Therapy for Gambling Addiction

Can Therapy Block the Slots?

Posted Sep 24, 2017

Every couple of years I’ll be coaxed into a trip to Vegas and amble into a casino, prepared to lose a few hands. Don’t get me wrong, I love playing blackjack. The best part is when I’ve been at the table for a while and I’m talking with the dealer and feel like I’m channeling basic strategy so well that I’m on auto-pilot. And if that results in winning a few bucks, all the better.

And then, when I get bored, or break even, or lose what I decided to spend, I get up from the table and walk away. For a year. Or two. It's as simple as that.

I just don’t care that much about gambling, and it's not a compulsion for me. It’s fun for a bit, but then loses it’s pizzazz, not unlike a televised game of water polo or a Dave Matthews concert. But for some, it’s not so easy to get up and walk away. I count myself among the lucky ones.

According to current research, about 2.5 million US adults suffer from compulsive gambling and as many as 15 million of us run the risk of becoming problem gamblers. While those general statistics are impressive, statistics are inherently detached. When you hear the stories of individuals caught in the trap of gambling addiction and the chaos it causes for them and their family, you grasp the devastating impact of this legal, yet lethal pastime.

I spoke with Dr. Martin Hsia, a clinical psychologist based in Glendale, California who counts gambling addiction among his specialties. Martin shared his approach to gambling addiction:

RH: Why do some people gamble even though I…uhh, I mean they… always lose?

MH: Gambling is somewhat similar to drinking alcohol or sex in that in many or most cases, it is not to a level or frequency that is out of control or dangerous. However, when recreational gambling develops into a habit that is problematic, it can result in serious financial, emotional, and personal consequences. 

It's tricky because in many cultures and in many families, gambling is a very common and accepted form of recreation. Also, when you see casino commercials where everyone is beautiful, winning a jackpot, and enjoying a drink, those positive associations can create a lot of internal conflict for someone who has suffered greatly as a result of gambling. Plus, as with other behavioral and substance addictions, a person's readiness to change or stop a habit like gambling can take time to develop, and many individuals may be starting from a point of denial that he or she has any problem.

RH: Why doesn’t losing deter them and get them to stop?

MH: Gambling can be rewarding for many reasons. It can be a way to escape unpleasant feelings. It can also be seen as a quick way to make a lot of money, or "chase" money that was lost. Someone who has not yet begun to recognize their gambling as a problem may also be inclined to just remember the euphoria they felt from the few instances when they won a big jackpot, and downplay far more significant losses as "bad luck." People who gamble may also be superstitious, developing routines like blowing on dice, having a lucky number or table, or believing that one can't lose on his or her birthday.

Each of us has a unique relationship to money, and gambling can be an expression of those ideas. For someone who does not struggle with an addiction, you might liken it to stopping yourself from eating too many sweets at a holiday party. Part of you "knows" you should and want to stop, but another part of you has a strong drive to keep going.

RH: How does someone finally decide to stop gambling?

MH: Like so many other things, no one story that I am aware of is the same. Some individuals have experienced so many negative consequences (financial, professional, emotional, legal, etc.) that they have no choice but to stop. Others are able to look down the road and see where their gambling is going to take them before they get there and decide to get help. Others begin to make changes when a spouse or significant other leaves, gives an ultimatum, or confronts the gambler with compassion. There's also some debate about people who don't decide to stop gambling completely, but merely to limit or put clear parameters on where, with whom, under what circumstances, and how much they allow themselves to gamble - and whether this is a safe and acceptable outcome.

RH: How did you get into this field in the first place?

MH: The state of California started a program called the California Gambling and Education Treatment Services, or CalGETS. It allows people with gambling problems to seek a number of sessions of therapy pro bono while also collecting data for research on the gambling problem in our state. I was interested in this issue, and the program offered an extensive training program to participate in their services, which I've been a part of now for seven years. Gambling is also a significant issue in the Asian American community, which I felt a personal burden to be able to help in this way.

RH: How was it telling this story on stage?

MH: I've loved being part of the Moments of Meaning events. Being a therapist is a profession that so many passionate and caring colleagues and I pursue because of a genuine desire to help people. Yet, there is so much work that needs to be done to educate and correct mistaken ideas about psychotherapy. Many people have also had negative and even harmful experiences in therapy, which pains me greatly, so I'm grateful to have the opportunity to present our work in what is hopefully a positive and moving way.

Telling the story certainly brought a rush of excitement and anxiety to be in front of a crowd. At the same time, there were a few moments while role-playing the client, "Simone" when I could channel her despair and sadness. The story is masked, distorted, and draws from multiple cases so as not to resemble any actual individual, but hopefully showcases therapy as a relationship which has an impact on both parties involved. I wanted to convey the humanity of a therapist - myself, in this case obviously - in a way that was anything but stoic or omniscient.

Of course, the main focus in therapy is always on the client and his or her needs, but therapists' own subjective experiences can be an essential factor in bringing about the desired change.


So there you have it. Gambling treatment in a nutshell. Learn more about Martin at his website (we talked about guilt a while back), and learn more about Martin’s talk and the Moments of Meaning project at our Facebook and YouTube page.

You’re always welcome to take the gamble of visiting my website or Facebook page.

Want to hear Martin and I talk? He interviewed me on his incredible podcast PsychRally a few months ago. You can hear us prattle on here. Listen closely, at one point I reveal the greatest movie of the 80's. Want to bet what it is?