I do have office hours in North San Diego

Dear W--

Thanks for getting back to me. I do have office hours in North San Diego County (Poway) 3 days a week: Tuesdays, Fridays and Saturdays. I have the Saturday hours because I know how hard it is for some people to have to take off work to see a doctor---and because I don't have evening hours right now.

You mentioned you have been in treatment for other issues. That makes sense since "escape-relief" gamblers, like yourself, who favor the machines are at a high probability of having an affective disorder. Research shows that 70% or more of escape gamblers suffer from major depressive disorder or are bipolar. You may be gambling to "self-medicate" your depression. Also, escape gamblers lose control especially because of unresolved underlying issues. For example: incidence of separation and divorce, loss of a family member or friend, loss of a job, or relationship issues, etc. Of course, it could be as simple as boredom. There is something that "drives" you to escape into the casino to "avoid" dealing with whatever is really bothering you. The gambling sets-up a "smoke screen" of sorts so the real problem doesn't get dealt with.

W, good for you for giving up the credit cards---one big pain you can live without. You made a large decision to do that---and demonstrated control--to keep it!

As far as face-to-face therapy versus online---I tend to agree with you. The added therapeutic input from visual cues cannot be denied, especially from a therapist's viewpoint. It is one of the major drawbacks of online treatment. However, there are a lot of gamblers out there who live nowhere near a credentialed and competent gambling counselor. Or even a gambling treatment program. Some of my patients drive from as far away as Los Angeles, Newport Beach, Huntington Beach, Palm Springs and Temecula to my Poway office. It takes strong motivation for a better life and to defeat gambling to make those long drives.

Basically, the online treatment program was developed for gamblers outside the San Diego driving area like Sacramento, Fresno and San Francisco. They have no treatment programs or certified gambling counselors in their area. Their only option is GA--and research shows that GA is not as effective because it isn't "treatment" per se--but it complements treatment. Others with gambling problems are Seniors who don't drive---you know, here in San Diego County where we have 10 Indian casinos (the most in any county in the US), the casinos have daily bus service that actually goes to retirement communities early in the morning, picks up the Seniors, gives them a coupon for lunch, transports them to the casino and takes them home in the evening so they don't have to drive! Certainly it contributes to the fact that Seniors have the highest gambling rate of any other age group.

OK, now W---let's do it! 1-866-40-NOBET or in San Diego 619-806-7453.

Dear Anonymous:
I know it's a terrible feeling to feel at the mercy of this disorder. It's like being on a rolling-coaster nightmare, isn't it? Somehow, you got to catch hold and get treatment. I doubt that you "never have any money"---and if you can stay out of the casino for even a week, that would pay for a treatment session. If you have insurance, that could be a bonus. As a provider, I accept some health insurance--which covers treatment.Online at SDCPG it only costs $60.00 a session---and it can be put on your credit card via Pay Pal. That's cheaper than some people pay to get their hair cut, nails done, or spend on dinner and a movie----or buy a couple cartons of cigarettes. And--you don't have to pay for gas or travel to the Poway office (end of advertisement :)

It is important that when looking for a therapist who is a gambling counselor you have to be careful what you get. You need to check credentials. There are a lot of drug and alcohol counselors who think they can treat gamblers when in reality they are practicing outside their training and credentials. This can be devastating to your getting better. Comparing the treatment of gambling and drug/alcohol is like comparing apples and watermelon! Beware of so-called "interns" who are "in-training" to become counselors. Some of these "beginners" charge outrageously low fees to attract gamblers like you because they know you have no funds and cannot afford to be picky. Do you really want to get "treatment" from someone who is "practicing" on you and may not be supervised---or worse yet, doesn't even have a college degree? I don't think so! If you needed open heart surgery would you want an intern to perform it? Get my point?

You know that the whole idea behind gambling is to get something for nothing---when what you end up with is nothing for something. There is no "free" anything--including your "comps" from the casino which you paid 2-3 times for through your losses. There's always a catch, or fine print. If it looks or sounds too good to be true---it usually is. If you pay $10-$15 for gambling treatment--you get what you pay for.

Research shows that when people pay for their therapy, they take ownership of it---therapy becomes more meaningful: they work harder to achieve their goals----and keep appointments.

So, before you get your "stimulus check" or bonus or whatever, stop doing the gambling thing of procrastination (yes, it is "dry gambling!") and living your life according to the "gambler's fallacy"---"If I gamble long enough I will win it back"--and find a good treatment program with certified mental professionals who have at the very least a master's degree. Gambling is a complex disorder that requires education and training to treat it effectively.

Get off the roller-coaster! You can do it---I see gamblers do it every day in my practice. Defeat this thing---get some help for yourself. And, I don't mean GA, which is great, but it is not treatment.You don't need to stop gambling before you go to treatment---you have a pathological gambling problem---you cannot stop without help.

Let me know how you do---I have the faith that you can begin the journey of recovery--if you want it bad enough. It's not easy, but escape-relief gamblers like yourself have an excellent prognosis.
Love yourself enough to take that first step.

Hope and Help for "Excess Gambler"

Dear "Excess Gambler":

Thank you for writing and sharing your story. I'm sorry things have been so rough and hope that you are seeking help for your pathological slot problem. You are what we call an "escape-relief" gambler.

This is how it works: The interaction between you (your brain) and the machine causes a release of brain chemicals called beta-endorphins--which is the brain's morphine--to be released. This results in a powerful trance with feelings of numbness and relief over which you have absolutely no control. It is a process that becomes addictive because it allows escape from all life's pain. The real downside, however, is that it also creates a NEURAL RE-WIRING OF THE BRAIN!!!! This is the reason why you cannot walk away--whether you are winning or losing. The brain is hooked-in. Since there is no off-or-on switch, you have no control over this. You are powerless of this process---as long as you are in the casino.

The key, is finding out why you are ESCAPING into the casino in the first place. You sound very depressed. If you have been hospitalized, you may be on psychiatric medication. If you are not, you should talk to your doctor about a psychiatric med evaluation. You mentioned playing the machines made you "manic"--perhaps, you have been diagnosed bipolar. Research shows that 75% of gamblers, and especially escape-relief gamblers like yourself have a mood disorder. Question is whether the mood disorder exists before the gambling problem or because of it---we do not know. There is not much funding for research nationally and absolutely NONE available in California.

Finding the source or underlying cause of your gambling---and for pathological gamblers THERE IS ALWAYS AN UNDERLYING PROBLEM--like depression, grief, loss, divorce, death, loneliness, health issues, financial issues, boredom, etc.--can only be discovered in treatment. GA is not the answer---because GA is a support group. I don't know where you live or what treatment resources are available to you but I would be glad to help you find them. You can contact me via the website: spikephd@sandiego-rx4gambling.com


January 1, 2008 I began to offer online gambling treatment via live chat on our San Diego Center for Pathological Gambling website by appointment for a small fee. Initially, this was available only to California residents because other than SDCPG, there are VIRTUALLY NO GAMBLING-SPECIFIC OUTPATIENT TREATMENT PROGRAMS in the State of California---AND NO STATE OR COUNTY TREATMENT FUNDS!!! I wanted to make treatment available and affordable to people suffering from gambling addiction who wouldn't otherwise be able to afford it or find it. In the next few months, this online service will be made to available to gamblers across the US---open to ALL gamblers. I will offer brief cognitive-behavioral therapy with a relapse prevention focus in an online chat format for a nominal fee by appointment through PayPal. For more information, please see out website: www.sandiego-rx4gambling.com

"Excess Gambler"---you might be interested in this new program. Please do not give up hope--help is available---escape-relief gamblers have an excellent prognosis if treated by mental health professionals who are certified gambling counselors. Please stay in touch, and let me know how you are doing.

I have an article called "Brain on Video" that shows an fMRI of a gambler's brain which I will post. It shows the effects of gambling on the cingular gyrus section of the right hemisphere of the brain. Most certainly a "scared straight" kind of video. Stay tuned.

WELCOME TO MY GAMBLING BLOG

Pathological gambling is a progressively chronic disorder that results in an uncontrollable impulse to gamble. It has the highest suicide rate of all psychiatric disorders. One out of 5 gamblers will kill themselves. Psychologically similar to alcohol and substance addictions, compulsive gambling affects the entire family. Considered a "pure or hidden addiction" because there are no visible physical effects, it is, however, a diagnosable and treatable condition.

The nation, and especially Southern California, has recently seen an upsurge in the number of Indian gambling casinos. As the popularity of these facilities increases so does the number of potential individuals who will experience gambling-related problems. It is estimated that 1 out 20 individuals have gambling problems. Many of these people currently have little or no resources or funds for getting help and even less available options to discuss or share their problems.

While this blog is not a place to give or receive counseling, the purpose of RX 4 GAMBLING is to open up dialogue and to provide a safe haven to share ideas, vent gripes, offer solutions and post helpful materials concerning problem gambling. In the process, the goal will be to diminish the shame, stigma, isolation, and self-defeating behaviors that are part of the gambler's world.

I look forward to participating in this dialogue with you. For those of you in the San Diego area, you can also visit our treatment site at www.sandiego-rx4gambling.com
Dr. Suz Pike
Licensed Clinical Psychologist CA PSY 16492
CA Certified Gambling Counselor-II (CCGC #122)