OVERCOMING GAMBLING ADDICTION

Contents
What Is Gambling Addiction? How Does Compulsive Gambling Affect The Gambler And Others? Treating Compulsive Gambling Motivating Yourself To Stop Monitoring Your Gambling Using Relaxation Techniques To Control Your Urge Handling Triggers Associated With Gambling Stress Awareness Training	Managing Your Time Problem-Solving Sleep Management Assertiveness Training Dealing With Interpersonal Relationships Removing The Obstacles To Intimacy Dealing With Irrational Ideas Conclusion

What Is Gambling Addiction?
- Gambling whether bingo, the lottery or a visit to the casino, is physically arousing.
- Gamblers are highly motivated to gamble and pressure to stop is usually external.
- You need to admit that your gambling is a problem to both yourself and others close to you, in order to be on the road to recovery.
- There are four legal categories of gambling:
  1. Gaming e.g. card games, fruit machine, casino games such as roulette;
  2. Betting e.g. horse races;
  3. Lotteries e.g. raffles and bingo;
  4. Speculation – gambling on insurance, business or stock markets.
- Not all forms of gambling cause problems – it is when there is an opportunity to place large and/ or frequent bets that addiction tends to occur. Examples are horse races, lotteries and fruit machines.
- Easy access to gambling is also likely to lead to compulsive gambling.
- Excessive gambling can lead to depression, anxiety, and alcohol and drug misuse. The stress of financial pressures may result in the person committing a crime to provide for their debts or further gambling.
- There is also emotional strain due to the fear of discovery and interpersonal relationships and performance at work suffer as a result of gambling addiction.
- Gamblers often experience a craving for gambling and are preoccupied with gambling to the exclusion of everything else. They fantasize about winning and are irrationally confident. They become irritated if anything hinders their gambling. On winning there is a sense of elation and on losing there is remorse and worry about how to cover living expenses, which can lead to alcohol and drug misuse to forget problems.
- Gambling addiction develops from gambling at acceptable levels to losing control at some point due to not being able to resist the chance to gamble or from not being able to stop gambling. Loss of control may be rapid or it may be gradual but progressive. Some may proceed to sudden prolonged sessions of gambling – a binge.
- There are three phases of pathological gambling:
  1. The winning phase – marked by ‘beginner’s luck’ leading to initial excitement and fantasies about winning more and more;
  2. Losing phase – The longer one gambles, the more likely one is to lose. Chasing losses begins and the gambler starts to gamble secretly;
  3. The desperation phase – a vicious cycle is set up of chasing losses, winning occasionally and suffering more losses and so on. Irrational gambling begins often leading to serious consequences such as court convictions.
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How Does Compulsive Gambling Affect The Gambler And Others?
- Those on low income and unemployed persons are more susceptible to gambling problems than those on high salaries.
- Impulsive gamblers tend to start gambling at a younger age and have more financial difficulty.
- For some gamblers, gambling is a form of emotional escapism to evade their emotional problems via the distraction of excitement.
- Depression can cause problem gambling and equally compulsive gambling can result in depression - 75% of compulsive gamblers suffer from symptoms of depression.
- Distress about financial problems, fear about being discovered to be gambling or to have committed a criminal offence as a result of gambling, as well as the low mood of depression – all lead to despair and put strain on interpersonal relationships.
- 60% of compulsive gamblers contemplate suicide and 20% have attempted suicide during a crisis.
- Gamblers suffer from anxiety and tension due to the stress associated with compulsive gambling, leading to irritability and outbursts of anger. Disturbed sleep causes fatigue and exacerbates bad mood.
- Excessive gambling can lead to an alcohol or drugs problem where the gambler tries to escape their worries by drinking or taking drugs.
- Alcoholism can lead to the alcoholic losing control over gambling – they may find it hard to stop gambling once started or go on a binge and lose a large amount of money.
- Gambling interferes with the gambler’s capacity to do their work effectively and often results in resignation or termination of employment – the former usually to avoid detection of criminal activities undertaken to secure money to gamble.
- Lying becomes a way of life for gamblers and you need to open up and admit the urge to gamble to someone close to you who can support you in your goal to overcome gambling addiction. Admitting to the urge to gamble often curbs the desire to do so.
- The stress of gambling can affect concentration and the ability to make decisions.
- Gamblers tend to suffer from stress-related physical problems such as headaches, muscular aches and pain and high blood pressure.
- Couples argue frequently about financial difficulties and the gambler withdraws from family excursions due to conflict with gambling opportunities or lack of funds, resulting in loss of friends. Gamblers become irritable and moody when social functions interfere with gambling. They are often abusive to their children and their wives. The result can be periods of marital separation and divorce.
- Spouses react with:
  1. confusion about what has happened;
  2. guilt that they did not realize earlier;
  3. anger at what their partner has done to the family;
  4. loss of trust, uncertainty, insecurity and fear; worry for the future.
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Treating Compulsive Gambling
- Aversive therapy can be used to treat gamblers, where a new association is formed between gambling which was previously seen as pleasurable, and an aversive or unpleasant stimulus such as electric shocks to the fingers when playing slot machines.
- A highly effective alternative is cognitive behavioural therapy.
- Gamblers have distorted or irrational ways of thinking which need to be identified and corrected if compulsive gambling is to be overcome.
- Gamblers often believe they have some skill in chance events. They tend to focus on wins and discount losses. Some gamblers may be superstitious and be over confident in their own luck.
- Pathological gambling may be treated with drugs which improve mood or reduce impulsivity but medication therapy is best combined with psychological approaches such as cognitive behavioural therapy – CBT.
- Depression associated with compulsive gambling may be treated with anti-depressants such as tricyclics (e.g. imipramine, amitriptyline) or monoamine oxidase inhibitors (e.g. phenelzine), especially when there is risk of suicide. Selective serotonin re-uptake inhibitors (SSRIs) may be used and work either by reducing depression or acting on lowering impulsivity.
- There are two principles of treatment ‘abstinence’ – no gambling whatsoever, and ‘controlled’ gambling – gambling at reduced levels has benefits despite the continued presence of gambling.
- Abstinence is advocated in the first instance and once control over compulsive urges is demonstrated, controlled gambling may be considered. However the best advice is always to avoid gambling.
- It is necessary to have a relapse prevention strategy to ensure you do not fall back into old habits of gambling.
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Motivating Yourself To Stop
- If you are in a crisis situation and likely to self-harm consult your doctor immediately. Once you are no longer in danger of harming yourself you can continue with this advice.
- First you need to decide if your goal is to become completely abstinent and never gamble again, or to control your gambling to acceptable levels.
- List reasons for and against complete abstinence and controlled gambling, to help you decide on your ultimate goal.
- You need to be honest to your partner, about your level of debt and perhaps seek financial assistance.
- If you are committing offences to support your gambling habit: stop any further offences immediately; take responsibility for your actions – accept the consequences, with legal help; discuss your actions with your partner.
- Avoid drinking before or during gambling; talk to your partner rather than drowning your sorrows in drinking after losing; if you are dependent on alcohol and/or drugs, consult your doctor; in a crisis seek help immediately rather than turn to alcohol or drugs which may increase your risk of self-harm.
- Marital problems are caused by the financial strain of gambling and you may want to consult a marital counsellor.
- Exposure to gambling may lead to the development of a gambling habit; gambling has many similarities with substance abuse and may be treated effectively using addiction treatment strategies; emotional responses such as stress, anxiety and depression may cause increased gambling behaviour.
- Keep in mind that overcoming gambling will considerably improve your quality of life.
- You may feel ambivalent about giving up gambling – it is necessary for you to understand your motivation.
- Write down at least ten reasons to stop gambling and list them starting with the most important. Do the same for reasons to continue gambling.
- Compare the two lists – can you see that your behaviour is affecting not only you but also others close to you; your gambling arises from selfish reasons and causes problems in all aspects of life; your stress levels would be much lower if you stopped gambling.
- Is your self-aim, abstinence or controlled gambling? If it is the latter you need to review your motivation. You will need to specify how much time and money you can allow yourself each week and stick to the plan. You should involve someone close to monitor your gambling each week, as well as seeking support from an external professional. If you are reluctant to do this and feel you can monitor yourself alone, you need to seriously reconsider your motivation to overcome your problem gambling.
- Others can help motivate a gambler by:
- Not pressurizing the gambler to seek help, since nagging tends to lead to resistance to help.
- Ensure the gambler takes responsibility for action to stop gambling.
- Provide him or her with information on what help is available.
- Do not keep the problem hidden from others.
- Protect yourself against any debts the gambler may incur and remove yourself from being responsible for these debts.
- Do not pay off the gambler’s debts – they need to learn to be responsible for any problems caused by their gambling.
- The gambler should not be seen as suffering from an illness and unable to control their self – rather they fail to control their self.
- Consider the benefits for yourself and others if you stop gambling. Determine your level of motivation – are you realistic in your goal?
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Monitoring Your Gambling
- Monitoring your gambling: will make clear any patterns in your gambling; you will notice the change in your level of gambling from following this advice and your motivation will increase; also you will become aware of exactly how much money you are gambling.
- Use a separate sheet for each day and record gambling details immediately rather than rely on your memory later.
- Make eight columns and:
  1. Record the time and place you gambled;
  2. Write in detail your specific thoughts and feelings that made you decide to gamble. Rate your level of anxiety/depression 1-10 (1 is no anxiety/depression and 10 is extreme anxiety/depression);
  3. Note any money borrowed for gambling, from whom and the total amount of money owed to that person;
  4. Record cash you actually have at your disposal before gambling, and not that which has been borrowed in any manner e.g. withdrawn from savings account or used instead of paying the rent or bills;
  5. Record cash remaining at the end of a gambling session;
  6. Record your winnings;
  7. Record your losses;
  8. Note in detail your thoughts and feelings at the end of a gambling session. Rate your anxiety/depression 1-10 (1 is no anxiety/depression and 10 is extreme anxiety /depression).
- At the bottom of the sheet total column 3 to see how much borrowed money you are risking.
- Total column 7 and subtract this loss total from the total of column 6 (wins). If the figure is negative you have lost. You will need to record this figure on another sheet as explained below:
- Make three columns with seven rows - one for each day. In column 1 record the date for each day; in column 2 record the total winnings for the day; in column 3 record the total losses for the day. Total the loss column and subtract from the win column total to get the overall loss or winnings for that week.
- Review your monitoring sheets regularly. Consider any patterns in your gambling e.g. are there particular times, specific emotions or regular venues associated with your gambling? Does a particular emotion or reference to gambling trigger your urge to gamble? How do you feel when you lose and what effect does this have on your gambling?
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Using Relaxation Techniques To Control Your Urge
- You may feel that the urge to gamble is overwhelming and beyond control. Your mistaken confidence and tension grow until the urge is finally satisfied through gambling.
- Imaginal desensitization is a relaxation based technique which reduces the urge to gamble and the tension produced in resisting the urge to gamble.
- Physical relaxation is combined with mental images of being confronted with the chance to gamble but not doing so.
- Write in detail a typical example of your pattern of gambling then break this down into six scenes, from the instructions to imagine the start of the urge to gamble to successfully not gambling despite the opportunity.
- Read out aloud and tape record the following: Relaxation instructions, scene 1; relaxation instructions, scene 2; relaxation instructions, scene 3; relaxation instructions, scene 4; relaxation instructions, scene 5; relaxation instructions, scene 6. Each scene should take about five minutes to complete.
- Controlling Your Breathing: Hyperventilation – faster breathing occurs in response to exertion and stress. In the long-term this can be uncomfortable and cause unpleasant physical symptoms which trigger more anxiety and more hyperventilation. Another cycle of stress is set up and can result in a panic attack.
- You can rectify hyperventilation by learning to control your breathing.
- First practice lying down and later sitting or standing. Place one hand on your stomach and the other on your chest. Breathe in slowly through your nose until your lungs are full then exhale slowly through your nose. Breathing in and out counts as one breath – aim to take 8-12 breaths a minute.
- In order to be effective you need to practice this exercise repeatedly.
- Relaxation: You need to develop relaxation into a skill you can use when you feel muscular tension due to stress.
- Try to develop a routine and practice your relaxation exercises. Start by lying down and later you can try sitting or standing. Control your breathing.
- Record your experiences noting the date and time. Rate your distress before the relaxation exercise, 1-10 (1 is tense and 10 is very relaxed). Which exercise did you use? Rate your distress afterwards. Make notes of the sort of day it was, your preoccupations etc.
Below are three exercises – only move to the next one when you are fully relaxed after a routine.
- When you have learned to relax using the three exercises you can start to use the skills throughout the day. Use something to remind you regularly to relax. Apply your relaxation skills whenever you need to use them in response to physical tension.
- Formulate relaxation instructions for imaginal desensitization using the above method of PMR.
- As you listen to the imaginal desensitization tape follow the relaxation instructions then imagine each scene remembering to relax during each scene.
- The more you practice, the more skilled you will become in applying the technique efficiently. You will need to listen to the tape 2-3 times a day for a week then once a day until you have mastered the technique. After that, you may use the tape as needed.
- The first tape is sequence 1 – write two other such sequences describing your behaviour, thoughts and feelings prior to, during and after successfully not taking the opportunity to gamble.
- Eventually you should be able to apply the technique automatically whenever you experience an urge coming on
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Handling Triggers Associated With Gambling
- You become conditioned so that certain cues or triggers activate gambling-related thoughts and feelings which can be so strong that they have been described as being similar to a drug ‘high’.
- Triggers include emotions, times and places as well as cues directly related to gambling.
- Review your monitoring sheet and write down any physical situations you notice lead to increase in your gambling urge e.g. seeing a betting office as you pass it or a lottery broadcast on television.
- In order to control your urge you need to avoid any situation that reminds you of gambling. Realistically you will not be able to avoid every cue but you can try to:
- Avoid reading the race results in the newspaper and switch of the television or radio when results are being broadcast.
- Decline any social gambling activity – you will not lose any friends worth keeping. Ask for your friends’ support in helping you.
- Avoid gambling on the way home by changing your route or having company with you.
- Arrange activities with others at high-risk times so that you are distracted and do not dwell on your urge to gamble.
- As a cue sets of your urge to gamble, use imaginal desensitization to relax and release tension so help you control your urge.
- On a flash card write the four most negative consequences of acting on your urge. On the other side write: How will I feel when I lose? Keep this close at hand to read frequently and whenever you feel the urge to gamble.
- For many people gambling temporarily reduces their level of tension so when they are stressed they gamble to lift their mood and evade worries and cares or ‘take-out’ their anger on gambling.
- Review your monitoring sheet to see if unpleasant mood states are associated with your gambling.
- Write down the emotions that trigger your urge to gamble.
- List situations that remind you of gambling and write down strategies to avoid these situations.
- Mood: Your mood affects almost every area of your life. Irregularities in your mood lead to feeling irritable with no obvious trigger. When this is the case almost anything can set off your anger.
- The main factors influencing your mood and how you can attain a stable good mood are considered below.
- Your body wants to eat and sleep regularly so you need to form a good circadian rhythm or daily routine. Make a list of your rising time, mealtimes and bedtime and try to keep to within 30 minutes of these times either way. Record the actual times you eat and sleep in a diary.
- Exercise is good for you and it need not be strenuous – do not undertake strenuous exercise without consulting your doctor. Wear comfortable and even stylish shoes and think of exercise as important. Exercising will increase your energy. Try exercising earlier in the day if you are usually too tired in the evening. You should get as much exercise as you want. Keep a diary of how much exercise you are getting. This can be part of your routine (e.g. walking between places) or planned timetabled exercise (e.g. going for a swim).
- Eat a balanced diet and make sure you chew your food well to digest it properly. Drink plenty of water. You should eat mostly fruits and vegetables, least of high fat foods such as cake and chocolate and a moderate amount of foods such as bread, rice and potatoes and high protein foods such as meat and fish with less of the latter category than the former.
- Cut down on your stimulant intake to about three cups of coffee a day. Reduce your alcohol intake to 21 units a week for a man and 14 for a woman. Go easy on nicotine and other ‘recreational’ drugs. Try to get down to your recommended alcohol intake. If you need help to do this your doctor may be able to suggest someone or you could contact Alcoholic Anonymous (contact number available from local phone book) – you do not need to be drinking excessively to enlist their help.
- Get into the routine of getting a good night’s sleep. Rise and eat regularly and reduce your stimulants and alcohol intake. Get sufficient physical and mental exercise in the day and be less active before you go to bed so that you do so more relaxed. Make sure you are adequately full and have a regular bedtime. Try to go to bed happy and comfortable without any disturbances such as external noise.
- If your bad mood is due to illness then try to get well. When this is not possible endeavour to blame your illness rather than other people. For those whose bad mood is caused by depression see ‘Overcoming Depression’ in the Forward Counselling Advice Service.
- Reduce the effects of stress on your life by: Examining the pressures you are under and removing one or two of these stresses; Learning to deal with the stresses more effectively – identify your stresses and ask others how they cope with those stresses then make a plan of action and implement it; Viewing your stresses in a different way and acting on this new view
- Nurture and consolidate your intimate, work and outside of work and intimacy relationships (e.g. friends and neighbours). Beware of distributing disturbances in one area to the other two areas.
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Stress Awareness Training
- You need to monitor your stress and become familiar with what sets it off and the feelings, thinking and actions associated with the anxiety. You can do this by keeping a diary. When you feel anxious note the date and time. What was the event? Rate your distress 1-10 (1 is no distress and 10 is extreme panic). What caused your anxiety? What was your response to cope with the problem? Re-rate your distress.
- After two weeks of monitoring your stress levels you should become aware of what triggers your distress, your bodily feelings and thoughts when distressed, how your distress levels vary with different situations, what you tend to do when distressed and what is the best way for you to cope with your distress.
- Make two lists – one of short-term only coping strategies and the other of long-term coping strategies. You can refer to these when you feel stressed. Try to incorporate more of the long-term strategies into your set of coping techniques and attempt to gradually abandon your short-term methods.
- Avoid turning to stimulants such as alcohol, caffeine and nicotine as coping methods. These have unpleasant effects in the long-term.
- Study your diary to determine what drives your cycles of distress. Is it bodily, psychological, behavioural or social?
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Managing Your Time
- Good time management requires being aware of:
  1. Your needs and strengths – list these opposite each other.
  2. Your standard procedure – find out how you use your time at present by keeping a record of how you spend your time. From the record you will be able to work out the best way of working. Try to get a balance of work tasks and include breaks.
  3. Your priorities – identify and rank in order of priority the different areas of your life. Consider the time you allocate to each and what is realistic and necessary. Perhaps others are making demands of you that you need to be more assertive about?
  4. Setting reasonable goals – keep in mind the important areas of your life when pursuing goals. Clearly define your goals so you know when you have achieved them. Some goals will need to be broken down into more manageable steps.
- Once you know the above you can draw up a new more efficient schedule. Use an organizer and list long-term (within six months), medium-term (within a month) and short-term (within a week) goals. Set aside time each day to organize. Try to do a ‘To do’ list of prioritized tasks every day. Plan flexibly and review every month.
- Delegating – giving over responsibility with authority, to others for appropriate tasks, is part of good time management.
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Problem-Solving
- Problems of any sort can cause a person to become distressed, frustrated and angry.
- The problem-solving approach can be useful in these cases. You learn to focus your thinking and find solutions to your problem instead of becoming angry. There are six steps in problem-solving:
  1. Define the Problem – Be specific and try to break the problem into more manageable tasks. Do one task at a time. Choose your task and specify your goal.
  2. List Solutions – Try to write down as many ideas, to solve your problem, as you can.
  3. Evaluate the Pros and Cons of Each Solution – Consider your solutions and reject the unsuitable ones. List the remaining solutions in order of usefulness.
  4. Selecting a Solution and Planning Action - Choose your first solution and decide how you will put it into action. Rehearse your task and make sure you have a back-up plan in case your task does not go as planned.
  5. Do it - Attempt your solution.
  6. Review the Result of the Solution – If your solution is successful try to understand why it was so. If your solution is unsuccessful try to comprehend why it did not work. Praise yourself for having tried and choose your next solution from your list.
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Sleep Management
- The length of sleep necessary varies from person to person.
- Worrying will prevent you from sleeping.
- You need less sleep as you get older.
- Sleep is affected by mood, stress, food, alcohol, exercise and medicines.
- In the long-term, sleeping tablets are not helpful and can be addictive.
- You can manage your sleep problems by changing your behaviour rather than resorting to medication.
- Keep a sleep diary for several nights to ascertain if you have a problem. Note the date and anything that might affect your ability to sleep e.g. your activity before retiring. If you have waking episodes, note your activity to restore sleep. Was it helpful? Next day note the number of hours of sleep you managed to get and rate how alert you feel 1-10 (1 is dull and sleepy and 10 is very alert). Rate your performance that day 1-10 (1 is poor performance and 10 is performed well). If you do have a problem the following suggestions might be helpful:
  1. Analyze your sleep diary to see if poor sleep is due to stress and is likely to get better as this eases; are there behaviours which result in poor sleep that you could change?; identify helpful and unhelpful ways of coping and avoid the latter.
  2. Introduce pleasant smells into your sleeping environment to help you relax e.g. potpourri or lavender oil.
  3. Try to relax an hour or two before you go to bed. Keep your daily stress low and seek counselling or the support of friends if you feel the need. Exercise during the day. Avoid caffeine, nicotine and alcohol and try a warm milk drink before bed. Make sure you are not hungry before retiring as this will keep you awake. · Ensure you have a quiet bedroom and a comfortable bed and have emptied your bladder before trying to sleep. Use your bed only for sleeping and set an alarm so you wake regularly each day. Avoid naps during the day.
  4. If you sleepwalk you are advised to discuss this with your doctor as it can be dangerous.
- To cope with disturbing dreams you could try:
  1. Constructing a positive ending to your disturbing dream and mentally practicing this alternative ending several times before sleeping;
  2. Practicing beforehand what you might say if the dream occurs;
  3. Keep water and a towel by your bedside to wash your face with if you wake up sweating - this will help you re-orientate;
  4. Keep a notepad and pencil within reach so you can record your dreams but beware of reading too much into their interpretation.
- Relaxed Breathing Method:
  You could try the following method of relaxed breathing to ease tension and promote sleep:
  1. Ensure you have some time to yourself and push your worries to one side;
  2. Sit or lie comfortably and close your eyes with your arms by your side;
  3. Concentrate on breathing naturally;
  4. Place your hands on your stomach and breathe in deeply and hold for a few seconds feeling your stomach rise. Breathe out and feel your stomach contract. Repeat and as you breathe out think of a relaxing image or sound. Continue doing this until you feel thoroughly relaxed;
  5. Count back from 10 then open your eyes and feel how relaxed you are now. Slowly get up and resume normal activities.
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Assertiveness Training
- The aim of assertive behaviour is to stand up for your legitimate rights and face others without putting yourself or them down.
- Assertiveness training teaches you to increase the number and variety of situations in which you are assertive.
- There are three types of interpersonal behaviour:
  1. Aggressive - you may be forceful in expressing your opinions, feelings and wants.
  2. Passive - your opinions, feelings and wants may be withheld completely or partly.
  3. Opinions, feelings and wants are stated with respect for the rights of others.
- Make sure you are aware of your fundamental rights which include: asking for what you want; saying 'No' without guilt; not being perfect; being ignorant about something; being responsible for your actions; having your own perspective and emotions; being indecisive; choosing whether or not to deal with others' difficulties; expecting privacy, independence and success.
- There are five steps to being assertive:
  1. What do you want? ;
  2. What is fair? ;
  3. Be clear in asking for it;
  4. Contemplate and be ready for the risks;
  5. Stay calm
- Practice your arguments in advance and repeat yourself to get the message across. Be prepared to negotiate.
- Think about situations in which you are not assertive and how you could change this and be assertive.
- Write out a detailed description of problem scenes - note when and where the problem occurs; who is involved; what your difficulties are; how you handle it; your fear of what will happen if you are assertive; your goal.
- To deal with a problem situation:
  1. Consider your rights and wants.
  2. Unless spontaneous action is required, arrange a mutually convenient time to discuss your problem with the other person.
  3. Define the problem as specifically as possible.
  4. Describe your feelings using 'I' messages, to give the other person an understanding of how important the issue is to you.
  5. Make your request in one or two simple but firm sentences.
  6. Give positive reinforcement to get what you want e.g. we'll be able to spend more time together. If this will be ineffective try negative reinforcement, describing the alternative way you will look after yourself if your wishes are not met.
- You need to arrive at a workable compromise. Agree to review this after a specified length of time and if you are not both satisfied you can renegotiate.
- Avoid being manipulated - techniques include:
  1. 'Broken Record' where you choose a concise assertive statement to say over and over to get your message across.
  2. Delay responding to a challenging statement until you are more prepared.
  3. Inviting criticism may reveal what is troubling the other person.
  4. When someone puts you down, acknowledge something you can agree with in their criticism and ignore the rest.
  5. You can change the focus, from discussing the topic to analyzing the interaction between the two of you.
- In instances where you lack time you could use the short form assertiveness technique. Consider:
  1. Your thoughts - state the facts as: 'I think…'
  2. Your feelings - express as 'I' statements: 'I feel…'
  3. Your wants - specify behaviour change as: 'I want…'
- You need to develop assertive body language. Practice the following basic rules in front of a mirror so that you learn how to apply them to problem situations:
  1. Maintain eye contact and an erect body posture.
  2. Speak clearly and firmly.
  3. Emphasize what you are saying with gestures and facial expressions.
- Learn to listen assertively:
  1. Make sure you are both ready to listen.
  2. Listen giving the other person your full attention and ask them to clarify if necessary.
  3. Let the other person know you have heard what s/he has expressed to you.
- Practice being more assertive in problem situations and consider how it makes you feel.
- Role-playing is a good way to improve your assertiveness in a safe environment before trying it out in real life situations.
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Dealing With Interpersonal Relationships
- Interpersonal relationships may have caused your gambling habit or may be preventing you from recovering – in any event interpersonal relationships will be affected by your gambling habit.
- You need to understand your personal relationships and be able to deal with them effectively.
- Draw interpersonal maps for:
  1. How your interpersonal relationships are at present;
  2. How your interpersonal relationships might be now if you did not suffer from your emotional problem;
  3. How your interpersonal relationships will be in 10 years if you continue to suffer from your emotional problem;
  4. How you would ideally like your interpersonal relationships to be.
- These will summarize all your relationships and allow you to recognize any changes you may desire.
- List all your important relationships and put yourself in the middle of the map in a circle.
- Place each person’s name in a circle on the map, around you in the middle – the closer the relationship to you, the closer the circle to you.
- Join these circle’s to you in the middle with an arrow outward if it is you mainly giving; an arrow inward if you are mainly receiving; a two-way arrow if giving and receiving is balanced; a question mark if you are unsure.
- Examine these maps noting any differences and set yourself goals to make any desired changes to your relationships.
- For each relationship ask yourself:
  - who initiates and terminates contact;
  - are you happy with how often you see this person? ;
  - who decides what to do or what to talk about? ;
  - is there a balance between giving and receiving? ;
  - do you want to alter the relationship in anyway?
- Consider questions such as:
  - who could I confide in and get advice from? ;
  - who would be there for me if I fell ill? ;
  - Who would lend me money at very short notice?
- Next time you have contact with each person, examine the relationship – participate and observe. Were your predictions correct? – If not, what was different?
- When you have a complete picture of your relationships, think about how you maintain them and in what way you want to change your relationships.
- Two important reasons for making changes are:
  1. A balanced and supportive social network is necessary for your well-being;
  2. By altering your relationships but avoiding being controlling, you may increase your sense of control.
- Start by making small changes and monitoring progress. You could also try discussing what you have learned about the relationship with the individual.
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Removing The Obstacles To Intimacy
- Record and examine closely the things that prevent you from achieving intimacy with someone. Note your thoughts and reactions when you distance yourself from a friend or end a relationship and make an analysis e.g. are you overgeneralising?
- Social inadequacy can be an obstacle to intimacy. Apply your assertiveness skills to your social and work life and observe how socially skilled people handle situations in particular difficult ones. Rehearse your social behaviours so that you are comfortable with them.
- Try to grasp your anxious thoughts, examine them closely and if required, challenge them. What are your anxious thoughts? Is your outlook biased – are there misjudgments? Consider the evidence to support and discount your thoughts.
- See ‘Overcoming Social Phobia’ in the Forward Counselling Advice Service.
- It is possible to become over-intimate and make ourselves vulnerable to exploitation. Trust can be given in a series of stages and you can fluctuate as to how much you trust someone.
- Communication is necessary for all relationships. Record the feelings which threaten your relationship (e.g. jealousy) and grasp the automatic thoughts. Analyze them and find alternative ways of dealing with the situation.
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Dealing With Irrational Ideas
- Your attitudes and belief structures related to gambling influence your behaviour.
- Write down your beliefs and attitudes about gambling e.g. ‘I am skilled at gambling and can be a winner’.
- Consider some common erroneous beliefs
- Gamblers mistakenly believe that gambling is a source of income rather than a costly form of entertainment.
- The most erroneous belief among gamblers is that they can win at gambling - this fantasy is encouraged by the media. Next time you win, note how much money you have lost trying to gain that win. Start to focus on your losses rather than emphasizing your wins.
- Gambling is a game of chance but many gamblers are deluded that they have special skills to influence the outcome of chance events.
- Write down the strategies you use and determine which ones are based on real skill and which are just superstitious beliefs.
- Biased thinking leads gamblers to take credit for winning and boasting of their skills whilst when they lose they dismiss the losses, blaming external causes.
- Write down the last three times you won, how much each time and where. Next write down the last three times you lost, how much each time, where and why in each case. You are likely to find it harder to remember your losses than your winnings.
- Near-wins are almost as exciting as actual wins but you need to realize that the end result is you lost and the near-miss has no bearing on the next event.
- Many gamblers mistakenly believe gambling can solve their financial problems. Since gambling got you into debt in the first place, it is illogical to believe gambling will solve your financial problems. Moreover, gamblers tend to prefer to keep their winnings for further gambling rather than pay off debts. Even if debts are paid off, continued gambling results in more debts.
- Gamblers often use the excuse that gambling is an illness over which they have no control but the truth is that they choose to gamble despite the harm to themselves. In order to regain control over your life you need to take responsibility for your actions.
- Challenging irrational beliefs:
- Write down a few thoughts you have when you feel the urge to gamble.
- Look closely at and challenge the evidence you think supports your belief. Is your thought rational? If not, why not? What is a more realistic view?
- You need to challenge that you are under an irresistible urge over which you have no control, and realize you are in fact making a voluntary choice.
- Replace irrational thoughts with rational, positive thoughts that give you confidence and self-control.
- Practice writing down the situation, your irrational thoughts, challenging thoughts and positive thoughts.
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Conclusion
- You need to learn to plan ahead and avoid risk situations that may lead to a relapse.
- You are bound to struggle on your path to recovery. Do not dwell on lapses – You need to be more careful in future. Re-read this advice and renew your efforts. For additional problems (e.g. depression), you may need to consult your doctor or a counsellor.
- Unpleasant moods and emotions, interpersonal conflicts and social pressure can singly or in combination contribute to the appearance of an urge. Note down a list of positive strategies you can apply to overcome these factors. Write the most useful strategies on an index card to keep close at hand.
- Do you try to justify approaching a gambling situation? If so, think of alternative action that avoids exposure to gambling cues e.g. Instead of playing the slot machines to relax, after an argument with your partner, try resolving the conflict.
- Write down on index cards alternative actions to avoid exposure to gambling cues in all circumstances you may face.
- On a flash card write down three good reasons why you should not continue to gamble and keep it close at hand, with the card on which you have written ‘How will I feel when I lose?’ When you feel a lapse is impending take these cards out and read them to remind you to avoid gambling.
- You need to practice declining invitations from others to gamble and make a habit of discussing your urges with your partner. Immediately inform your partner if you gamble any amount of money.
- Do not hold back your emotions and ask for your family’s support
- Work out a budget with your partner and limit your access to cash.
- Accept that your family are concerned about you and are trying their best to help you overcome your gambling addiction and move forward.
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