Causes and Treatment for Women who Gamble

Old 09-04-2006, 06:37 PM
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Thumbs up Causes and Treatment for Women who Gamble

Written by a friend of mine....
Gambling is a silent addiction. It goes unnoticed until it's too late. Much damage is done. My ex almost lost my house twice, and I was unaware until the phone calls came in. Gambling addictions are insidious.

Why Women Gamble:
The Causes and Treatment

By Thomas E. Broffman, LICSW, LCDP, LCDS, CEAP
Until the 1970s and 1980s, gambling in America was considered by the public to be largely a male pursuit. The traditional bastions of gambling: the racetrack, the casino and card parlors were male domains and historically "ladies" were not seen at these venues (Goodman, 1995).
However in the 1990s, with the arrival of state-sponsored lotteries, modern-day casinos, high stakes bingo parlors, and most recently video lottery, poker and slots, more and more women are participating in all forms of gambling. With changes in traditional roles and lifestyles over the past decade, women have the time, money and inclination to gamble. Gambling holds the same attraction for women as for men, and can be an equally powerful compulsion when the woman is vulnerable. Women now constitute one the fastest growing segments of casino and lottery gamblers (Moore & Carlson, 1998).
Pathological gambling is a devastating illness that affects the female gambler and everyone who has a significant relationship with her. Knowingly and unknowingly, female problem gamblers are being met in a variety of mental health and substance abuse settings. Substance abuse counselors need more training in identifying female problem gamblers and how best to approach such clients. Further research is needed to better determine the true scope of the problem of pathological gambling and the clinical implications of gender, race and age differences. More significantly, however, expanded private and public funding for gambling prevention, treatment and research depend on demonstrating a social cost associated with increased gambling problems among women.
What is gambling? Gamblers Anonymous (1994) defines any betting or wagering, for self or others, if for money, no matter how slight or insignificant, where the outcome is uncertain or depends upon chance or skill constitutes gambling.
Although gambling is something almost everyone does, it still has a taint of social disgrace for women. Nonetheless, the American Gaming Association reported females constitute 51 percent of their clientele (Goodman, 1995). As of yet, little is known about women gamblers and the etiology of problem gambling among women. As women increasingly participate in all forms of gambling, it is expected the prevalence of problem gambling among this group will likewise increase.
Gambling prevalence As the acceptance and availability of gambling increase, more people than ever are wagering. The recent Harvard Medical School of Addiction (Shaffer, et al., 1997) meta-analysis of gambling addiction data published between 1977 and 1997, revealed "the people who are most sensitive to social sanction or social pressures only begin to gamble when it becomes legal in more places." Legalized gambling in America has become institutionalized.
While gambling is an entertaining and recreational pastime for the vast majority of players, it is evident that for a small minority, out-of-control gambling behavior causes problems for the individual, his/her family, and the community.
The Harvard Medical School Division of Addiction meta-analysis of over 100 prevalence studies estimated there were 4.4 million adult and adolescent pathological gamblers. Further, it estimated an additional 11 million adult and adolescent problem gamblers (Shaffer, et al., 1997). The National Opinion Research Center (NORC) in its national household phone survey conducted as part of the National Gambling Impact Study Commission to Congress estimated there were 20.5 million pathological and problem gamblers (
NORC, 1999). Even using the Harvard study's lower number of 15.4 million adult and adolescent problem and pathological gamblers, and assuming five family members, friends or co-workers are adversely affected by pathological and problem gamblers, there are approximately 70,000,000 people indirectly impacted by gambling problems in the United States.
Since the 1970s, legalized gambling has spread geographically, and is now legal in all but three states: Utah, Hawaii, and Tennessee. Moreover, according to the recently released National Gambling Impact Study Report (NORC, 1999) legalized gambling has become one of the fastest growing industries. Casinos now operate in 27 states.
In 1997, Americans spent more on gambling ($50.9 billion) than it did on all other forms of recreation combined. Casino gambling accounts for 40.3%, lotteries 32.6%, tribal gambling 13.1%, pari-mutuel 7.5% and charity gambling 6.5%. Amazingly, only 2.5% of bettors account for 15% of the wagering in America (NORC, 1999).
Pathological gambling In 1980 the American Psychiatric Association (APA) accepted pathological gambling as a "disorder of impulse control." It is an illness that is chronic and progressive, but diagnosable and treatable. Pathological gamblers are those individuals who seem incapable of controlling the compulsion to gamble, despite adverse consequences. According to the American Psychiatric Association(1994), pathological gambling is "persistent and recurrent maladaptive gambling behavior that disrupts personal, family or vocational pursuits."
Historically, the psychiatric community viewed gamblers as masochists or psychopaths rather than people with a disease or illness. A psychiatrist was the first mental health professional to suggest gambling was an addiction rather than a moral or personality failure. Dr. Robert Custer founded the first in-patient treatment facility for compulsive gamblers in 1972 at the Brecksville VA Medical Center. He is an authority in the field of problem gambling and was first in identifying the progression of pathological gambling as including three phases: the winning phase, the losing phase and the desperation or chasing phase (Custer & Milt, 1985).
"Male-as-the-norm" bias Historically, clinicians and researchers have assumed that gambling problems among women should be similar to gambling problems among men. Since most gambling research has been conducted with males, the result has been an andocentric "male-as-the-norm bias" in the definition and analysis of gambling assessment and treatment. The "male-as-the-norm" bias describes male behavior as the normative standard by which female gambling is judged, consistent with a patriarchal notion of the world (Mark & Lesieur, 1992).
Since Freud's paper on compulsive gambling was published in 1914, there has been little systematic research into the female problem gambler (
Lesieur,1988). With few exceptions, until the recently published Harvard Medical School meta-analysis (Shaffer, et al., 1997), gender comparisons were rare in gambling research (Hraba & Lee,1996), because gambling has been considered a disorder that primarily affects men. Researchers have contributed to this false perception by using either all male or predominately male samples in their investigations (Mark & Lesieur, 1992), with white males who served in the military being the most frequent subjects of research (Hraba & Lee,1996). This sets the stage for inherent contradiction in that women's problem gambling has been viewed as abnormal or different to men's, but women are researched as if their gambling problems were like those of men (Broffman & Scanlan,1998).
Comparing male and female gamblers A paucity of research exists on female gamblers and on female problem gambling specifically (Mark & Lesieur, 1992). It is unclear if the deficit representing female gamblers in the gambling literature was created by disinterest, insensibility, indifference, apathy or sexism. From a feminist perspective, scant consideration has been paid to exploring the impact of social stereotypes, moral standards, and limitations imposed upon female problem gamblers in our society (Mark & Lesieur, 1994).
Regrettably, an insufficient amount of women have entered treatment to allow us to draw reasonably safe conclusions. We have learned from several surveys of female Gamblers Anonymous (GA) members in Las Vegas and Atlantic City or from interviews with their significant others (
Lesieur & Rosenthal, 1991). Hence, the literature provides only impressions, not conclusions.
According to the 1976 National Policy Toward Gambling (
Lesieur, 1987) approximately one-third of compulsive gamblers in the United States were female. Findings of more recent studies on GA members on the East Coast reveals 2-4% are women (Custer & Strachan, 1989). There is a higher percentage of female GA members in Nevada and Atlantic City, New Jersey (Walker & Dickerson, 1995). With these exceptions, female problem gamblers are underrepresented in GA.
One reason that GA fails to attract female members is the stigma that is attached to being a female compulsive gambler. Therefore, female gamblers are more likely to be closet gamblers, and have fewer social supports than their male counterpart (Mark & Lesieur, 1994). Women who enter GA are less likely to be married than are men (42% versus 83%) (
Lesieur & Blume, 1991). Their referral sources are also different from those of men. For example, they are more likely to be self-referred (62%) than men who are frequently brought in by their spouses (Federman, et al., 2000). This self-referral is reflected in Gam-Anon support. Mark & Lesieur's (1994) study of 186 male and 4 female GA members found that 69% of male gamblers had spouses that attended Gam-Anon.
A woman may also meet resistance from her spouse or partner if she has a male sponsor who calls almost every day to support her. In addition to lack of support, some women tend to feel uncomfortable in the predominately male setting. This discomfort is the primary reason for the higher-than-average female dropout rate from GA (
Lesieur & Blume, 1991).
Cross addiction as prevalent in women as men In treatment centers where gambling assessments are used, female alcoholics and drug abusers seem to have the same degree of prevalence of cross addiction to gambling as their male counterparts (New Jersey Ad Hoc Committee on Women's Addictions, 1996).
Many female gamblers report other addictive disorders, i.e., alcohol, drugs, overeating, overspending and sex (Mark & Lesieur, 1992). In the past, researchers believed that female pathological gamblers were depressed and that this might be the cause of their gambling behavior (
Zebrowski, 1991). One reason for the confusion and lack of knowledge about this disorder was that the female gambler hides her addiction until it is out of control before entering treatment. The manifestation of denial for female gamblers may be related to cultural implications of shame, weakness and depravity attached to it (Schull, 1997).
Gambling as an escape The dominant hypothesis on gender differences among pathological gamblers has been men are "action" gamblers who tend to gamble for excitement or to prove themselves smarter than their opponents. Typically, the male uses his addiction to enhance his male image in a "macho" manner, by bragging and exaggerating about his behavior, winnings and financial losses (Custer & Milt, 1985). Whereas, women are allegedly "escapist" gamblers, who tend to flock to the solitary pleasures of slot machines or video lottery slots to escape some problem in their personal lives. (
Ohtsuka, et al. 1997).
Hunter (1996) described video poker as the crack cocaine of gambling, as it is one of the most addictive forms of gambling. He found women prefer video gambling, as it is solitary, provides players instant gratification and the illusion of a skill factor.
While compulsive gambling affects both men and women, there are some differences worth noting. The addiction is progressive in women as it is in men, but with women it most often does not advance as far (Custer & Milt, 1985). Social and economic factors seem to brake the descent earlier.
Characteristics of females who gamble Typically, women turn to gambling for possibly five reasons: entertainment, economics (win money), escape, excitement, or addiction to fantasy. Gambling provides a way to escape overwhelming problems, trauma, childhood disturbances, loneliness and boredom. In addition, it creates an aroused state similar to the "high" produced by alcohol and other drugs. In this excited state, women focus on the gambling activity and ignore all other concerns in their lives. Therefore, many women experience shame and resentment for being a compulsive gambler and lacking willpower and for failing as a moral role model in our society (NJ Ad Hoc Committee on Women's Addictions, 1996).
The onset of gambling in women is often in adulthood rather than adolescence (
Volberg, 1996), and in some cases much later in life as a result of developmental life changes such as the "empty nest syndrome," divorce or widowhood (NJ Ad Hoc Committee on Women's Addictions, 1996). Most males report winning a large sum of money early in their gambling experiences (Custer & Milt, 1985). Women report some winning episodes, but less often a tremendous win (Zebrowski, 1991). Females' enabling systems seem to be more limited to family and friends (Lesieur & Rosenthal, 1991). As with males, there is usually a history of addiction in either the nuclear or conjugal family (Lesieur, 1988).
Desperation for women comes when they cannot bear the guilt and shame any longer, and seems to come more from emotional exhaustion than from a lack of funds (Hunter, 1996).
Relevance to substance abuse counselors With more people gambling, more women will have gambling problems. Substance abuse counselors are more likely to see an increase in female problem gamblers. Given this phenomenon, substance abuse counselors need to understand the clinical manifestations of pathological gambling, as well as its effects on the family system.
Problem gambling is often a hidden disease because it is not discernible by merely looking at a person. Breath or blood test cannot detect it, nor does it leave needle marks. An old Gamblers Anonymous maxim advises "you cannot smell cards on our breath." Pathological gamblers hide their gambling from their family, friends, and co-workers. A female gambler may present seeking assistance with either financial, relationship or work problems, so gambling may be undetected as a primary problem.
More education, training needed for this addiction Few substance abuse counselors are adequately trained and prepared to deal with the newest addiction in our society. Most have little education or training in identification, assessment, or treatment of pathological gambling. Substance abuse counselors require additional training in assessment and diagnosis of gambling problems. In addition counselors need assistance in identifying financial options to assist clients, because the costs of this addiction are enormous. A compulsive gambler can destroy a family system by undermining family finances, by jeopardizing the physical and emotional health of family members, and by destabilizing marital and parent-child relationships.
The research suggests female pathological gamblers can be found in psychiatric and substance abuse populations and are easily screened with existing instruments (
Lesieur, et al., 1986). Knowing more about the interaction between gambling activity and other problem behaviors has significant implications for intervention. Substance abuse, use of illegal drugs and gambling often occur concomitantly, however, it is uncertain which of these problem behaviors precedes the other (Spunt, et al., 1996).
Social costs In addition, substance abuse counselors need to become concerned with the social costs associated with a proliferation of gambling. The impact of pathological gambling goes well beyond the identified patient. Family and friends are pulled into the whirlpool of this deepening problem. Corporations are acutely affected, with the pathological gambler using funds embezzled from an employer to maintain the addiction. Substance abuse counselors need to be aware of the likelihood of misdiagnosing or failing to identify the problem, particularly in the early stages. This is partially due to the lack of familiarity by substance abuse counselors, and partially the denial and mislabeling of the problem by clients and their significant others. In short, there is a real need to begin training substance abuse counselors to practice in this vital area, assisting female problem gamblers and their families.
Increasing dilemma The results of future research could be helpful to professionals working in the field, by offering a more clear-cut picture of the relationship between female gambling behavior and the development of a pathological gambling addiction. New knowledge about female gamblers will aid professionals working in the field to select more appropriate treatment modalities to ensure recovery, and to reduce the recidivism rate.
Because gambling among women is such a destructive influence on the marriage, family and all social and business relationships, it is extremely crucial to understand all the aspects of this rapidly increasing social dilemma. It is imperative that this problem be understood.
Thomas E. Broffman, LICSW, LCDP, LCDS, CEAP,
is vice-president of the Rhode Island Council on Problem Gambling.
He is the dual diagnosis coordinator for the Eleanor Slater Hospital
and an adjunct professor at Rhode Island College. Mr. Broffman
has more than 25 years of experience as a social worker in the
substance abuse and addictions fields. He is a certified Employee
Assistance Program Professional.

American Psychiatric Association. (1994). Pathological Gambling. In APA DSM-IV Task Force (Ed.), Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (pp. 615-618). Washington, DC: American Psychiatric Association.,
Broffman, T. & Scanlan, K. (1998, June). Focus Group Research with Female Problem Gamblers. Paper presented at the National Conference on Problem Gambling Conference, Las Vegas, NV.
Custer, R. & Milt, H. (1985). When Luck Runs Out: Help for Compulsive Gamblers And Their Families. New York: Facts-on-File Publications.
Custer, R. & Strachan, M. (1989). The Nevada Experience: The Female Compulsive Gambler in Las Vegas. In Eadington, W., (Ed.) The Gambling Studies: Proceedings of the Tenth National Conference on Gambling and Risk Taking (pp. 101-122), Reno, NV: University of Nevada.
Federman, E., Drebing, C., & Krebs, C. (2000) Don't Leave It to Chance: A Guide for Families of Problem Gamblers. Oakland, CA: New Harbinger Press.
Gamblers Anonymous. (1994). Sharing Recovery Through Gamblers Anonymous. Los Angeles, CA: Gamblers Anonymous.
Goodman, R. (1995). The Luck Business. NYC, NY: Free Press.
Hraba, J. & Lee G. (1996). Gender, Gambling, and Problem Gambling. Journal of Gambling Studies, 12, (1), 83-102.
Hunter, R. (1995). Pathological Gambling and Its Treatment. The Clinical Exchange, 2, (2), 2-3.
Lesieur, H. (1987). The Female Pathological Gambler in Eadington, W. ,(Ed.) The Gambling Studies: Proceedings of the Ninth National Conference on Gambling and Risk Taking (pp. 230-258), Reno, NV: University of Nevada.
Lesieur, H. (1988). Female Pathological Gamblers and Crime in Eadington, W. & Cornelius, J., (Ed.) Gambling Behavior and Problem Gambling (pp. 495-515). Las Vegas, Nevada: University of Las Vegas Press.
Lesieur, H. & Blume, S. (1991). When Lady Luck Loses: Women and Compulsive Gambling. In Van Den Bergh, N. (Ed.), Feminist Perspectives on Addiction (pp.181-197). New York: Springer Publishing.
Lesieur, H. & Rosenthal, R. (1991). Pathological gambling: A Review of the Literature (prepared for the American Psychiatric Association Task Force on DSM-IV, Committee on disorders of impulse control not elsewhere classified). Journal of Gambling Studies, 7, (1), 5-39.
Lesieur, H. Blume, S., & Zoppa, R. (1986). Alcoholism, Drug Abuse, and Gambling. Alcoholism: Clinical and Experimental Research, 10, 33-38.
Mark, M. & Lesieur, H. (1992). A Feminist Critique of Problem Gambling Research. British Journal of Addiction, 87, 549-565.
Mark, M. & Lesieur, H. (1994). Women Who Gamble Too Much. New York City, NY: National Council on Problem Gambling.
Moore, T. & Carlson, M. (1998). Video Poker and the New Pathological Gambler. The Counselor, 16, 5, 13-16.
National Opinion Research Center (1999). Gambling Impact & Behavior Study: Report to the National Gambling Impact Study Commission. Chicago, IL: University of Chicago, NORC.
New Jersey Governor's Council on Alcoholism and Drug Abuse (1996). Ad Hoc Committee on Women and Addiction Report: Women's Addictions. Trenton, NJ.
Ohtsuka, K., Burton, E., DeLucs, L. & Borg, V. (1997). Sex Differences in Pathological Gambling Using Gaming Machines. Psychological Reports, 80, 3, 1051-1057.
Shaffer, H., Hall, M., & Vander Bilt, J. (1997). Estimating the Prevalence of Disordered Gambling Behavior in the United States and Canada: A Meta-Analysis of Twenty Years of Gambling Studies, 1977-1997. Boston, MA: Harvard Medical School, Division on Addictions.
Schull, N. (1997). Addicted to the Machine: Women and Video Poker in Las Vegas. Doctoral Dissertation, University of California, Berkeley.
Spunt, B., Lesieur, H., Liberty, H.J. & Hunt, D. (1996). Pathological Gamblers in Methadone Treatment: A Comparison Between Men and Women. Journal of Gambling Studies, 12, (4), 431-449.
Volberg, R. (1996). Gambling and Problem Gambling in New York: A 10-Year Replication Survey, 1986 to 1996, A Report to the New York Council on Problem Gambling. Roaring Springs, PA: Gemini Research.
Walker, M. & Dickerson, M. (1996). The Prevalence of Problem and Pathological Gambling: A Critical Analysis. Journal of Gambling Studies, 12, (2), 233-249.
Zebrowski, M. (1991). The Significance of Depression in the Causality of the Gambling Phenomena in the Female. Doctoral Dissertation, Union Institute, Union, NJ .

Hope you find it interesting.
Anyone care to share their ESH on gambling here? And whatever methods you've used to overcome this form of addiction.

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Old 09-04-2006, 10:29 PM
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Whereas, women are allegedly "escapist" gamblers, who tend to flock to the solitary pleasures of slot machines or video lottery slots to escape some problem in their personal lives. (Ohtsuka, et al. 1997).
Yep... there I am. When AD was at her worst, and before I found Alanon... I was out several times a week at the casino. At least when I was spinning slots, I was not obsessing about her.

The first "warning" in my mind came when I realized I felt "hung-over" the next day.... the same sort of "I can't believe I did it again" thoughts I had when I drank.

Stupid "ism".... it's EVERYwhere....
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Old 09-05-2006, 04:56 PM
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This is so interesting to me Teach.

I work with women living in poverty in the downtown area of my city - some street women, all with emotiona problems. None of them are capable of working due to paranoia, schizophrenia, depression, etc. and so they are on welfare. This means surviving on very, very little money. And, yet some of them come into our Centre with a fistful of lottery tickets each and every week. Some of them beg on the street for money to buy lottery tickets. Some of them go without food to buy lottery tickets.

I understand that it is an addiction. I also understand that it is their only glimmer of hope in a life of endless poverty. It is the only chance that anything in their lives will change for the better, before they die.
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Old 09-05-2006, 05:11 PM
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That is so sad...

I've watched my ex fall farther and farther into the debths of gambling. He is now living in a broken down trailor in a bad city. His brother just came up from FL and they are living together. The ex just got audited by the IRS. He hasn't done his taxes since we divorced, @ 7 years ago. He never claimed the income from when I bought his share of the house. He spent those tens of thousands of dollars in a matter of months.
It's very very sad.
He's still in denial of a problem.

Thanks for your work. It's difficult, and so necessary.

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