A chance to change

Gambling, like alcoholism, is a disease that can destroy addicts and their families. VASANTHA SURYA writes on the struggle of some victims to overcome their illness with the help of institutions and family support.

THESE quotes (see box on right) are not from those who try their hand occasionally at games of chance. Neither are these speakers who have made gambling their "profession" and never take risks. Their problem is "maladaptive compulsive gambling" - a psychiatric disease. They speak out only for the express purpose of curing themselves and others like themselves, and on condition of strict anonymity.

Chennai may not be a hotbed of high-flying casinos like Kathmandu or Las Vegas. But if you want to gamble badly enough, you will find that like all major Indian cities there are gambling joints and clubs tucked away in many areas, apart from the posh clubs. Today most forms of gambling are legal. Back in the 1950s there was a move to ban horse racing, commemorated by a statue of a horse being restrained by a man which stands at the Gemini Flyover in Chennai. There are the video game parlours, the TV competitions which are more like gambling than genuine tests of skill, the cotton and bullion rate bets placed by hundreds of people every day. Betting on cricket is common, but it made news only when the fixing of matches was exposed. There are the state- sponsored lotteries - especially the surandal or instant lottery.

All the speakers quoted have refrained from gambling for the past four to ten years. They want to stop gambling completely. They are on the way to doing it, too. Every Sunday, sometime after 11:00 a.m., in two rooms lent to them by a Chennai school, two New Leaf meetings take place. In one, the wives of some compulsive gamblers and alcohol addicts - not to cry on one another's shoulders, but to learn how to gather resources to maintain their mental health and to run their lives intelligently. One woman says, "Because of his gambling behavior, I tend to think everything he does is wrong... That's not really true, and it doesn't help. He is better at handling the children than I am."

In the other room the Gamblers Anonymous (Gam-Anon) meeting takes place. Three to twelve men are trying not so much to heal, but to deal with their primary disease which is not alcoholism, but pathological gambling. Ranging from their twenties up to their sixties, these men have been through the gamut of this disease. In pursuit of the money to gamble, they have lost job after job, piled up debts and driven their families to financial ruin. Lying and cheating, embezzling and stealing, their personalities have undergone striking changes. Some have been to jail. Often highly intelligent and resourceful individuals, they have suffered crushing despair and self-hatred. Such feelings of guilt and shame - known in psychiatry as dysphoria (the opposite of euphoria) - become progressively more intense, and further fuels their compulsive behavior - sometimes until the bottomline of suicide is reached.

At this point genuine, disinterested fellowship alone will help the sufferer to struggle back from the brink. Many studies, especially in the U.S., have been done to show that compulsive gambling requires treatment involving networking, as exists in Alcoholics Anonymous. Gamblers Anonymous was set up in the U.S. in the 1950s. Says Ms. Raymol Rachel Cherian, clinical psychologist and counsellor at the TT Ranganathan Clinical Research Foundation, compulsive gambling is an "impulse disorder", the specific psychiatric definition being "maladaptive gambling behaviour". As research advances, criteria distinguishing pathological gambling from recreational gambling, heavy social gambling, relief-and-escape gambling, have been revised and refined through the last few years. It is now recognised that people with certain personality traits are prone to the disease. It is thought that there may be a genetic factor also at work, with close relatives exhibiting the same behaviour.

According to Ms. Cherian, a specific module of treatment for this disease is being prepared at the TT Ranganathan Foundation for the first time in India. Along with counselling for both gamblers and their families, and formalised group therapy, patients will be instructed on how to improve their socialising skills. They will be taught techniques of dealing with mental habits such as restlessness, daydreaming about "The Big Win" and boredom. "They need to know how to derive pleasure from harmless things, like physical exercise and family outings," says Ms. Cherian. "Gamblers are in general not violent. The police should be trained on how to deal with them and in prison they should be treated for their disease."

De-addiction procedures for alcohol are well-known: in Chennai a 25-day treatment module for alcohol de-addiction is offered at the 65-bed TT Ranganathan Clinical Research Foundation. The fellowship of Alcoholics Anonymous has performed a vital role not only in rehabilitation, but also in creating the public awareness necessary for a better understanding of the problem as a disease, and catalysing better methods of treatment. The road to normalcy is long and hard and the recovery rate is not sensational, but at least there is a known procedure of treatment for alcohol addiction. More difficult to treat is the compulsive gambling which hides beneath at least 25 per cent of those addicted to alcohol.

A one-time compulsive gambler who set up New Leaf in Chennai ten years ago after reading about the movement's formation and progress in the U.S., a counsellor at the TT Ranganathan Clinical Research Foundation says that the secrecy imposed by the habit results in great stress. The breaking of ethical codes takes place, and there is the destruction of the self-image as a decent person . It is absolutely essential that a sufferer must honestly face facts. Inevitably, overwhelmingly negative feelings do make their appearance. But these emotions invariably reach a point where the law of marginal returns sets in. Neutralising them with other, more constructive feelings is necessary. But how does a compulsive gambler teach himself, or relearn, these attitudes? How does his cruelly disillusioned wife re-examine their relationship, make the most of it and/ or completely transform it so that they both emerge from the problem, whole and sane, and if possible still united?

At the Gam-Anon meetings there is nobody dishing out advice, or preaching. (Or taking notes. It was politely explained to me that this would inhibit the free flow of conversation. But they were ready to talk to me afterwards, as individuals, of course on condition of anonymity.) There is no formal evaluation process going on. Whatever evaluation exists is done within the individual. The help the participants offer each other is not material or financial but psychological. The ground rules of civilised conversation among equals are scrupulously observed, and a spirit of fellowship and dispassionate helpfulness is sought to be built up. Anonymity is the one condition of membership. It clears the air for the frank and fearless sharing of experience at these meetings.

An emphasis on spiritual renewal and an occasional mention of a Higher Power is all that could be called "religious" about the meetings, which seem to be to re-connect people with their lives and their closest relationships. (In fact, the Latin root of "religion" is religare which means to re-connect.) There is a modest element of ritual - non-denominational, and almost embarrassingly simple, even childish to somebody who considers himself or herself a "better-adjusted", more "rational" person. Greeting each other, and acknowledging that they exist also as a group, they repeat certain life-affirming words. Sometimes they read out and discuss a brief passage from a self-help manual for those afflicted by addiction either directly or indirectly. But mostly, and most importantly, they talk and listen to one another. The meetings are not solemn. There are smiles, occasional chuckles. This goes on for about an hour or two, as they try to encourage each other on the road to the personality changes they have now recognised as necessary, in order to go on constructively with the business of living.

Are the gamblers cured of the urge? About one hundred people have attended the Gam-Anon meetings over the past ten years, but there is not much follow-up or feedback. Understandably, once out of the problem, many may not wish to be reminded of it in any way. Compulsive gambling is a behavioural phenomenon, a hidden insidious disease, and no physical change is apparent as in alcoholism. It is very difficult to identify the compulsive gambler. But now younger gamblers are turning up at the meetings. Gam-Anon helps those in earlier stages of the disorder by giving them a chance to contrast their fantasies of "The Big Win" with real life stories of illusory success and all-too-real sufferings.

New Leaf recently celebrated its tenth anniversary, with two ex- gamblers and their wives coming out with moving accounts of their struggle to resume normal life. Chief guest Visu, known for his quick-witted repartee on his TV talk show, confessed to being quelled into near-silence by their honesty and psychological maturity (mana-pakkuvam). "These stories are not so much secret as sacred," said the Mother Superior of the school where New Leaf holds its meetings, visibly moved by the "humility" of the speakers. Being on a somewhat different wave-length, the advocate Sudha Ramalingam who has been working with wives grappling with their husbands' excesses in both drinking and gambling suggested that the real reason for the fellowship's effectiveness was not its spiritual orientation, but because human beings are by nature gregarious, and need each other. "This is not a platform for religious preaching," she declared. "Believe in yourselves." She suggests that skilled and semi-skilled workers drawing salaries, construction workers and others from the poorer sections could be approached through trade unions, who could send problem gamblers to New Leaf.

Most of those attending the meetings don't seem to see any contradiction between the "spiritual" and the "pragmatic" approach. One person quotes two commitments from the little blue handbook in the "Unity Program":

"Gamblers Anonymous has no opinion on outside issues; hence the Gamblers Anonymous name ought never be drawn into public controversy."

And "Anonymity is the spiritual foundation of the programme, ever reminding us to place principles above personalities."

A few, however, have emerged from the cloak of anonymity, after years of abstinence from gambling which have been spent in encouraging and working constructively with others to break the habit. One of them is Rangarajan, who gave permission to quote him. He tells me about how he became a compulsive gambler, the impact on his life, and the simple technique of group meetings which has made him literally turn over a "new leaf". Now a counsellor for the TTK Foundation, he comes across as a soft- spoken, gentle person with an amazingly focussed energy. It is not his the externals of his individual personality that impresses so much as his utter dedication to the idea of renewal. For him, quibbling about whether this is a "spiritual" experience or not is besides the point.

* * *

"I started gambling when I was eight years old. Walking to school with my friends, I began to bet on car licence numbers. If I won, I would get the loser to carry my bag to school. As I grew older, we made bets for ice-cream, or a cool drink."

* * *

"Everybody thought me a decent and respectful youth, but my behavior changed with my need for gambling money. At 'joint study' sessions we played cards for high and then higher stakes. On the way to a 'club' I saw my mother on the street, jumped down from the auto and snatched a bangle from her wrist. Sh She said: 'Why only this one? Take the other one, too!' But that didn't stop my gambling."

* * *

"Horse-racing suited me because the timing (one to six in the afternoon) made secrecy possible. I promised myself I would stop after I'd made a couple of lakhs. Once I got as much as ten thousand. A sambalam (salary) of twenty thousand a month wasn't enough, now I needed kimbalam (income from bribes) to stay in the gambling-debt cycle. The alcohol problem I acquired along the way drove me to hospital, with amnesia. I came out, but the main problem remained untreated - the sick thrill of gambling. At one or two in the afternoon, when the races begin, I still feel restless."

* * *

"At the Adi Padinettu fair I was fascinated by the dart-throwing and ranganna kattai games. I spent the money given to me for school books, ran away for three days. That was my first major crisis. But it went on to cards at college, then surandal lottery...

My father tried to help me out of the habit, but when he died I was back to gambling within ten days."

"My pregnant wife became psychologically disturbed, gave birth to a still born child. I swore over my daughter's body that I would not gamble, but on the way back from the burial ground I stopped to play cards..."

* * *

"I thought of share market gambling as a calculated intellectual exercise. My wife was awed by my 'financial acumen'. I closed my business and began investing in shares. Then in 1995 computer terminals came in, and it became a faster operation, with a gap of two or three per cent and up to eight per cent between high and low share prices. The idea is to take advantage of the difference. But it's impossible to really do it... Two years ago my wife came to know the real reason for our financial collapse. Now she handles our finances."

Identifying a gambler

AT least four out of ten identifiable criteria characterise the pathological gambler. They include:

* An increasing pre-occupation with gambling.

* A need to gamble with ever-increasing amounts of money to achieve the desired "excitement".

* Restlessness and irritability.

* Lying to family members or others to conceal the extent of involvement with gambling.

* Committing forgery, theft and embezzlement.

* Jeopardising significant relationships.

* Repeated unsuccessful attempts to control or stop gambling.

"Diagnostic Statistic Manual (IV)", quoted by Dr. Richard Rosenthal in Psychiatric Annals (February 1992)

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