Did you buy a lottery ticket this week? Did you contribute to the major league sports office pool? Gambling is an accepted part of our culture, but how do you know when a trip to the casino stops being fun and becomes a problem?

Listen as Allison Henning, LCSW, LCAS breaks down gambling and helps us understand the nuances of this common pastime. Where’s the line between recreation and addiction and how to help someone who has crossed it?

Allison Henning, LCSW, LCAS

Allison Henning, LCSW, LCAS, is employed by MindPath Care Centers. MindPath Care Centers is committed to supporting the highest quality and most comprehensive outpatient mindcare available to help people navigate life’s challenges, whenever and wherever they need it. Their unique, collaborative care approach and integration of the latest mental health treatments and technologies ensure patients receive the continuum of care required for optimal outcomes.

MindPath’s services are delivered at more than 25 locations in the Carolinas and include medication management and individual therapy both in office and via telehealth, addiction recovery services at the Addiction Recovery Center (ARC), group therapy sessions and TMS (transcranial magnetic stimulation) therapy. For more information or to schedule an appointment, please visit mindpathcare.com.

Gabe Howard

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, “Mental Illness is an Asshole and other Observations,” available from Amazon; signed copies are also available directly from the author.

To learn more about Gabe, please visit his website, gabehoward.com.

Producer’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to Inside Mental Health: A Psych Central Podcast where experts share experiences and the latest thinking on mental health and psychology. Here’s your host, Gabe Howard.

Gabe Howard: Hey, everyone, I’m your host, Gabe Howard, and I want to thank our sponsor, Better Help. You can grab a week free by visiting BetterHelp.com/PsychCentral. Calling into the show today we have Allison Henning LCSW, LCAS. Ms. Henning’s belief of utilizing programs that integrate family, individual and community to create a strong foundation for a sustained recovery in addiction and or mental health is vital to her success. She comes to us from MindPath Care Centers, which is committed to providing the highest quality and most comprehensive outpatient mind care to help folks navigate life’s challenges, Ms. Henning, welcome to the show.

Allison Henning: Good morning. Thank you. I am honored to be here.

Gabe Howard: Well, I am excited that you are here, because today we are going to be talking about gambling addiction. And I want to share a couple of quick bits of information with our listeners. First, I enjoy gambling and I do so two to three times a year, and generally, when visiting with my mom. My mom also enjoys gambling, but she generally goes about one to two times a month. Now, I only bring this up because my entire family loves to tease my mother, and we call her a gambling addict. Now we understand that she is not. But in preparing for the show, it occurred to me that I don’t have the foggiest idea how to tell if someone does have a gambling problem outside of your more extreme examples, like if they literally lose their home. Now, Ms. Henning, can you tell our listeners what criteria professionals look for to diagnose gambling addiction?

Allison Henning: Absolutely, and that’s a good point that you bring up, Gabe, because that would be more classified as recreational. There is that social component. It starts out that way. You know, I’m hanging out with my friend, my mom and I might buy lottery tickets for each other’s birthday. When that starts to spiral, the professionals mostly look for has that turned into increased time? Are they spending more money? Have we changed the structure of well, let’s just do this for a birthday and do $10. Now we’re doing it every month for $20. How do I start to feel? So someone tells me, you know, I’ve been lying and like you said, let’s do your reference to the loss of a home. So there’s that finances start to change inexplicably and we don’t acknowledge it.

Gabe Howard: What would be like step one? Like, I hate to use my mom as an example, because I know she’s listening to this right now, thinking, why does my name keep coming up? But what would we look for? Would it be if she lied to my dad about going, would it be if she got fired from her job because she was going? I know that if she bet the house and lost it, then we would all know for sure. But what are like the little things? Is it just that $20 lottery ticket or is it more subtle? Or less subtle?

Allison Henning: There are some subtle changes there can be, that’s absolutely correct. Look for their isolation. Are they withdrawn or are they hiding activities? And here’s a good one, have I neglected my obligations? Am I still getting food on the table for my family? Am I still cutting the grass every other week? You know, what are my obligations? And have I started to neglect those? So am I irritable? Am I restless? Is anything in jeopardy or my relationship starting to change? How am I doing at work

Gabe Howard: It sounds like one of the key component is prioritizing gambling over other things, things that really should be more important, family job, selfcare, things like that. If you start giving it too much time or priority to a hobby, that hobby can become an addiction. And specifically for this podcast, we’re talking about the hobby of gambling, and that’s when it turns a corner. Is that sort of a step one?

Allison Henning: Yes. So when the fun leaves and the problems enter, when the socialization of it disappears and now it’s no longer something that we do in a social arena with our friends or with our family, we step away from that. And now we do it on our own.

Gabe Howard: is that mechanism that makes somebody a quote/unquote, addict? Does the body literally become dependent on the need to gamble?

Allison Henning: Yes, Gabe, that’s a hundred percent. It is non substance related, but it’s the exact same process. It’s a physiological process that the brain goes through. Experts and all the scientists refer to it as the pleasure principle. It doesn’t matter if it’s from a psychoactive drug, monetary reward or any other encounters like food, a satisfying meal. There’s a release of that dopamine. And that dopamine floods and all of this is tied with pleasure. And the neuroscientists refer to that as the pleasure principle, because in that system is our reward system so our thought and our memory. If we’re gambling and all of a sudden we have this flood of excitement and pleasure, that stays in our brain. So it’s reactivated in that part of the brain regardless, even if we’re not a good gambler and that we lose all the time. It still stays in there.

Gabe Howard: It sort of sounds like a runner’s high, right? Like runners always describe they’re running and they get this, whether it’s endorphins, dopamine, there’s some process that when they run enough, they feel really good and they’re chasing that, quote, runner’s high. Is that an equivalent? Is there a gambler’s high that they’re chasing that they’re waiting to kick in?

Allison Henning: That’s exactly what I was going to bring up next. They call it chasing the win or chasing the losses. Even though we have all these negative effects from our gambling, we still have to chase it. So, yeah, it’s exactly the same. So now we’re getting a double whammy. The dopamine and endorphins. Now, that is also reward related. And all of that’s getting activated when we’re gambling.

Gabe Howard: Now, obviously, what we don’t see as a problem is the recreational gambling. I mean, for example, I believe every state has a lottery and if not every state does, I believe most of them do. And that’s gambling, right? Whether it’s a dollar scratch off or a dollar Mega Millions, you’re wagering. Our culture, our society, well, we just like gambling. We like gambling a lot. But I think that all of us don’t like it when people lose their jobs, cars, families and homes because they’re gambling so much. So, is it fair to say that our society does still see problem gambling, even if they don’t necessarily think that gambling in and of itself is a problem?

Allison Henning: Well, those factors definitely determine problem gambling. But then you go back to is this a moral problem? Why did you choose to lose your car or your home? Why did you choose to lose your family? Well, again, you get when you have this, your brain helps you to do that.

Gabe Howard: It’s a very interesting thing that you said there, that people believe that it’s a choice. It sounds like you’re saying that it’s not a choice. Is becoming a gambling addict or a problem gambler, is it not a choice? Is it just something that happens to us? Do we have any control whatsoever?

Allison Henning: No, it’s not a choice. That is something that does just happen to us. And when we get back to what happens when we activate that pleasure principle, right back to your running example, you know, that’s what gets us up to keep running every day. That’s why we do marathons. Let’s look at the people that have had knee surgery and they continue to run despite maybe the orthopedist says maybe we should back off of these marathons, Gabe, and start walking. You go to a marathon and you look at people’s knees and you see scars from the surgery, no different. And the accessibility is another problem. When you were talking about the states that don’t have government funded lotteries, Alabama, Alaska, Hawaii, Mississippi, Nevada and Utah, I have to move to one of those in order to not have this constant urge or need, cause there’s that chase.

Gabe Howard: And, of course, what’s interesting about Mississippi is that gambling is legal in Mississippi, along the Mississippi River, and I, I only know that because that’s where my mom’s casino is.

Allison Henning: Ah, right.

Gabe Howard: So even, even the states that put up some barriers, one of them at least doesn’t have all barriers.

Allison Henning: The operative word there, that’s not government funded.

Gabe Howard: Interesting. Good point.

Allison Henning: I mean, we do things, all there back to the social component. You know, think about fundraising. People will do mock casino to raise money for charities.

Gabe Howard: Or like I always joke, Chuck E. Cheese is just gambling for children because you play all these games of chance and skill to win tickets for prizes. So it really is everywhere, which I guess from my perspective, makes it that much more difficult to notice if you are having a problem or your loved one is having a problem and probably to know what to do. And we’ll be right back after a word from our sponsors.

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Gabe Howard: And we’re back discussing gambling addiction with Allison Henning from MindPath Care Centers. Let’s say, Ms. Henning, that I come to you and I say I accept that I am a problem gambler. I have a problem. Help me. What do you do

Allison Henning: Therapy is always helpful when it’s become problematic. I want to back up a little bit about what you said the approach. I think the approach is most important, because regardless of the manifestations, regardless of how I can justify and say it’s legal. So is purchasing alcohol. But that all fine and well, because it is true. But how do I approach? And there is an acronym, LUV, Listen, Understand and Validate. You have to be supportive and concerned about the manner in which the problems have started. The biggest key, do not ignore it. So if you think in terms of the statements, I think everyone’s familiar with an I-statement. Now, I notice you’re spending more time on betting out or I see you’re becoming more stressed, a little more anxious when you play and lose, which is all a sign of problematic gambling or I’m worried that betting has created some stress and worry. So I think there it’s more about the approach and allowing that person to have time to maybe process what’s being seen and give them the space to say, oh, my gosh, yeah, my credit card is maxed out. Do I have enough for rent, for mortgage? Can I skip lunch this week? Having the space to acknowledge it, thinking about it. That’s the understanding part.

Gabe Howard: And then once you do acknowledge it and you go and get help, what’s? What happens?

Allison Henning: There are resources when you get help. A lot of that, the mutual aid. So those are all 12 steps. Like in AA or NA, the first real process when you come in, if you seek help there’s the assessment. What are we looking for here? Are we looking for the behavior that caused the distress? What are the real markers? What do we rely on? What happened financially? Is there the obsession, the persistent thoughts? And then how do we plan for that? What do we do now to address? Because we can’t take someone’s finances away from them. So create a real structured plan that addresses the goals. I’m talking about structure to from 9:00 to 9:30, here’s what I’m involved in, from 10:00 to 11:00, here’s the next thing that I have to do. And stay addressed and obviously stay away from the scratch off, the places that provide that, which is even harder as both increase. But build that into, well, what can I do in place of this? How can I make a more informed and positive decision? It’s not so much about having a formal education. It’s more about educating yourself. You know how they say knowledge is power? That is very true.

Gabe Howard: Is cold turkey the only solution to problem gambling? Meaning you just, you just don’t gamble anymore? Or is it possible to go from problem gambling to quote/unquote, slowing down and becoming a, I don’t want to say a safe gambler, but I guess a non-problem gambler would be the right words.

Allison Henning: That’s a good question, because even in substance use, drugs and alcohol, there’s a term that professionals use that it’s called harm reduction, and it’s like, well, can I get back to the social component that I used before? Can I stop making this an obsession? Can I get back to where I was at work and still maybe go out and go to Buffalo Wild Wings and watch a game and say, OK, I’m only going to bet on one game because it’s also in our vernacular. You know, Gabe, I bet that you can’t figure that out or I wouldn’t bet on that.

Gabe Howard: Very true.

Allison Henning: I believe there are some people that have that ability, but I also have seen that no one is able to do anything completely by themselves or alone. A support system is more valuable than we realize.

Gabe Howard: And that support system doesn’t just include our friends and family, but that support system includes getting help, whether it be like a gamblers anonymous group or a peer support group or meeting with somebody like you. There’s not just a single path to recovery or prevention. There is probably an element of whatever works for you.

Allison Henning: Right.

Gabe Howard: And just to clarify from earlier, I don’t believe that there’s a medication for gambling addiction. Is that true?

Allison Henning: Not that I know of. I will say this, there could be one by the time we hang up. I know none of my current patients or clients are having medicated treatment for gambling, it is all like you said. You know, there’s formal and the informal supports, mutual aid, friends. Actually, I have some that even get involved when we’re talking about hobbies earlier. There’s music and theater where they can become interactive. So, again, I just want to emphasize back to the socialization part. So if we use that, if that’s how we socialize with through gambling or with gambling, then what do we do to socialize now?

Gabe Howard: It is fair, of course, to point out that things co-occur, for example, I live with bipolar disorder, and when I was in a manic state, I abused drugs and alcohol and well, I just, I just had all kinds of problems as people who are suffering from the symptoms of untreated bipolar disorder do. Once I was treated for bipolar disorder, which did include medication, some of those things naturally fell away because I didn’t have the manic thoughts, the grandiose thoughts, etc. I imagine that co-occurring disorders play a role in gambling addiction as well. It doesn’t just exist all by itself.

Allison Henning: That is 100% accurate, Gabe. I would like to see a casino where someone is sitting there that does not have an alcoholic beverage. I would also like to see a casino that doesn’t offer you alcohol for free. That’s a business plan. That’s a business model that they created. So, yeah, and just off the top of my head with the patients and the clients I work with and I’m not thinking of one that is strictly gambling. So, yeah, there’s always something else that can occur.

Gabe Howard: That is very interesting, and of course, it’s also important to say that research is always ongoing and things change rapidly. But for all of our listeners who are thinking to themselves, I’m really worried about my spouse, my friend, my brother, my sister. What advice do you have for them to help their loved ones see or consider whether or not they have a problem? Because, again, I just imagine sticking your finger in their face and saying you’re an addict is never going to work.

Allison Henning: No, you’re right, that’s never going to work. I want to go back to the acronym of LUV, to Listen, to Understand and to Validate with the loved one. Talk about your own experience of how the other person’s gambling is affecting you. Ask that other person for their perspective. Give them that space to think about what their actions have been and what their behaviors have been. Give them time to tell their story and listen without arguing and put the finger down, you know, get that finger out of their face when you’re listening. Don’t argue. That will definitely shut down the conversation, reassure them that there is help, that you do care, and that you want to be there to help. You know, there’s shame there, there’s discomfort, there’s the guilt, the judgment, the stigma.

Gabe Howard: Ms. Henning, thank you so much for being here, and I want to give our listeners the National Council on Problem Gambling helpline. It’s a national number in the U.S. It’s 1-800-522-4700. Again, that number is 1-800-522-4700. If you or a loved one has a gambling issue, please give that number a call. Thank you so much for listening. And please follow the show wherever you downloaded this podcast. It’s absolutely free. Also, take a moment to write us a review. Words matter. Review us. We love it. My name is Gabe Howard and I am the author of “Mental Illness Is an Asshole and Other Observations.” And I’m also a nationally recognized public speaker. I think it would be cool for us to hang out in person at your next event. You can grab a signed copy of my book or learn more about me over at gabehoward.com. I’ll see everybody next Thursday on Inside Mental Health.

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