds itself in the process of adopting a more holistic approach in response to the chameleonic nature of a gambling addiction.
In 2013, The American Psychiatric Association (DSM V) addressed the fact that gambling presents similar characteristics to substance addictions and has thus elevated it from an impulse control disorder to be included in the section of substance related and addictive disorders. O’Gara (2017) states that “This change has added further weight to the call for implementing a modern regulatory framework for gambling in Ireland” (p.2). It follows that when the modified 2013 Gambling Control Bill is eventually enacted, it will provide such a framework to address gambling with regard to a more holistic biopsychosocial (BPS) approach to addressing gambling addiction in Ireland.
It is envisioned that the Gambling Control Bill will address the multifaceted nature of problem gambling. This will include the establishment of a gambling regulator to monitor the gambling operator’s ethical responsibility in areas such as advertising, promotions, self-exclusion policies and staff awareness training. It is also planned that Bookmakers will be legally required to pay into a social gambling fund. This will be partly be used for research, and towards the establishment of specific treatment programmes for the benefit of the problem gambler. Funds may also be used for the development of education and gambling awareness programmes. These protective objectives are guided by moral principles of gambling regulation to ensure:
o Fairness in the conduct of gambling with regard to
o The protection of vulnerable persons, including children, from risks to their well-being arising from gambling
o The avoidance of circumstances where gambling could, inadvertently or otherwise, facilitate or enable criminal or illegal activity
o Consumer choice and protection
Gambling Control Bill (General Scheme) 2013.
Rewind back to 1984.
I was a care free youngster whose sole focus was on football, whether that be playing U11s with St Patrick’s Boys in Graiguecullen on a Saturday morning or watching the vidiprinter on BBC at 445pm that evening to check the results of Liverpool and their nearest competitors.
I can still remembering very vividly coming home from a match one Saturday at lunch time to find that My Dad had bought us an Amstrad CPC 464 complete with a green screen monitor. Instantly I was mesmerised. I remember shuffling through the free games that came with the computer (which loaded by cassette tape) and discovered games including Bolderdash, Harrier Attack, hangman and Roland on the ropes.
I was instantly hooked on Bolderdash and Harrier Attack and played for hours on end. Kicking the ball against the wall to improve touch suddenly didn’t have the same appeal as it did only days before. I obsessed with getting through as many levels as I could whenever I could. At lot of my friends got the CPC464 around the same time and I can remember being especially jealous of my next door neighbour who got the colour monitor version.
One of the games that I eventually played more than any was ‘Fruit Machine’. I can still recall the noise of the nudge and the flashing lights and sounds when I got 777. I would spin for hours on end not knowing that years later I would be doing this in real life with devastating consequences. I played the game on my next-door neighbour’s computer one day and the colour screen was even more absorbing and exciting. I don’t blame the fruit machine game for my gambling addiction but am curious if it may have played a part given the current research on gaming and the links to gambling.
Fast Forward 36 years and to a report on ESPN which stated that:
“A 15-year-old European Fortnite player is now $120,000 richer. The teenage pro competitor from Germany who goes by JannisZ in-game and is representing Wave Esports won the Fortnite Champion Series Invitational Europe title, finishing with 254 points.
The Fortnite Champion Series Invitational boasted a $2 million prize pool that included $120,000 for the European winner and $100,000 for the North America East champion.”
“On average, 95,000 viewers watched the sixth and final contest in the European region on Twitch and YouTube.”
The mind boggles, and I wonder where we will be in 5 years’ time, let alone in another 36
My First experiences of Cuan Mhuire Treatment Centre
As I approached the entrance of Cuan Mhuire, Athy at 3.45pm on Friday 22nd July 2011 I wondered to myself how I got to this point in my life. I was about to enter a treatment centre for addiction for the next 12 weeks. I had been here once before but just to visit a friend who is a recovering alcoholic and who had completed the programme last December. Even though I had chatted to him briefly I had no idea what was ahead of me or how the programme would help me. I didn’t know what to expect or what would be expected of me.
As we drove up to the side entrance I thought of the carnage I have caused with my gambling. I have done things that I would never have done in my wildest dreams to fuel my addiction. I have lied to family and friends for years to hide my illness. I had become insidious in every aspect of my life. For me my addiction and my gambling became more important than anything else in my life, more important than eating, sleeping, my health, my marriage even the birth of my daughter. It dominated my day from the moment i got up to the time i eventually got asleep at night. I could not think straight but i managed to carry my secret with me for years without anyone knowing. I had put myself through weeks, months and years of extreme stress, worry and anxiety and now my family and friends were experiencing the same feelings and fears that have haunted me and that will probably continue to haunt me for years to come.
I felt at this point that I had lost everything including countless money and my job. I have lost the trust of loved ones but mainly i felt that i had lost my sanity and my mind. My head was like a roulette wheel spinning spinning spinning but never coming to a stop.
I arrived at the side entrance where the admissions are taken in. There are men in pyjamas waiting to get through a locked door…… Why didn’t I stop when I was ahead?….. My father is with me putting up a brave face reassuring me that everything is going to be ok….. Why didn’t that team just hold to that one goal lead for five minutes more and give me the big win that I craved and needed to get me back to the point where I got the buzz from gambling….. The door is opened and I am greeted by the nurse….. How is my wife going to manage for 3 months without me?….. In fact how are we going to manage with all the crippling debts?….. What are people saying about me behind my back?
My head is like the spin drier now spinning faster- faster -faster.
How do I stop the madness in my head? How do I stop the headaches? How do I slow everything down? How do I beat this? How do I get better? Why are people in Pyjamas? Surely I won’t be asked to do the same! How do I get out of here? How can I turn back the clock?
There must be an easier way.
I am now standing beside a plague on the wall that reads:
“Cuan Mhuire a place where I change myself and nobody else.”
I want to change everything, I want answers, I want to be better, I want to be finished the programme, I want the quick fix like all gamblers do I want it now.
My mind is still racing as thoughts of bets, scenarios; fears, shame, guilt and worry come flooding into my head. The gambler juggles dozens of thoughts in his/her mind at any one time.
Bang-Click the door is closed and locked behind me it’s now flight or fight time. For a moment my head stops spinning I focus myself my thoughts take a deep breath decide to Let go and let God and accept that I have this problem, this illness, this gambling addiction……. I decide to Fight
Fight my addiction and all the negative thoughts. With that my journey starts on my road to recovery. I walk towards the nurses’ station and my head is again full of a dozen thoughts the main ones being how did it come to this……. I am so sorry….. I am so sorry…
The nurse meets me in the men’s sitting room in the Detox area and checks me in. She tries and succeeds to make me feel at ease, I must look horrified and nervous. I haven’t shaven for weeks and have been wearing a baseball hat anytime that I have ventured out of the safe haven that is my house. The embarrassment and guilt that I feel is almost unbearable and such is the enormity of the lengths that I went to in order to obtain money for gambling that I feel I can never face anyone that i know ever again. I can barely look at myself in the mirror.
The Unit man then shows me to my bed which is one of twelve beds in a separate room that resembles a hospital ward. He then checks my bags for any electrical equipment, papers etc which are not allowed in the house. I am then asked to change into a pyjamas which is provided (A lovely paisley one).
I look around and see men that are underweight, weak and visibly sick. There are a few just lying in bed sleeping or reading, the rest are out smoking or comparing drinking stories in the sitting room. I think to myself I am not like any of these people I am here for gambling. I am not sick; I just need time to sort out my head.
But the harsh reality hit me, I was sick, I probably looked a lot worse that a lot of the people there without realising it. I was bloated with stress and had put on a lot of weight from eating badly. I had black rings and bags under my eyes from lack of sleep and I felt exhausted and probably looked worse than I felt. I had been physically sick from anxiety attacks brought on from losing bets and from the bad situations I constantly found myself in. This was all due to my out of control gambling. Occasionally I experienced severe weight loss from a lack of eating and I had broken out in rashes numerous times. I had constant headaches and experienced constant pressure in my head, a pressure that I can best describe as how it would feel if someone placed their hands on the top of your head and squeezed, sometimes hard and sometimes not so hard but always squeezing.
But worse than all the physical symptoms of my disease is how my head was. To this day I believe that in the latter stages of my gambling addiction I lost control of my mind and my ability to rationalise and think straight.
I was living in a parallel world to the real nightmare I was living. In this world I could justify what I was doing and I felt that I would always get that big win that would get me back to the time when I was ahead, back to the initial buzz. In this world everything was ok, I felt safe and could gamble freely without fear of the consequences that I would inevitably and eventually have to face. I could block out all the bad and cocoon myself away from all my problems both financial and personal.
When I talk to family and friends they ask me how I didn’t crack and slide over the edge. To this day I really don’t know but I do feel that the times when I was at the bottom of the hole I had dug for myself, I felt suffocated, isolated and could see no way out, no glimmer of light above. The harder I tried to dig myself out and get back money to the people and places from whom and where I had borrowed or stole from to fuel my addiction and my nightmare, the deeper I got into everything and the further I found myself from salvation.
My first few days in Cuan Mhuire were mainly spent in bed either sleeping or reading. I suffered with constant pounding headaches and my mind was racing full of fear, worry and anxiety. I started reading “The Gambler” a book written by Oisin McConville. I had rushed around for days trying to buy in shops and on line thinking that it would have all the answers (A typical trait of a gambler wanting all the answers wanting them now wanting the easy way.) I finally got it and when I started reading it I realised that it was mainly about his football career and only had a small bit in it about gambling. I would have to do it all myself, the hard way, the proper way. I realised that I would have to slow everything down be patient and work through everything myself.
I spent a lot of time reflecting on the last number of years. I thought about the bets I had placed, the money I had won and subsequently lost. I tried in vain to count up the vast amounts of money I had squandered on gambling. I thought a lot about the losing bets, the last minute goals and the horses falling at the last. I remember waiting on bets where the long odds on shots would somehow inconceivably lose and cost me the big accumulator that would have “got me back”. Even if this had happened I would have started the whole crazy cycle all over again. Looking back now, I can see the madness of the whole thing, but while in the grips of my addiction I was blinded to everything else other than gambling.
Nothing else mattered, I fretted to get that first bet on in the morning, every morning. I can relate to how a drug addict or alcoholic must feel when they wake and instantly want their fix just to function, just to feel right. I just needed to place a bet it didn’t matter if It won or lost I just needed to place it. I used to stay up into the early hours most nights gambling on line and sometimes I wouldn’t sleep for days. I would have blackouts and wake in the middle of the night in a pool of sweat with thoughts of nothing else other than gambling. I would set my alarm to get up during the night to check results and ongoing bets. I eventually started staying in the spare room so my wife wouldn’t notice my erratic behaviour using our new born baby as an excuse. I would use any excuse so I could gamble when and where I wanted without question or interruption.
Is Knowing why we gambled important?
“We are all addicts. Even if we don’t become hooked on alcohol, cigarettes, or other drugs, we rely on different things to avoid pain and cling to pleasure. The wish to feel good and avoid emotional pain is very natural and deeply rooted” (Peltz, L., 2013, p.ix)
In his book Overcoming Gambling, Mawer (2010) states that “research into problem gambling is still in its early stages” (p.18). He adds that there is limited information available on why people gamble and, in particular, why some people become compulsive gamblers. Today, there is a marked increase in literature available on the subject and more research is being carried out trying to make sense of this baffling and insidious condition. There are conflicting views among authors and theorists on how problem gambling should be defined and treated. Some, class gambling as an illness, while others categorise it as an impulse control disorder resulting from imbalances in brain chemistry. However, the classical belief is that gambling is a coping mechanism used by some to deal with or escape from their problems or life issues.
Lefever (2014) poses the question “how do we get inside the madness of behaviour that is obviously self-destructive? If we can’t understand it, we can’t treat it” (p.14). The exploration of underlying issues in addictive behaviour can lead to an awareness and understanding into the driving force behind the addiction. Lefever also states that “the final stimulus required for the development of full-blown addiction is the exposure to mood-altering substances or processes that “work” for the individual in producing a mood-altering effect that transiently fills the sense of inner emptiness” (p.39). Therefore, it may be argued that if a client presenting with a gambling addiction or indeed any addiction explore what these feelings of inner emptiness are, or where they stem from, it may help them in their treatment and recovery.
In Gamblers Anonymous and other fellowships, it is the firm belief that addiction is an incurable disease, progressive in nature that can only be arrested by working the twelve step program of recovery. It is also the belief that it is something that is out of the control of the person affected, and is a condition for life. However, Thompson (2013) surmises that “addiction is characterised by inability to consistently abstain, impairment in behavioural control, craving, diminished recognition of significant problems with one’s behaviours and interpersonal relationships, and a dysfunctional emotional response”. (p.41). This would suggests that recovery is in the person’s control and possible if the root of the problem or issue can be unearthed, accepted and dealt with.
Chris Prentiss is a co-founder of Passages Addiction Cure Centre in Malibu, California. In the opening statement of his book ‘The Alcoholism & Addiction Cure’, Prentiss (2010) makes the claim that “within the covers of this book, I will show you how you can cure your alcoholism or addiction”. He goes on to postulate that the “statement is based on the results we achieve at Passages. At Passages, we assist people every day to cure themselves. We don’t cure them- we assist them to cure themselves” (p.1). His premise to this statement is that he believes that addicts are “not incurably diseased”. They have “merely become dependent on substances or addictive behaviour to cope with underlying conditions” (p.15).
Prentiss (2010) accentuates that there are four causes of dependency:
Cause 1: Chemical Imbalance
Cause 2: Unresolved events from the past
Cause 3: Beliefs you hold that are inconsistent with what is true
Cause 4: Inability to cope with current situations
Prentiss (2010) also makes the point that people become addicted to substances or behaviours because of their addictive qualities, but after a while away from the substance or from the addictive behaviour the withdrawal symptoms disappear along with the physical dependency. Therefore, something else (one of the four causes) has to be present for the person to want or need to continue the addictive behaviour or re-enter the addictive cycle.
He states that “we can easily break those dependencies once we cure whichever of the four causes listed above is underlying the addiction” (p146).
Following on from this it can be argued that attending G.A. meetings or completing a residential treatment programme can break the addictive cycle and ease the physical need or craving to gamble. However, working with underlying issues may help the client to rediscover themselves thus leading to sustained recovery.
This is a point backed up by Blaszczynski (1998) when he states that “clinical research has consistently revealed that up to 75 per cent of compulsive gamblers suffer from symptoms of major depression” (p.42). He also expounds that “some clinicians suggest that depression is one of the driving forces leading people to gamble compulsively in the first place” (p.42). In these particular cases, if the depression can be treated and understood by the client by engaging with counselling or treatment, then it could be argued that they might gain a greater awareness of why they gambled compulsively in the first instance.
It can also be disputed that gambling and other addictions are coping mechanisms. Virginia Satir once famously said that “Problems are not the problems; coping is the problem” (BrainyQuotes.com). Custer & Milt (1985) also sum this up beautifully when they write that
“People who escape from problem situations by indulging in gambling say, in thinking back, that they knew it wasn’t going to solve the problem. But what they were looking for there and then was relief and escape, not solutions. One gambler explained: ‘When you’re suffering with a splitting headache or agonizing toothache, what do you think of? Long term medical, psychiatric or dental treatment? No. All you want, desperately, is to get rid of that pain right away, this minute. You look for the simplest, quickest way to get relief, and if that’s what gambling does for you when you’re facing a tough, painful problem, naturally, you plunge into gambling” (p.29).
This point is backed up more recently by Carr (2013) when he writes that “Just as gamblers believe they get pleasure from gambling, they also believe it provides some sort of crutch. This is because they tend to turn to gambling at times of stress and regard it as a relief” (p.157).
In Gamblers Anonymous, the focus seems to be on accepting that addiction is a life long illness that can never be cured. The compulsive gambler must accept this affliction and fight it on a day to day basis by attending meetings and working the 12 step programme. Nakken (1996) suggests that “the addict does not focus on the Self but perpetuates the fight between the Self and the Addict within. The two are always in conflict, struggling for supremacy, with the addict invariably winning out” (p.65). Nakken (1996) adds that recovery from addiction is found in the renewal of the self. Forming a new accepting caring relationship with the self and then eventually forming meaningful relationship with others is the key to a sustained, happy and addiction free life. The best way to reconnect with ourselves is by understanding and taking responsibility for our lives.
Dodes (2011) states that “addictions are emotional symptoms, they should be treated together with everything else troubling a person. Understanding what makes a patient depressed will help him understand why he has developed an addiction, and understanding his addiction will help explain why he is depressed”. He continues by questioning “Why, then, do people so often divide addiction from general psychological treatment?” (p.208).
This research piece hopes to challenge the statement written in the G.A. handbook that none of the G.A. members who were interviewed found that having knowledge of why they gambled to be of value to them when stopping gambling. This statement is not backed up with research and may be misleading to some members. A lot of literature written on the subject would seem to suggest that addressing underlying issues can be of benefit in the treatment of this addiction.