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Section 3
Giving Support to the Problem Gambler

Question 3 | Answer Booklet | Table of Contents

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In the last section, we discussed another negative and unproductive response to gambling problems which is called enabling.  The family and friends of a client may end up making gambling easier through enabling the client to continue this activity.  We outlined this often unwitting and well-meaning but nonetheless destructive response to gambling problems in four categories.  These four categories of enabling are covering up and covering for the gambler, attempting to control the gambler’s behavior, bailing him out, and cooperating with him.

In this section, we will discuss raising bottom.  Methods for raising bottom include no more bailouts, continued emotional support, deciding when to bail out, and knowing what to expect.  You might consider playing this section in a session with a friend or a family member.

Family and friends can raise the bottom by refusing to deny the problem and refusing to engage in any enabling behavior.  To some spouses or friends, this may seem like more bad news, for the pain involved for the spouse and family is immediate and acute. They may feel as though they are making things worse for the gambler, and possibly for themselves as well. 

But would you agree that things sometimes need to get worse before they get better? Therefore, anything which can be done to speed the gambler’s downward progress is, as paradoxical as it may seem, extremely helpful to all parties involved.

Three Methods for Raising the Bottom

♦ Method #1 - No More Bailouts
First, let’s discuss no more bailouts.  By bailouts I mean not bailing out of jail but bailing out of traumatic life situations the gambler has created.  As explained in the last section, Mary frequently bailed Alan out when he failed to act on his responsibilities.  I stated to Mary, "Anytime you bear the consequences of Alan’s actions for him, you are slowing his slide toward desperation." 

Mary responded, "But how do I avoid bailing him out when I love him so much and see him struggling?"  How might you have responded to Mary?  I stated, "This requires tough love, and it is easier said than done. A gambling addict who appears seemingly repentant and bent on reform and putting things right if only you supply just a little relief is a heartbreaking thing to turn your back on.  You don’t want to see your husband suffer.  So you buy into the illusion that if you help him a little bit, just one more time, then everything will be okay."

As Reverend John Landrum of the Mississippi Coast Rehab Center says, it won’t be.  Landrum states, "We have seen it happen time after time, when you bail somebody out, that takes the pressure off.  Then they go right back to it.  And then the next time, it’s usually a bigger hole they’ve dug." 

♦ Method #2 - Continued Emotional Support
Next let’s discuss continued emotional support. I explained to Mary, "Though enabling behaviors should be stopped, continued emotional support is an integral part of using the client’s family in the therapeutic process."

I continued, "Emotional support, though, may help the no-bailout philosophy go down more easily. I would counsel you to still be there with Alan and for him.  Be able to talk with him about the issue, the problem, emotionally supporting him. But don’t do anything toward bailing him out."

I find that absolutely no bailouts coupled with emotional support is simple yet effective.  Sometimes, however, would you agree that following through on the no bailouts commitment can be more difficult than it seems for some clients?  Whether to bail or not to bail grows very complicated when the welfare of others is at stake.  For Mary, bailing Alan out became a necessary evil on occasion. 

Mary stated, "Sometimes, instead of saying no, I find myself saying ‘yes, just this one time."  For example, Mary related an experience to me regarding the time Alan had decided the family didn’t have sufficient money to send their daughter to volleyball camp even though he’d promised her that she could go.  Because he gambled the camp money away, Mary felt that she had to bail him out and borrow the money from her father in law. 

What do you think could have been the most productive approach for Mary?  How does one decide?

♦ Technique:  Deciding When to Bailout
According to Berman and Siegel, clients like Mary can ‘accept the fact that a bailout may sometimes be needed for the sake of others.’  I stated to Mary, "Find the courage to refuse when you should and try to find the wisdom to know the difference.  In the end, however, bailing Alan out only perpetuates the gambling problem."

♦ Method #3 - What to Expect
In addition to no more bailouts and continued emotional support, let’s discuss what friends or spouses can expect from refusing to enable the gambling client. 

I stated to Mary, "Your refusal to bail Alan out does communicate that you’re onto his gambling problem and that you’re not going to take it anymore. And it may also tell him deep down that you love him enough to help.  Gamblers who are not to far into the addiction may begin to turn things around simply because of your  refusal to bail. 

"However, if he’s well into his addiction, don’t expect him to like what you’re doing.  In fact, steel yourself for anything and everything in response to your refusal of monetary or emotional relief.  This might include anger, rage, abusive comments or anything else.  Stay strong in the face of onslaught, though.  Your refusal to assist in the short run only accelerates any possible help he may receive in the long run." 

Think of your Alan.  How might you prepare the family of your client for the client’s reactions to the family putting a stop to enabling behavior?

In this section, we discussed raising bottom.  In my practice, I find that the addict must ‘hit bottom’ and want to change.  Methods for raising bottom include no more bailouts, continued emotional support, deciding when to bail out, and knowing what to expect. 

In the next section, we will discuss interventions.  As you know, this type of confrontation involves the leadership of a trained professional and incorporates the help of a ‘team’ of people close to the gambler.  This section will cover goals of the intervention, rehearsals and contingency planning, and the effectiveness of intervention. 
Reviewed 2023

Peer-Reviewed Journal Article References:
Dash, G. F., Slutske, W. S., Martin, N. G., Statham, D. J., Agrawal, A., & Lynskey, M. T. (2019). Big Five personality traits and alcohol, nicotine, cannabis, and gambling disorder comorbidity. Psychology of Addictive Behaviors, 33(4), 420–429.

Hutchison, P., Cox, S., & Frings, D. (2018). Helping you helps me: Giving and receiving social support in recovery groups for problem gamblers. Group Dynamics: Theory, Research, and Practice, 22(4), 187–199.

King, S. M., Keyes, M., Winters, K. C., McGue, M., & Iacono, W. G. (2017). Genetic and environmental origins of gambling behaviors from ages 18 to 25: A longitudinal twin family study. Psychology of Addictive Behaviors, 31(3), 367–374.

LaBrie, R. A., Peller, A. J., LaPlante, D. A., Bernhard, B., Harper, A., Schrier, T., & Shaffer, H. J. (2012). A brief self-help toolkit intervention for gambling problems: A randomized multisite trial. American Journal of Orthopsychiatry, 82(2), 278–289.

Magnusson, K., Nilsson, A., Andersson, G., Hellner, C., & Carlbring, P. (2019). Internet-delivered cognitive-behavioral therapy for significant others of treatment-refusing problem gamblers: A randomized wait-list controlled trial. Journal of Consulting and Clinical Psychology, 87(9), 802–814.

QUESTION 3
What are four methods for ‘raising bottom? To select and enter your answer go to Answer Booklet