Chapter Eleven

The House Call and the Madness of the Enabler

“Hello, is this Dr. Taber?”

“This is Taber. How may I help you?”

“Well,” said a testy male voice, “it would help if you were easier to get hold of. I’ve been trying all day and I’m long distance.”

“Sorry for the delay,” I answered, “but if you’d left a message with our secretary I could have been back to you in less than an hour.”

“I don’t want to speak to any damn secretary. You’re the one who runs the Gambling Program, aren’t you?”

“Yes, I coordinate the program and arrange admissions. But our secretary could give you a lot of useful information. If you happen to call back at any time, please talk to Ruth and let her know who you are, and the purpose of your call.”

“You guys have a lot of rules, don’t you?”

“Civilization has a lot of rules. You probably have a few of your own. How can I help you?”

“Well, you run the damn program and I want in right now.”

“Two things,” I said. “First, we can get you in fairly soon if you’re a qualified veteran. There are only two other vets on the waiting list. Second, I’ll need to ask you a few questions, and then we can set an admission date.”

“I’m a compulsive gambler and I’m in deep trouble, damn it. What the hell else do you need to know? I can’t wait. Mine is a very serious case!” shouted the caller.

“We only deal with serious cases here. Let’s start with your name and phone number.”

Our interview proceeded with my angry caller grudgingly giving information and learning to talk in a non-combative way. Harry lived and worked in Florida. He gambled at the horse and dog tracks whenever he had any cash, but self-induced poverty was not his complaint.

His wife Karen was about to dump him. That, he thought, was a real problem! I gathered from what he said that she had supported him, paid his bills, and mothered him, but now she was on the way out. Harry thought if he went for professional help, it would cool her down again.

“Some stupid !%&#! social worker,” he said, had put a bug in Karen’s ear, and now his wife’s mind was messed up. Harry told me he was just a normal, fun-loving guy with a marital problem caused by a malicious social worker, who had told his wife not to tolerate abuse any longer.

“Have you abused Karen?” I asked.

“Naw, that’s bull! We argue, who doesn’t? But I’m no wife-beater. In fact, she hits me and I put up with it. I only shoved her once because she was standing in my way when I wanted to leave the house. She called the cops and made a big deal about it. Crazy woman!”

“So you love Karen enough to come 1,500 miles and put yourself in a hospital for several weeks just to make her feel better, although you don’t think you have a serious gambling problem?”

“Hey, you got it, Doc. I wouldn’t know what to do without that lady.”

I suspected that much was true, even if the rest of Harry’s story needed verification. We covered all the routine details: military service, medical problems, the legal situation, Karen’s complaint to the police, and so forth. I gave him an admission date two weeks in the future and the phone number of the local Gamblers Anonymous group in his hometown, but I didn’t get the impression he wrote the number down.

“OK. Harry, I have to run now. I look forward to working with you. And remember, get to the hospital as early in the day as you possibly can. There may be a wait down in admissions. I’ll call you if an earlier date opens up. Put your life on hold for now, and don’t do anything drastic or impulsive. Don’t try to force Karen to do anything she doesn’t want to do.”

When we hung up there was actually a measure of relief in Harry’s voice. I hadn’t argued with him or questioned his story, but he knew that I knew there was a lot more involved here than an angry wife. Without arguing the case, we both knew he was an immature, dependent, and abusive pathological gambler who had come to some kind of psychological bottom. As yet, Harry had no idea of the kinds of changes he was going to have to make in himself, not in his wife. But he had taken the first, most difficult step.

Although several new programs in private hospitals had recently opened for gamblers, our gambling treatment program had a nationwide reputation. This was, I think, mostly because for years it was the first and only inpatient program, not because it had a great success rate. In fact, no studies of treatment outcome had yet been done. Just surviving as a program and coping with the patients and hospital politics had been work enough, although by now we had several outcome studies in progress that would soon appear in leading psychiatric journals.

We would find, eventually, that more than half of our former patients were able to abstain from gambling for significant periods of time. And we found that for most of them, life was a lot better, even if they did relapse to gambling from time to time. It seems we took a lot of the fun out of the old habits.

People often asked what we did to treat gamblers. My honest response was that nothing we did was ever as important as that first decision by the gambler to walk through the door. My main job was to make that easy for people—those who for some reason had the willingness—to begin to change. That was really our secret: Offer a place where gamblers could begin a lifelong process of self-development, if they earnestly desired to do so.

A man once told me he had made three appointments to begin our program. Twice he had driven up to the front door and sat in his car for hours, afraid to come in and afraid to leave. On the third try, he arranged for a member of the local Gamblers Anonymous group to bring him to the front door. He never tired of telling about the enormous relief he experienced when he finally did walk in. This man had the ability to laugh at himself and not take himself too seriously; these skills help a lot, too.

“This must be one of those days when all I do is deal with family problems,” I mumbled to myself. I had an early afternoon date with a lady named Sally. Neither she nor her gambler husband was a patient, or veteran of military service, so, strictly speaking, I had no authorization or obligation to talk with either.

But I was the only properly licensed psychologist in a three-state area who had experience with pathological gamblers, and good public relations were high on the VA list of priorities at the time. So one visit was permissible under our policy.

Local Gamblers Anonymous and Gam-Anon groups had told Sally about our work, and her situation seemed quite desperate. Could this marriage be saved? Since the husband could not enter our program, would he be willing to travel several hundred miles to a different program that would make the effort to help him? And what about my sticking my nose into the lives of people for whom I might feel some ethical obligation, but whom I had no authority to treat, even without compensation?

Fortunately, the law tends to look kindly on Good Samaritan interventions by health professionals who offer aid and assistance when no other help is available. I was willing to take a slight risk, primarily because senior members of Gam-Anon had asked me to help Sally. And there was a selfish motive: I wanted experience with interventions, those attempts to move families more quickly toward change by the use of orchestrated confrontations, done under the supervision of professional help.

There are serious ethical questions involved in doing a family intervention, rather than waiting for the inevitable family breakup. On the one hand, I do not believe that anyone should be forced or coerced into accepting hospitalization, except in the most extreme cases involving psychotic behavior; and pathological gamblers, in spite of irrational and dangerous behavior, are not psychotics. On the other hand, I was uncomfortable just sitting on the sidelines hoping a gambler would go for help before the family disintegrated, a process that was often long and painful for everyone, including the children.

When I finally got to the modest brick home in the suburbs, I was a little ahead of schedule. I had spent the long drive rehearsing and worrying about what was coming. I was about to intervene in a man’s life, a person I had never met, who didn’t want my services, and who could easily find grounds for legal action if I went too far.

Sally’s living room was spotless, but she had little more than bare necessities for furnishings. There is often a barren, empty look in the homes of most pathological gamblers. She welcomed me with coffee and nervous comments about the possible success of what we were to do. I had seen her in my office several times, and we had spoken often during the past three months. Psychologically, she had made enormous progress in getting ready for this afternoon’s work. After a struggle, she had begun to see that there were valid alternatives in her life, besides living in her present misery.

Kirk, her husband, had not been living at home lately. Sometimes he was with his aging parents, sometimes with friends. When he did come home, it was fight, fight, fight. He had been violent, and Sally took my advice to consult with an attorney, but she declined to report the violence to the police. The young daughter had become a school problem and was also seeing a counselor.

The next person to arrive was a priest, an earnest young man who already had a reputation in his parish as a radical. He had been most helpful in arranging this meeting, and especially adept at getting Kirk’s parents, an emotional and family-oriented couple from the old country, to take a hard look at their own alternatives.

A tall, awkward young fellow named Henry came next. We had been unable to get Kirk’s boss to join us, but were glad to settle for one of Kirk’s friends from work. Henry was truly a friend, who had covered for Kirk many times, asking only that Kirk try to do better in the future. Sally had tried several times to interest Kirk’s boss in our project, but he had simply scoffed and said that his employees’ private lives were none of his business. The truth was, the boss was a heavy gambler himself. Had Kirk worked for a larger company with an employee assistance counselor, it might have been a different story.

Next came Kirk’s parents, the so-called primary enablers. It was their love, for the most part, that had permitted Kirk to escape the consequences of his gambling. They doted on their only son, and they had enabled him for years by making his delinquent mortgage payments, occasionally filling Sally’s cupboards with groceries, and buying off the bookie’s hostile collectors. They were such warm and loving people it was hard, even for me, to understand the critical role they had had in actually worsening the situation we were going to try to correct. They greeted me with warm praise and great respect, which made me nervous. The parents knew their roles in what was to take place, but they were probably expecting too much. They apparently believed that some miracle, magic, or complex method would suddenly restore Kirk to normal living, while leaving everything else unchanged. The problem was, their beloved son had never experienced normal living. Although the parents had rehearsed well for the scene to come, I doubted they could really maintain a consistent tough love attitude. Time would tell.

The daughter’s place was represented by an empty chair on which sat a tape recorder. Sally had decided to send the child off with friends, thinking the whole episode would be too traumatic for an eight-year-old. She was probably right.

It was now a half hour before the guest of honor was to arrive. We did our last dress rehearsal, coaching and encouraging each other and making hopeful comments.

Finally, 15 minutes late, Kirk breezed in and took over.

“I appreciate your little tea party in my honor,” he joked, not waiting for introductions, “but I’m really pushed for time. I have a lot of collections to take care of for the local boss, so I gotta keep moving.”

Kirk pretended to be a bookie himself, but all he really did was make a few minor collections for his bookie in an effort to stay in his good graces. I was sure Kirk had some notion of why his wife had arranged this meeting, but his attitude was that the whole affair was a product of her misplaced imagination. He acknowledged each of us with a cold nod. He wasn’t interested in shaking hands or finding out who I was.

I got to business right away. “Kirk, as you may know, I’m a clinical psychologist who happens to work with problem gamblers.”

Kirk found this rather funny, “Wow, a gambler’s shrink. I know a lot of fools out there who should talk to you.”

I pressed on. “I don’t really know whether or not you have a gambling problem, Kirk, or if you have any other kind of problem, for that matter. Since we’ve never met, I’ve not been able to do what we call a mental status examination, or get to know you personally. My purpose here is not to analyze you, though. Your family and your friends find it very hard to live or work with you. I’m here because they asked for help, not because you did. The important people in your life have targeted your gambling as their main concern. They seem like good, sincere people to me, so please just hear me out for a moment, and then the others will add their thoughts.

“I’d be happy to help you get into a treatment program, one that your health insurance will pay for. In the program it would be possible to find out quickly just what problems, if any, you may have, gambling and otherwise.”

I explained briefly what the program was like, how long it would last, and how much it would cost. There would be interviews, psychological tests, medical examinations, group discussions, and meetings of Gamblers Anonymous.

“Kirk, if it turns out you’re not a pathological gambler, you’ll be asked to leave the program within a very few days. If you’re really what you say you are, a man misunderstood by family and friends alike, a man with no serious problems, then the people here in this room will have to look within themselves to find the source of their unhappiness. If, however, you do have a serious gambling or personality problem, then you’ll have a choice: Stay in treatment and try to win your family back by changing who you are, or leave treatment and live on your own resources.”

Without giving Kirk any chance to respond, I turned to Father Paul and asked him to explain the Church’s position.

Father Paul did a marvelous job, starting with a simple review of the demands and responsibilities of a marriage contract. “The Church places the highest importance on the sacred vows of marriage, since marriage symbolizes the mystical union between Christ and His Church. Your family responsibilities must come before everything else, just as my service to the Church must come before everything else.”

Father emphasized that we all thought Kirk was a good person who had a serious disease, and the priest ended with a strong endorsement of Sally’s determination to protect herself and her daughter from further abuse and neglect.

I was not sure Father himself had a clear idea of the differences between immoral behavior and mental disorders, but this was hardly the time to get involved in that. I certainly wasn’t the one to answer that question at any rate. He had delivered his role extremely well.

Now it was Sally’s turn, and she spelled out all of her newly found alternatives and resources in a calm voice. If Kirk could no longer function as a husband, then she knew of a work-study program at the local community college where she could learn office skills, and where she could get childcare for their daughter while attending evening classes. She had put a refundable deposit on a small apartment, and had filled out all the necessary papers for getting a student loan at the college.

She did not mention that Kirk’s parents, for the sake of their granddaughter, were prepared to help with the apartment rent while Sally attended school. There would be no money left to continue Kirk’s bailouts.

Sally paused now … and there were tears on her cheeks.

“I love you, Kirk, and I always will,” she began. “Nothing can ever change that. But I have so much more to think of, and I know I can’t do what I have to do, and continue to live with the problems your gambling creates for all of us. I have resolved, Kirk, with the help of Father’s counsel, that if I must part from you I shall do it with love, not with hate or anger. Although I might never be able to live with you, Kirk, I have decided that I shall never marry again. If you can’t or won’t stop gambling now, I’ll be here if you ever do reach that point. But, please, never again ask me to give you anything of a material nature to help pay for your gambling. And don’t ever expect to be with me in the family so long as you continue gambling. All I have to give now is my love, respect, and hope.”

Kirk had stared at Sally during her speech, but showed no hint of feeling or understanding.”

I called on Henry next, Kirk’s friend form work. In a quiet voice Henry said, “Kirk, me and the boys at work are through lying and covering for you. No more loans from any of us. Hell, the boss and all the secretaries know that you spend nearly all your time and energy gambling. We’re tired of carrying you, and even the boss—he likes you a lot and gambles himself—has had it with you. So, OK, guy, here it is: If you don’t agree to go for help and honestly try to stop gambling, I’m gonna have to tell the boss about those shortages in some of our cash accounts.”

This last bit of information was news to all of us. I decided not to tell Henry just now that he could be an accomplice to a crime if he continued to keep silent about Kirk’s suspected misappropriation of money. He should have reported this to the boss immediately. I made a mental note to talk with Henry on the phone as soon as possible.

Next, with Dad doing most of the talking, the parents told of their genuine, deep love for their son, and their firm resolution to offer him nothing further in life beyond this love. He could never stay with them again without his wife and child present. He would get no more money from them and, although it would break their hearts to see it, he would have to live from now on with whatever punishments the bookie and his henchmen dished out. Both parents said they would see him in jail or dead before they would try to buy a solution to his problems one more time. They said they knew they had the blessings of the Church in their resolve. With many tears, they ended by saying they would pray for him constantly. Although Mother had little to say, she sobbed and rocked back and forth in enormous distress as Kirk’s father did the talking.

From what I could tell, Kirk was unmoved by any of this. “When do I get a turn?” he demanded. “Are you all finished yet?”

“No,” was Sally’s answer. “Not until you hear from our daughter.” She reached over to the tape recorder on the empty chair and pushed a button.

The thin, hesitant voice of a child, recorded on a cheap tape recorder, filled the room. “Hi, Daddy. I love you and wish I could talk to you like we used to, but I know you’ll listen and call me when you can.”

Quietly, the girl’s voice spoke of her love and respect, of wanting to have more of her father’s time and attention, and of having tried so hard to please him. She begged him to find help and to stop gambling. She was sorry if it was her fault. She promised that she would try to do better. At the very end, however, she said, “So Daddy, if you’d rather gamble, that’s up to you, I guess. But you’re not the same when your mind is always on gambling. If you don’t want to change and be with us, then I can’t be your daughter anymore. It will be just Mommy and me. And I’m sorry, but I can’t be your daughter …”

For a few moments the room was very quiet.

Then Kirk walked out.

And nobody thought they had failed, because each now knew exactly what he or she had to do for their own sanity. And from that day on each began to do those things.

The late afternoon sun was mostly in my eyes on the long drive home. Although I knew we had accomplished much, I was filled with a deep sadness. Even some of my favorite Baroque music on the radio did little to improve my mood. There is no guarantee, I told myself, and there is no magical entitlement that each and every one of my efforts has to pay off. It was a learning experience; not about how to succeed, but how to fail and still be a winner.

They had been far too polite to mention it, but I saw the disappointment in the parents’ eyes. Sally’s eyes, however, were on her future, and I could tell that for her, Kirk was a part of the past. I could not be sure the parents would not continue to be victimized. If they were, then it was just too late, and too bad for them.

Giving up the habit of helping dependent, irresponsible people can be as hard as giving up any addiction. In fact, such codependent behavior of the parents seems like an illness in itself. Sally was going to make it, but the parents had no experience with any other way of solving problems for the people they loved. I thought of other enablers who had sought my help; few of them, in truth, ever came to understand that the problems from which they suffered are largely of their own making. Just like the gambler, the enablers want others to change, but they consistently fail to see that the only possible changes are those they must make themselves.

It’s not unusual, and it isn’t what I would call stupid, for a loving rescuer to try to help a desperate gambler by offering money or even by tolerating abuse. It does seem like the logical thing to do sometimes. After a time or two, however, most friends and relatives see the foolishness of their attempts to solve the gambler’s problem with bailouts. They learn to keep their hands in their pockets and offer only what we call tough love. They learn to respect the gambler’s right and need to experience the inevitable consequences of pathological gambling, painful as they may appear to us.

But there are those chronic enablers who cannot or will not stop. Year after year, the devoted mother, father, sister, or wife goes on arguing and pleading, yet always coming up with bailouts. I could remember so many incredible examples of selfless generosity, each harder to believe than the last. After a while, one gets suspicious about the rescuer’s true motives. Why would someone continue doing something so expensive, frustrating, painful and obviously futile? And what was different about Sally that would let her let go and get on with her life?

As I drove, I thought of a phone call from an elderly woman in a distant state. She had heard about our program and wanted me to help her son.

“Does he want to come for treatment?” I asked.

“No,” replied the mother, “if I mention gambling he gets furious.”

“How old is your son?”

“He’s 42,” she told me.

He’s old to be still hanging around Mom. “Where does he live?” I asked.

“He lives where he can; in his car sometimes. He lives by stealing my checks and signing my name.”

“What about getting some help from the police?”

“I cover the checks so he won’t go to jail.”

“Why are you calling?” What did she expect me to do?

In reply, she said, “All the money is gone now. I have a few savings left and he says he has to have the money or the loan shark will kill him. Can’t you help him, please? I just want you to make him love me, and be the kind of son I can be proud of.”

I tried to help her see that her goals for her son were not well thought out, and that she might be too personally involved in the details of his life. I pointed out that, since her son was 42, she could legally and honestly just let go of him and his problems. She could just walk away and devote the rest of her life to hobbies, travel, or good works for more deserving individuals. I suggested that perhaps she could find emotional support and greater understanding of her own motivations by consulting a psychotherapist or going to a self-help group. But I must have gone too fast because she suddenly decided I was being critical of her, that I was unsympathetic and indifferent. She hung up in a huff because she hadn’t heard what she wanted to hear.

Gamblers often do that, too.

Helping by giving bailouts to gamblers is just as irrational and hard to understand as pathological gambling itself. Like the gambler who finally admits he cannot win, that he gambles only for the action, the dependent enabler must finally admit that the bailouts never help. Just as the gambler must admit that he is powerless over the gambling that controls his life, so also the enabler must realize and admit he or she is powerless to stop the gambling or control the gambler. That’s what Gam-Anon teaches so well.

At some level of consciousness, I believe, the persistent enabler realizes that he or she actually needs and wants the gambler to be dependent. The enabler lives in fear of abandonment, or of being unimportant and powerless. Sometimes it seems that the enabler is devoted to the soap opera drama of constant crisis. In some strange way, the weakness of the gambler proves over and over the illusory importance and strength of the enabler.

It is as if the enabler is saying, “You can’t make it without me, without my help; I am necessary, indispensable, powerful, and all-important. To get the gambling you crave you must depend on me. It is by helping you that my life takes on meaning. It is through your weakness that my worth and strength become manifest.”

No enabler ever actually spoke such words to me, of course, but psychologists learn to listen to acts, not just words. One old timer in Alcoholics Anonymous once told his friend, “What you do is so loud and clear, I cannot hear what you’re saying.”

The persistent rescuer is at least as sick or disturbed as any pathological gambler, needs very special help, and is just as difficult to change.

As I drove along with my ghosts, Hilda the Magnificent came back to haunt my memory. Hilda was about 65 when she finally forced her gambling son to come into treatment. She had come to the point where she had had to remove him from the family business.

The family was well-to-do, and for several generations had operated a well-organized and growing chain of hardware stores. Son Dave had not moved up in the company and was still doing what he did when he finished high school years before; he was basically a truck driver, pickup man, and general delivery boy, although he called himself a supply manager. Whenever Dave got into money problems because of his visits to the racetracks— ne or another of the company trucks was often out of service in some track parking lot—he borrowed money from other company employees, money that Mom eventually had to pay back to keep the peace. Hilda and the union steward had an unwritten arrangement: Whenever an employee complained that Dave was welshing on a loan, the union steward would call Hilda. After a short yelling match with son Dave, Hilda would make the bailout.

For a long time Hilda had tried to get the union man to prevent other employees from lending Dave money, but of course that was something he could not control. Dave used his own form of blackmail on other workers by implying that he would get the victim fired by Mom, or at least blackballed. Dave had often harassed other workers for failing to cooperate. He wielded a two-edged weapon. If the employee balked at making a friendly loan, Dave implied he would cause trouble in the front office with reports of inefficiency or theft. And when the victim did make the loan, the chances of repayment were slight because any pressure from the employee only resulted in the same threats, and even outright sabotage. Dave regularly stole items off the trucks and made it look like other employees were guilty, so his threats were far from idle.

Hilda had repaid dozens of loans, which she estimated to have exceeded $100,000 over the years. And, sadly, some very fine workers were fired in the early days. But as time went by, Dave’s behavior became better understood, even by Hilda, and she gradually took a firmer stand. In recent years, Dave had only been tolerated by his mother. Putting him out on the trucks was her attempt to isolate him from the workforce, and minimize the havoc.

Like any spoiled brat, Dave was prone to outbursts of temper. One of these outbursts became the final straw for Hilda. Dave had punched another employee during a loud argument in the warehouse, and everybody within earshot knew the boss’s son was furious because his fellow worker had the audacity to demand repayment of a loan. Nothing was getting done at the warehouse, and everywhere Dave went worker morale dropped to zero. There were constant grievances and mutterings among the workers. Now Dave was costing even more money by eroding employee motivation throughout the company.

At last, in a rage over Dave’s latest immature behavior, Hilda jumped into her Cadillac and tracked down her son, forcing his truck to a halt and ordering him out of the cab. She personally took away the keys, locked the truck, and drove off in her own car ordering Dave never to return to any of the company’s stores or its warehouse. She wasn’t quite done yet, however.

Hilda was tall and erect, a most impressive grand dame type who came to my office in feathered hat, fur neckpiece, and white dress gloves, her son following behind. She ordered Dave “Sit!” Mother, was all business. She carried a practiced, easy authority. Although she had put Dave out of her business life, she still obviously felt he was her responsibility, that she had an unending obligation to do something with, for, to, or about Dave.

Like Kirk’s parents, Hilda had great respect for men of learning, lawyers, physicians, psychologists, and such. From the beginning, she gave me an uncomfortable sense of my total responsibility to fix the problem for Dave, so much so that I soon had to report these feelings to her, in an attempt to have her examine the realistic limits of what a therapist might be able to do.

But of course, Hilda was a realist, and knew perfectly well that therapists have no magic pills. She was setting me up, and we both knew it.

Dave, after all, still had free will of his own. Hilda understood all this, and reluctantly agreed that we would not try to control him, just help him accept personal responsibility for the consequences of his own behavior.

Since Dave wasn’t doing much talking, Hilda told her story. On the surface, she appeared to be a strong, loving, altruistic, hard-working woman. She had raised four children while she managed a family business left to her by her father. Her husband, a good but ineffective man, had retired early from his own occupation and now spent his time speculating in the stock market. From what she told me, the husband seemed to be a controlled or social gambler who played the stock market for excitement and ego, not investment. It was a hobby for him, although apparently he was a long-term net loser.

Hilda was the strong center and principal organizer in a large network of cousins, aunts, and uncles. She was active in their temple and in civic affairs, and had even held public office at one time. She supported several local charities and was the driving force behind her community’s effort to buy and renovate an ornate old school building into an art museum. I got the impression that here, indeed, was a living saint full of love and elegant humility. She never claimed any credit for her good works. To view such a person as sick would be like slinging mud at a statue of the Madonna. How could anyone criticize such a loving, strong, and altruistic pillar of family and community?

Beneath the surface, where people like me are trained and paid to explore, the picture that emerged may be surprising.    

The more I spoke with her, the more I began to see that her strong will was actually a self-centered, power-driven willfulness. There is a difference. A strong will can be directed to selfless causes, but willfulness is directed to the achievement of personal, selfish, and egotistical goals. Covering it in the cloth of noble service only makes matters worse.

It became clear that she was on a lifelong power trip. Her psychological survival depended upon her ability to control her widespread family network. She was a queen bee. Her business, in her mind, was only an extension of her family, and her benign dictatorial management had little to do with earning profits. She made money, of course, but that was merely secondary to managing the lives of the people who worked for her. She needed to be needed in a most desperate sense, for her own self-esteem, and she used money, loyalty, and guilt to bend the family to her control. She was a master at doing things first and better, and she knew the weaknesses of each family member and employee. Dave wasn’t the only one who had become dependent on Hilda for bailouts.

Hilda gave me permission to obtain information from other family members. What I found was fascinating! My suspicions that Hilda was a power-hungry manipulator were confirmed as one family member after another said that they had been trying for years to get Hilda to see her own possessiveness. Some referred to her as “Madam Hitler.”

Ethically, there was nothing I could do about Hilda’s personality or habits; she had not come to me for help for herself, and had not invited me to be her therapist. She saw herself as the afflicted and abused one, not as the sick one. She wanted Dave fixed, but had no intention of challenging him to become independent or competent in his own right. And she certainly was not going to shut him completely out of her life, although that was probably the best thing she could possibly have done for him. She was slowly killing him with her brand of caring, enabling him to pursue a life in which he wore the mask of adulthood while living as a dependent, spoiled child.

Madam Hitler, it seemed, lived behind a mask, the image of long-suffering sainthood.

The difference between Hilda, who would probably always want to play the enabler’s role, and Sally, who I was sure would make a good life for herself and her daughter, was that Sally was a whole person within herself. She had made a great mistake. She had fallen in love with and married a pathological gambler. Now she would correct that error. But Hilda needed dependent people to give meaning to her life, to fulfill her own feelings of self-worth.

Behind the persistence of many chronic enablers lies a deep and irrational need to control or be needed. Many spouses of gamblers, it seems, are members of the helping or service professions. If they are not professional helpers, they tend to be responsible business leaders, mother figures, or executive father figures. They end up holding jobs in which they can serve the needs of others, and this becomes their personal path to self-esteem. Very often, when a gambler does stop gambling, the relationship with the rescuer gradually starts to disintegrate. It is amazing how often the enabler-spouse begins to be really unhappy when the gambler stops gambling. It is as if the rescuer were being deprived of something vital to life itself, as if some kind of withdrawal were taking place. They may become irritable, restless, and angry, all of which are signals of addictive withdrawal.

Faced with a non-gambling gambler, the chronic rescuer is suddenly full of resentment, and cannot seem to resist bringing up the past. The enabler may now turn attention to other weak or sick family members, searching for a replacement; there seems to be no time now for the abstaining gambler. The enabler feels rejected, lost, and without purpose. The anger of rejection may be focused on the recovering gambler, while the expectation of relapse to gambling is held out repeatedly as a kind of bait.

Sadly, in the most difficult and chronic cases, the gambler can’t seem to start a meaningful and lasting recovery until after the death of, or divorce form, the rescuer. I have seen that happen in several cases.

Hilda’s Dave did enter the hospital program. Hilda came to visit often, bringing bags of home-cooked food, fruit, cakes, and chocolate milk. She asked if I thought it would be all right if she gave Dave a car when he left the hospital. After all, he would need a car to look for work. At this suggestion, I finally lost my composure and suggested that she seek therapy for herself and get out of Dave’s life. Now, much later, every time I see one of her company trucks around town, I reflect with sadness about Dave, sacrificed on the alter of his mother’s ego. Not surprisingly, his gambling money still comes from mother, and still goes to the ponies.

Not all enablers have Hilda’s kind of personal and emotional problems. Most are able to separate themselves financially and psychologically from the gambler, and thereby help in the recovery. But the willingness to allow the gambler to be, and to become, his or her own person, is a difficult step for every enabler.

Letting go is never easy!

In our last meeting together, Hilda offered a perfect example of how she helped people. She and her husband came to pick Dave up on the day of his discharge from treatment, and we met for a final brief conference together. The situation was classic. Hilda wanted to know exactly what she should do to help Dave’s recovery, as if recovery depended upon something she could do, not on what Dave would do. It was like a mother wanting instructions from the physician on how to deal with a child’s measles. In my opinion, she shouldn’t even have been there to pick Dave up. She should have been out of his life long ago.

At the end of our talk, most of which had no impact on Hilda, she reached into her purse and pulled out a small box. “This is for you, Dr. Taber. Please think of us when you use this, and let it remind you of our gratitude.”

I opened the box and found an expensive gold pen and pencil set. “Please, Hilda,” I said, “I’m not allowed to accept gifts from patients or their families. We have strict rules against it. I appreciate your kindness very much, but I cannot accept this.”

She refused to take back the gift, and grew impatient with my lack of cooperation. When there was something Hilda wanted to do, nobody’s silly rules were allowed to get in the way. Never mind that it might be a federal offense for a government employee to accept gratuities or gifts from patients or family.

Then they were out the door and away, and I was left caught in an ethical bind that I had to take very seriously. After advice from superiors and co-workers, I offered the gold pen and pencil set to our hospital volunteers, and it made a fine Bingo prize for the evening entertainment they ran for patients. Our gambler patients were, of course, forbidden to participate in bingo, cards, or lotteries in the hospital, but it is ironic that a form of gambling became the solution to my ethical trap.

After my drive from Kirk’s intervention, I stopped by the hospital to check messages. The need to be needed, to be important and was no stranger in my own head. The action, stress, and drama of a gambling treatment program were, I have to admit, a bit intoxicating. I would have been disappointed if there were no messages. There were two.

Mrs. Harry from Florida wanted to speak with me. And Kirk had called.

Interesting. Neither should wait until morning, I decided.

“Hi, Kirk, it’s Taber. What’s up?”

“I’m just not ready, Doc. I appreciate what you tried to do, but I’m just not ready.”

“Your family’s ready, Kirk. You know that.”

“Yeah, but they’re out of my life now. That’s what I mean. I’m just not ready to be a husband and a father. What you did was give me the chance to call it quits and break it off once and for all. I know they’ll be fine; they can make it better without me. You can’t help me, but you sure helped them figure out what to do.”

“So why are you calling me now, Kirk?”

“Well, Doc, I wanted to say thanks, and I mean that. You helped me figure out who and what I am. I can’t gamble and have a family at the same time, not the way I gamble. And Sally’s too good a person for me to hurt any more than I have already. She’s going to make it.”

“Your parents will have to live with your problems, Kirk. They don’t have much left to do with their lives at their age.”

“Mom and Dad?” mused Kirk. “They spoiled me rotten. They know it, and I know it. That’s how they control. They just buy what they want, or they try to. They never really cared much about what I wanted to do, what I wanted to be. They always had some crazy idea of what a family should be: Mary, Joseph, and Jesus is their idea of family life, I guess. I’ll never be a Jesus, that’s for sure. I think they just want a dependent child, and I keep falling into the trap. They use their old-country idea of a model family to put you on a guilt trip when you don’t measure up. Money, guilt and shame, that’s how they control and get what they want. Sometimes I just wished they’d beat on me as punishment and stop with the mind games.”

“Well, I can’t wish you luck, Kirk. That’s not what you need. But I do appreciate your honesty. That’s a strong point in your favor. And I think you’ve described your situation and your personality pretty accurately. You’ll be ready to quit gambling someday. You’ve made a mess of things, but I do feel you’re on the road to maturity.”

“Doc, gimme the name and number of that damn program you talk about. I’ll stick it in my wallet. Yeah, I know I can’t quit for anybody else, and I’m beginning to think I may find my own reasons once I’m alone and don’t have to play the family game anymore. To tell you the truth, Doc, I hate gambling. I really hate it, and I don’t give a shit about money. It’s just the way playing used to make me feel.”

“Call me any time, Kirk,” I said.

I hung up and spent a few moments in meditation. Once again, in a curious and controversial way, Kirk had proven the truth of a saying my old professor in graduate school used to fall back on. Under his supervision, I did research on learning in rats, and often the outcome of our experiments was not what we predicted. Sometimes what the animals did made no sense at all. My professor would run a hand through his hair and say, “The rats are always right. They’ll teach us the truth if we know how to listen.” And so we would go on to design another question to put to nature in an experiment, hoping eventually to find understanding.

The rats are always right!

Later, as I learned more about people from patients and from senior clinical psychologists, I heard the more experienced therapists expressing the faith that patients, no matter how upset or disturbed they might seem, almost always have wisdom about their condition buried deep within them. Whatever the patient is doing is what he or she should, will, and must do, given their particular circumstances in life.

The patients are always right! Learn to read their behavior and stop trying to impose your own expectations on them. That’s so hard to accept, and such an invaluable lesson.

There are always reasons for any behavior, no matter how bizarre, dangerous, or illogical it might seem to me. Given the right kind of help, most patients can come to understand their behavior, and when they do they usually know exactly what they have to do to make life better. Not that they can just pick up and be different, but they have the wisdom to recognize their own capacity, their own limitations, and their own reasonable goals. And certainly, what they must do for themselves will not often be what we most want them to do for us. While gambling is a sign of dependence, social conformity may not result from self-sufficiency.

With the right kind of help, Kirk would make it. Perhaps not in the ways we would wish, or on the schedule we would set—but he will do better if others do not try to impose their values on him, if others do not go on insisting that he be someone he lacks the ability to be.

I could not bring myself to voice it, but the thought was loud and clear. Kirk was the wisest person at our conference that afternoon!

I made the last call. “Hello, Mrs. Curtis? This is Doctor Taber. I believe you’re Harry’s wife, and that you were trying to reach me earlier today.”

“Oh, Dr. Taber, I’m so glad you called back. Harry told me that if I went through with a divorce, according to you he’d be in serious danger of suicide. He said you told him to tell me to sit tight until he gets out of treatment, that he’d be a new person and we could start all over. Dr. Taber, I have to tell you that there’s no way I’ll stay married to Harry. I don’t want to see him kill himself, but I just can’t live with him anymore.”

“Karen,” I said, “Harry is just trying to manipulate us. We never discussed suicide, only that he’s a gambler, that you say he has abused you, and that he wants to come into treatment. In fact, he claimed you hit him.”

“Damn straight I hit him. He was standing there, lying about my falling down the stairs while I was on the stretcher being put in an ambulance, and he bent down to kiss me. I slugged him as hard as I could with my good hand.”

“Why were you going to the hospital?”

“Harry had another bad day at the track, we argued, and he just lost it. He came at me and broke my nose and a couple of ribs. He stomped on my hand when I tried to pull off my wedding ring to throw at him.”

“Was that the first time he abused you?”

“Before that it was mostly yelling, stealing my paycheck, and not coming home. We’ve been married three years and I had no idea what I was getting into with this nut. My lawyer is suggesting marriage counseling, but the hospital social worker thinks I need a restraining order, and she thinks divorce is best. I’ve come to agree with her. And, please God, I hope you won’t try to talk me out of it.”

“Karen, in my opinion a single blow from a spouse is cause for immediate separation. Any abuse at all calls for serious psychotherapy for the people involved. Marriage counseling is for grownups, not for violent, immature, impulsive children in big bodies. It’s always amazing how some wives will stay with a violent man hoping that things will change. By the way, I’ve known several battered husbands, all of them married to fanatic bingo or video poker machine players. Some people seem to be addicted to violent relationships. Others are just too afraid to get out on their own. You sound like you’ve thought this out pretty well yourself.”

“I don’t want Harry to hurt himself,” Karen responded.

“If he talks to you about suicide your only responsibility is to call for emergency help. Report where he is and what he’s talking about doing. What Harry is trying to do to both of us is called emotional blackmail. He’ll do anything to get his own way. Harry is one of those immature people who never do anything for its own sake. He seems to do everything in order to achieve something else, some hidden agenda. He’s a child trying to bully us as if we, too, were children.”

“But, Dr. Taber,” she protested, “why would you admit a man to treatment when you know he’s only bluffing, that he’s not serious, that he only wants to keep me trapped in a bad marriage so he has a cushion to fall back on?”

“To me, Karen, it doesn’t matter why someone wants to come for help, as long as they come. Most of our patients come for the wrong reasons, and if I waited for them to come for the right reasons, I’d never help anybody. We often see big changes in thinking and attitude while our patients are here, even when their reason for coming was to manipulate someone’s feelings.

“About half of all compulsive gamblers coming for hospital treatment are divorced. The wives of these men realized what they had married, and left. These were probably the smart, healthy women. Those wives and spouses who decide to stay often have personal problems, low self-esteem, and insecurities of their own that hold them in an unrewarding marriage. Unfortunately, there seems to be a kind of psychopathology or mental illness that controls the chronic battered wife, and clouds her mind to alternatives. In my opinion, it is essential for any battered wife to get professional help for herself, so she can sort out her alternatives. No woman ever has to stay with an abusive partner. My friend, you’ve got it sorted out. You’ve got a plan. Do it.”

“Do you think that if Harry did quit gambling our marriage could work?”

“Gambling isn’t Harry’s only problem, Karen. It’s a mistake to think that when the gambler does give up gambling he’ll stop beating his wife and just turn into Mr. Nice Guy. There may be an overall improvement in the gambler’s disposition when he or she quits, but just as often we see that spouse abuse has a life of its own. It may require separate treatment, and that treatment is better done, I think, during physical separation. Once battered, in my opinion, no spouse should take the partner back until the partner has been released as improved, by a therapist qualified for work with that specific problem. If, following therapy, battery occurs again, permanent separation should follow immediately, with no looking back and no second chances. This is a drastic step, but the problem of spouse abuse is an extremely dangerous and difficult situation that should never be minimized by outsiders who don’t feel the blows or experience the fear.

“If Harry threatens you again, you should immediately—repeat, immediately—report that threat to civil authorities. Report it even if you don’t take it seriously. The police may not be able to do much, but your report makes it a matter of record. And by reporting it, you show the gambler that you have alternatives, and that the threat will not work.”

After we had compared the stories Harry was telling us, Karen felt reassured. Her self-confidence was restored. I reminded myself that Harry was not yet a patient. Once he was, I would need his permission to speak to his wife. I did not feel I had violated his confidence, since he had not asked me to avoid speaking to Karen. She had called me asking for advice for her own reasons.

Maybe someday, Karen and Sally—maybe even Hilda the Magnificent—can say to their gamblers something like, “I love you and want the best for you. I cannot fix your problems and I cannot change you. I will live with you if you begin to behave like an adult, if you stop gambling, get help, and let me control the cash. I will certainly live without you if you do not begin a program of your own immediately.”

It was well after seven in the evening when I finally got home. My wife hadn’t held supper, not with hungry kids to feed.

I kissed my bride of many years and took my sandwich out to the barn. In the last of the daylight I sat in the open cab of the 1934 Studebaker pumper engine which had once shared the garage with the Woonsocket rescue wagon. Eating in peace in the still, quiet building, from my shirt pocket I fished out one of the little cards I always carry with me. I’d handed out several to Sally’s family, and hundreds more over the years. The card carried a simple message taken from the audiotape of a workshop given for the families of problem gamblers years before, by a Catholic brother named Bernard Shannon. Later, I understand, he became Father Shannon. In his own, personal and professional life he had to work on the problem of what to do with a family member who gambles.

I read over the words once more, marveling in their simple wisdom. That I am an agnostic takes nothing away from their profound meaning and importance.

The Wisdom to Know the Difference

I am willing to trust the Spirit of God for others. I will not worry, fret, or be unhappy over you. I will not be anxious concerning you. I will not be afraid for you. I will not blame you, criticize you, or condemn you, and I will not give up on you. I will remember first, last, and always that you are God’s child. That you have His Spirit in you, and I will trust this Spirit. I will think of you always as being surrounded by God’s loving presence, as being enfolded in His protecting arms, as being kept safe and secure in Him. I will be patient with you; I will have confidence in you. And I will stand by in faith and bless you in my prayers, knowing that you are growing, knowing that you are finding the help you need. I have only good feelings in my heart about you, for I am willing to let you live your life, as you see fit. Your way may not be my way, but I will trust the Spirit of God in you to show you the way to your highest good. I will always bless you.

Such tolerance and selflessness, it seems to me, are necessary in both union and separation.