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Exploring Mutual Aid Pathways to Recovery from Gambling Problems

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Exploring Mutual Aid Pathways to Recovery from Gambling Problems Exploring Mutual Aid Pathways To Recovery From Gambling Problems Peter Ferentzy, PhD Centre for Addiction and Mental Health Wayne Skinner, MSW, RSW Centre for Addiction and Mental Health University of Toronto Paul Antze, PhD York University 1 Table of Contents Acknowledgements 3 Abstract 4 Executive Summary 5 Introduction 8 Purpose and Goals 9 Literature Review 13 Research Design & Methodology 26 Research Sample 30 Findings 31 Interpretations 42 Conclusions and Implications 65 Future Research 66 References 68 Appendix 87 Project Report 91 2 Acknowledgements We would like to thank the Ontario Problem Gambling Research Centre, not only for the initial grant, but for their extra support to allow us to complete this project when external events, including the SARS crisis of 2003, interfered with our work. The support and encouragement of the entire staff team at OPGRC is deeply appreciated. We would like to thank Ines Moreira for her administrative support throughout the study. Finally, we are deeply indebted to those who participated in our individual interviews. By sharing their stories they help us to understand how people can make and sustain positive change, and offer lessons of hope for people affected by gambling problems. To those who made us welcome at GA and NA meetings, we are indebted to their invitation into those moments of fellowship. 3 ABSTRACT: This ethnographic study, involving participant observation at Gamblers Anonymous (GA) and Narcotics Anonymous (NA) meetings and interviews with subjects from both fellowships in the Toronto area, was designed to provide a more in-depth and empirically grounded account of GA’s recovery culture than what has been available so far. A secondary aim was to develop a better understanding of NA beliefs and practices and their use as a resource by problem gamblers with substance abuse issues. Not only has GA been understudied, with the literature providing more evaluation than description, this study has revealed that the little available information on GA is now largely dated. GA has earned a reputation for being an almost exclusively male fellowship, pragmatically focused on abstinence from gambling and on debts at the expense of discussions of emotional issues, and as a 12 Step fellowship in name only where the spiritual side of things is mostly ignored. Yet today in the Toronto area, the percentage of women in GA may be as high as 20 percent and rising, discussions of feelings and “life issues” are actively encouraged, and members have become far more focussed on the 12 Steps than in the past. Possible reasons for these changes – which seem to be taking place in GA throughout North America – are discussed, along with GA’s culture of recovery and its unique (among 12 Steps fellowships) emphasis on the virtue of patience. Our impression of NA as a potential resource for problem gamblers is also discussed. Key Words: Gamblers Anonymous; Narcotics Anonymous; Self Help; Mutual Aid; Pathological Gambling. 4 Executive Summary This ethnographic study, involving participant observation at Gamblers Anonymous (GA) and Narcotics Anonymous (NA) meetings and interviews with subjects from both fellowships in the Toronto area, was designed to provide a more in-depth and empirically grounded account of GA’s recovery culture than what has been available so far. A subsidiary aim was to develop a better understanding of NA beliefs and practices and their use as a resource by problem gamblers with substance abuse issues. This project was preceded by the compilation of an annotated bibliography – funded by an OPGRC Incentive Grant – covering literature on Gamblers Anonymous and other material as it pertains to mutual aid options for gambling problems and co-occurring substance abuse problems. We were, therefore, fully acquainted with the available material on GA before embarking upon this inquiry. Our investigation drew its rationale from two central premises, widely supported in the literature: first, GA is an influential movement (and in fact a standard adjunct to many gambling treatment programs in North America); second, the actual functioning of GA – how it works, how it affects the lives of members – was still poorly understood. The literature on this organization was rife with controversy on such basic questions as whether GA is suited to the most troubled gamblers or those who are least troubled, whether it is the most effective approach or largely ineffectual, and whether its purported benefits stem from aspects of the “program” itself or are simply the function of group support. Our study was designed to be descriptive rather than evaluative: rather than pass sweeping judgement on GA, pro or con, we wanted to learn about whom, and in what way, GA is able to help. We sought to uncover information about the following ways in which: 1. GA members perceive problem and pathological gambling. 2. GA members perceive and practice recovery. 3. gamblers reconstruct and describe their past experiences according to narrative formulas shared by GA. 4. their descriptions of their current lives “in recovery” conform to certain tenets which define the group’s understanding of what recovery means. 5. the lessons behind these stories are employed by members in managing their lives (choices, plans, etc.). GA had earned a reputation for being an almost exclusively male fellowship, pragmatically focused on abstinence from gambling and on debts at the expense of discussions of emotional issues, and as a 12 Step fellowship in name 5 only where the spiritual side of things is mostly ignored. Commentators have claimed that GA is less effective as an overall therapy than AA which supposedly provides a broader conception of recovery. By contrast, NA is strongly geared toward discussions of feelings. Partly because it deals with a range of drugs, NA has no substance specific physical addiction concept like the one used by AA but a broader, psycho-emotional conception of addiction. Regarding NA, the following questions guided us: 1. Whether NA’s broader addiction concept, which includes all drugs and emphasizes the notions of compulsion and obsession rather than physical addiction, may be more helpful to gamblers who may attend two fellowships than AA’s conception as gambling addiction involves no substances and is also understood in psychological rather than physical terms. 2. Whether NA’s emphasis on emotional issues may provide a counterweight to GA’s alleged exclusion of such matters for members attending both fellowships. 3. Whether many problem gamblers with substance abuse issues could find their recovery exclusively in NA. Not only had GA been understudied, this inquiry has revealed that the little available information on GA is now largely dated. Today in the Toronto area, the percentage of women in GA may be as high as 20 percent and rising, discussions of feelings and “life issues” are actively encouraged, and members have become far more focussed on the 12 Steps than in the past. These changes seem to be taking place throughout North America. We found that GA views pathological gambling in very strong terms, with most longstanding members perceiving themselves as potentially vulnerable to relapse and in need of avoiding gambling establishments. We have spoken to GA members who will not associate with persons who gamble, even those who only do so recreationally. We have learned that GA’s culture of recovery is unique among 12 Step fellowships, and that this is partly because pathological gamblers are perhaps unique among addicts in that beyond the quick fix provided by one’s substance or activity of choice, gamblers must be on guard against another “quick fix”: the real possibility of huge winnings which could, conceivably, solve many problems immediately. For a gambler, any urge to solve problems quickly can conceivably lead to relapse. For this and other reasons specific to gambling. GA’s overall culture of recovery seems to be geared towards teaching patience to its members. While the latter is emphasized in others 12 Step fellowships, it is pronounced more strongly in GA. For example, GA members tend to go through the 12 Step process at a slower pace on average than their AA and NA 6 counterparts. It is possible – with caution – to view the 12 Steps of GA as an exercise in learning patience. We found that GA, long known to be more secular in orientation than AA, NA and many other 12 Step fellowships, has at least some good cause to have evolved this way. Anything associated with the mystical can be reminiscent of the mystification endemic to a problem gambler’s mindset with respect to odds, hunches, good luck charms. Further, the type of quick conversion experience often mentioned in AA’s Big Book is far too similar to a quick solution – akin to winning fast money – and in some ways the opposite of what recovery in GA seems to be: GA’s 12 Steps do not mention a “spiritual awakening”. There may be other reasons for GA’s aversion to religious proselytizing, but from the perspective of recovery this may be the most important. While many GA members seem to experience legitimate spiritual awakenings – and GA is keen to emphasize the importance of spirituality while insisting that this need not involve a deity – they tend to occur at slow and measured paces. While we have cause to believe that NA may be helpful to gamblers with co- occurring substance abuse disorders, we uncovered little evidence that NA in any way amounts to a better place for gamblers than AA. Further, GA has changed and is currently a far better place for discussions of emotions, throwing into question the need for any “compensation” NA may provide. With respect to the possibility that some gamblers with substance abuse issues could use NA exclusively, we found that NA is no substitute for GA due to a host of issues specific to gambling addiction which a substance oriented fellowship is poorly equipped to address.
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