Chapter Six

Casino Capers

As my flight continued, I became absorbed in the scenery below. Suddenly the majestic, snow–covered Sierra Mountains began to march past under me. It was a cloudless evening. The landscape, nothing less than spectacular, kept my eyes and thoughts focused outside. Soon the broad expanse of Lake Tahoe appeared far below. I have never seen anything on earth quite so beautiful, a clear blue gem set in a ring of high, snow-covered mountains. It was a secret and holy place for the Native Americans who came here first. Later it became a site beloved by Mark Twain and all the other writers and artists who ever visited there. I didn’t know then that I would come to know this place much better in future years. Its sparkling beauty would offer both great joy and profound personal sadness.

This was my first trip to the Reno area, however, and everything did seem a little exotic. Noise was my first impression, stepping out of the walkway from the airplane; electronic chimes and the tinkle of coins filled the air. The chance to gamble in Reno begins while you are still in the airport, which offers wall-to-wall slot machines. Signs along the corridors hawked the wonders of the casinos in Reno. An endless stream of free casino vans picked up passengers bound for the Reno hotels. In the distance were the mountains that cradled Lake Tahoe, the surface of which now lay some 2,000 feet above us.

I picked up my rental car and found lodging. Still on Cleveland time, I was tired, and no thoughts of gamblers filled my head now. Sleep came quickly.

The morning was bright and warm as I drove to South Lake Tahoe. Along the way, I stopped to watch hang gliders overhead, and to take pictures of donkeys. In a small general store, I bought a sandwich and a brightly colored strap for my camera. It was beginning to seem like a real vacation.

The drive up the mountain west from Washoe Lake presented a series of dramatic views. At various lookout points, I could see for miles across the valleys and forests of this sparsely settled land. A kind of tension, an expectation, seemed to increase with each new view from ever-higher altitudes. Finally, just over the crest of one last, steep hill, was the huge expanse of Lake Tahoe. The water was a deep, clear blue, in reflection of the cloudless sky above. Huge boulders and tall ponderosa pines framed the lake at every turn.

This area is incredible at any season, a world of beauty and serenity sufficient to restore even the most battered soul. I would eventually decide that, in comparison to Lake Tahoe, all other Nevada gambling towns are full of cheap tinsel and vulgar noise. At its southern end, Tahoe had only a short casino strip, and somehow the casinos seemed dressed in less garish clothing—out of respect, perhaps, for the magic of the environment.

It is neither a search for serenity nor devotion to gorgeous scenery that brings thousands of vehicles streaming in from California on any given Friday night. These cars and caravans of loaded busses bring an endless tide of dollars that will be left behind in the Tahoe casinos as exhausted gamblers head home on Sunday evenings. The action at South Tahoe's gambling tables is fast on weekends and holidays, when families and social gamblers seem to take over. During the week the more devoted gamblers and conventioneers provide an active trade. Food, alcohol, lavish decorations, and dramatically costumed employees create a gambler's dream world a timeless, comfortable, worry-free, exciting safe haven of easy living and high hopes.

As a visitor to this beautiful land, I could savor the feelings of excitement and wonder. Such an unspoken, awesome presence—how easily one surrenders to its lure!

How easy to forget that gambling is a business, a very lucrative business!

I found my motel on the California side of the lake. It was only a short walk back to the Nevada line, and the casino where our meetings would be held. Hungry and looking forward to meeting old friends, I wandered onto the casino floor. You have to cross the gaming area to get to any other area of the hotel. Almost immediately, I spotted three friends, a psychiatrist and two psychologists. Knowing I was at last among like-minded and sympathetic specialists, I hurried over to their blackjack table. Too late, I realized my extended hand and enthusiastic greeting was an irritating interruption to their game.

“Oh, hi, Taber.” No eye contact. No handshake. No conversation. They were all fixated on the cards! Gambling experts like me absorbed in gambling? Over the next few days I observed that some were, most were not.

“Buy some chips and play a while,” said one friend of many years, who did not look up at me; a man who, I had hoped, would be eager to exchange information about treatment programs and theoretical problems related to unhealthy gambling!

Maybe there would be time for that later.

The sign on the table said $10 was the minimum bet. That's a lot of money to a married man with three children, so I didn't buy into the game.

“See you fellows later,” I mumbled, and wandered deeper into the casino in search of a dining room. There were five, as it turned out. I met a pair of social workers I knew, and we dined together on excellent Chinese food while a young man came to the table and entertained us with coin tricks.

The meetings of the mental health people over the next few days were, honestly, rather dull. They talked mostly about the same old theories. Real research was very rare. Many speakers seemed to have almost no clinical experience with problem gamblers. Most of us were there, I suppose, for the trip, the socialization, or to enhance our reputations as pundits.

Guilty at my disloyalty to my specialty, I attended some of the casino meetings, where management topics were discussed. Here I found energetic, talented businessmen deeply involved in sharing information about their industry. There were lawyers, financial experts, executives, personnel specialists, and advertising people, all exchanging ideas and experiences. Overall, the casino people made us mental health people look like the dull bureaucrats I guess we are. Despairing of hearing any new or inspiring clinical information, I finally abandoned the meetings and started off to drive the 70 miles of winding road that circumnavigate Lake Tahoe. It was good that I allowed a whole day for this.

At each town around the lake, I stopped to visit shops and view the lake from yet another angle. It occurred to me that it would be wonderful to have a home here. Over the next several years, this idea haunted me, and when, in time, a job for a psychologist opened up at the VA Hospital in Reno, I applied and got it. My family and I settled in Kings Beach at North Lake Tahoe, but that's another story.

Two more days of conference remained, and the titles of the papers yet to be given looked unexciting. My own 12 minutes in the spotlight were anticlimactic. There were a few polite questions, but no real discussion of important issues. I felt again the old unspoken judgments: Taber is original but rather controversial; he doesn't go along with the common wisdom on many issues, and we don't really understand or feel comfortable with what he says.

Strange, that's often what patients tell me.

As a member of my high school debating team, I learned how to research all sides of an issue and argue any position with equal vigor. Most people don't like controversy, but I was raised on it during my graduate training in Pittsburgh. We students argued day and night, loving it and learning during every minute of it. I have never learned much from people who agree with me, or who ignore my own disagreements.

Obviously, I don't see gambling and gambling treatment the same way many of my colleagues do. Moreover, no, I don't soften my arguments or engage in polite chitchat about my specialty. And yes, many folks go away from my talks disturbed and angry, sometimes with hurt feelings. So be it.

I found myself skipping the professional meetings going on in the conference rooms, and spending time on the casino floor observing because I could learn more there.

The hands and feet of the casino industry are the floor workers: the dealers, pit bosses, servers, change-makers, and security people who help the public spend its money on gambling. One is not supposed to look at casino workers. They are dressed and trained to be attractive but impersonal background figures in the casino dream world. At first impression, they all appear to be young. A few of the dealers at high stakes games, and some of the pit bosses, show carefully controlled signs of approaching maturity. However, the only man with graying hair I noticed was a former sports hero, now working as a credit manager and greeter to the high-rollers who sweep through the lobby, after alighting from the complimentary limousines that fetch them from the airport in Reno, or from the small airfield for private jets.

In the better casinos, youth and beauty characterize those who do the actual customer contact work. This is not just because the casinos practice an up or out employment policy. There is a huge turnover rate among the workers, and a significant problem with burnout. Research shows that casino workers tend to be more alienated, and to have more feelings of isolation, than do other kinds of service workers. Alcoholism rates and the incidence of other mental health problems are high among casino workers. For many of them, gambling is a favored recreation, although, under their polished and smiling exterior, most hold considerable disdain for their patrons.

The casino floor—packed with eager gamblers whose wits may be addled by travel, flashing lights, noise, and alcohol—is the scene of some of the most bizarre behavior to be found anywhere on earth, outside a mental ward. If you are employed there to do a tedious, repetitive job, if you are just there, not drinking, while hearing the endless shrieks and groans of gamblers; if you are stuck there with your feet hurting and a tough boss standing right behind you, well it's rather easy to feel alienated. It's also rather easy to feel resentment toward the endless stream of suckers who belly up to your table. Each new player, having what he or she thinks is a unique and special adventure, merges into an endless, dreary sequence of mindless faces. It’s boring to be a dealer!

The starting pay isn't too good, either.

It was in just such a casino dream world, set in the real dream world of Lake Tahoe, that I met Barbara the dealer. My attention had first been drawn to a tall, dark-skinned man whose movements in placing chips on Barbara's roulette table had a jerky, almost spastic quality. His stacking of chips showed absolutely no organization, and he frequently grabbed into his pockets to get more.

In contrast, Barbara was a picture of calm organization. She smiled at everyone and seemed really sincere. She was tall, very thin, in her early 20s, with long, blond hair falling down the back of her stylized tuxedo. With quick and careful motions, with a sense of organized dignity, she paid out winnings, raked in losing bets, and sold chips for cash.

Her customer had eyes and mind only for the table. He kept brushing his curly black hair out of his eyes with one hand as he scattered his bets across the table with the shaking, bony fingers of the other. Under his breath, he was muttering in what sounded like Spanish. My first impression was that he scattered his little stacks of chips randomly around the squares of the table. There was no apparent consistency in the number of chips in each stack, and different colors of chips were mixed together. He was losing, of course. It was soon clear that he was losing hundreds of dollars on each spin of the wheel.

After watching about five spins, each preceded by frenzied distribution of chips, it suddenly dawned on me that the gambler was making the sign of the cross on the table each time with his little stacks of chips. Sometimes he made a cross in one corner, sometimes it was up the length of the board, and sometimes it went from side to side—always the sign of the cross, and always attended with muttering.

Then, suddenly, leaving no tip for his dealer-hostess, he swept up his remaining chips and darted from the table.

“Get many like that?” I asked her.

I was looking for information, not action, and had chosen roulette tables because in American casinos roulette is a dull game with relatively few players. Casinos in the United States insist on having better roulette odds in their favor than those in their European counterparts.

“Oh, he's a strange one, isn't he?” was her reply. “The son of a South American oil family, I think. He's been back a few times this week.” With this, she became the distant professional once more. Perhaps she realized she was being indiscreet.

Now the only player at the table, I kept the conversation going with conservative, one-chip bets on black or red, explaining I was a psychologist, a specialist in gambling problems, attending a convention here on gambling behavior. I told her I really didn't know much about gambling, just something about gamblers. It was the truth.

At times another player or two stopped by, and for a while the action would pick up. During these periods I could hold off a bet on every other spin and cut my losses. Among the other players, there were never any big winners, and play was quiet and rather slow. In the background, the dice table crowds gave out roars, and the slot machines provided metallic counterpoint.

We psychologists prefer to gather our case material in the controlled context of treatment, but the world has so much more to teach us if we make use of every opportunity to study it live; in the field, if you can do that. People are often willing to tell all if they have a good listener, since it’s a chance they don't often have. Barbara readily answered my questions.

Bit by bit she told me something about her life during several fragmented, casual conversations over several days. Finally it was my last day at Tahoe, and Barbara had agreed to have lunch with me so I could interview her away from the casino. I had become a participant observer in an interesting social situation. She knew I was a harmless old duffer, curious, and quite completely married. My convention nametag was authentic, and she knew I was genuinely interested in learning about her work environment. I was delighted to have an uninterrupted hour with her.

Like many other dealers and game operators at Tahoe, Barbara was from California. Her father was strict, conservative, and successful. Mother worked. College was supposed to be her path to a successful life, but Barbara wanted something more exciting.

She liked people, liked to dress up, and liked to have a good time. She had come to Tahoe with her family several times, and loved the mountains and the winter skiing. In the 1960s Barbara surely would have revolted against her conservative background by becoming a flower child, a hippie. Drugs, not gambling, might have been the dominant theme in her life. But the 1980s had become the days of the Me generation. Like thousands of other young people, Barbara focused not on the injustices of Vietnam, but on self-fulfillment.

At 21, she had quit college and left California to live with a friend at Lake Tahoe, her only farewell the angry protests of her father. She hired on as a cocktail waitress at one of the casinos and soon found that what was a dream world for customers was plain drudgery for a floor worker. She earned a minimum wage and got nice tips, but she also got pinched, patted, pushed, and stepped on as she slid her way across the crowed casino floor at odd hours of the night and early morning. The casinos never close, not even on Christmas.

Drunken male customers often assumed she would double as a prostitute, and more than once she suffered the abuse that only an immature, rejected male ego can heap upon an innocent female. She could have dramatically increased her income had she been willing to join the ranks of hookers who work around the edges of the gambling action. However, she seemed to have strong feelings of self-worth, and very real ambitions of moving up in the gaming industry.

Taking advantage of the classes offered to motivated employees, Barbara soon learned how to work the various table games. Her intelligence and personality must have impressed the pit bosses and floor supervisors. Like many aspiring workers, she put a lot of her own time into learning to be a good dealer. In addition to her classes, she often partied with other dealers and their bosses. She loved gambling, and read everything she could find on the subject. Soon she had shed her off-the-shoulder cocktail costume in favor of the black-and-white of a dealer, and was working the usual brief, in-and-out stints at the blackjack tables. She also filled in at roulette and other games.

Many casino workers enjoy going out together in groups to gamble, eat, and see the shows. Many, avoiding the house cut, gamble with friends at home, although most are no more than occasional social gamblers. Some do become problem or pathological gamblers, but many simply tire of gambling and abstain in favor of other recreations. Others may develop alcohol and drug problems. Very few stay in the trade very long if they don't move up.

During my stay, I visited with Barbara several times without interfering with her duties, and each time she was willing to talk about her life. The chance to talk to a sympathetic psychologist was perhaps the determining factor in her decision to have lunch. She knew also, of course, that I would soon be thousands of miles away.

She confessed that she had became over-involved in her first year at Tahoe, and had spent much of her free time playing slots and blackjack. Several times she had to send home for money to pay her bills, telling her family she needed to pay for the classes she was actually getting free from the casino. She knew from the beginning she was not really gambling for the money. That illusion is too difficult to sustain when you work in a casino. Barbara loved the action.

Her roommate also became over-involved in gambling, and Barbara had to move out when the girl turned to freelance prostitution to earn gambling money. In talking with me, Barbara made it clear that she was not a degenerate gambler, the term used in casinos for a pathological or habitual gambler. She said she had quit gambling for the last six months. She couldn't afford it because she was living alone and had higher expenses. In speaking of her own gambling, and of how she had let it go, her eyes seem to focus on some faraway point. For just a moment, the warm smile and engaging personality faded, and I saw in her face a melancholy, sad emptiness, perhaps a hint of depression. Clinical intuition told me that for Barbara gambling still had a very large role to play in her future.

The next morning I drove back down to Reno where I planned to spend one more day soaking up the casino environment. Barbara has been in my thoughts often since our meeting, and as I drove, I reviewed all that she had taught me. Was she a pathological gambler? In my opinion, yes, she was probably in the very early stages of that problem.

Without having gone out into the field to observe gambling as a part of our culture, I might never have seen an early-stage problem gambler. It is somewhat like watching young people drink at a party: potential alcoholics and problem drinkers are not hard to pick out. They arrive early, they drink a lot, they tolerate the alcohol well, they usually show some kind of personality change as they drink, and they are quick to deny that alcohol is in any way a problem for them.

Barbara's abstinence from gambling, while exposed to gambling everyday, was a white-knuckle style of abstinence. She was stuck, unable to move on in life to some better environment, some better career. She had already invested too much of her life in gambling. I doubted that she would be able to move up to a management job without college training. More importantly, she would not move up as long as she loved to play the games more than she loved the business side of gambling.

Down in Reno, while I was wandering through the casinos along Virginia Avenue, I met what might become Barbara's future. Hanging around a nearly empty slot machine room that cold morning, I spent some time talking with an elderly bag lady. Everything she owned was stuffed into three canvas bags tucked away under the nickel slots she was playing. This day she was working four machines at a time: drop the nickel, work the handle, move to the next machine. It was bad luck to pick up the frequent small payoffs unless you needed the money to play. Modern machines simple accumulate electronic credits rather than dispense nickels.

The bag lady's flower-print dress clashed with her dirty green sweater. Her dilapidated shoes were nearly covered by stockings that had worked their way into rumpled heaps around her ankles.

Conversation was definitely unwelcome, but she accepted my offer to bring coffee. When she glanced briefly at me for a quick, “Thanks, mister,” there was the same distant emptiness in her eyes I had seen in Barbara's. It is a trademark of the active pathological gambler. It proclaims that action is the most important thing, the only thing.

It didn't take an interview or clinical assessment to figure out that my nameless bag lady was a late-stage pathological gambler. You can find them by the hundreds in Reno, Las Vegas, or Atlantic City—and it takes no special skill to diagnose them. You can easily spot them in New York City off-track betting parlors, and frequently in the state lottery sales lines, Indian gaming casinos, sports bars where gambling is legal, and at local bingo games. They’re all around us, if we care to look.

Later, when I came to live at Lake Tahoe, I was to see even more of the dark side of a gambling town. All the grocery stores offer a bank of slot and video poker machines at which I would see housewives, clerks, even casino workers still in their uniforms gambling away their change. Sometimes all the grocery money, not just the change, went into the slots. Storeowners showed little concern about how the money was spent—they made a profit either way.

Some years later, I became the technical supervisor of a group of employees on the Addictive Disorders Treatment Program at the Reno VA Hospital. One day an order came down for all supervisors to try to get employees to accept direct bank deposit of their pay since it cost the government almost $2 to write and mail a paycheck. Most of us had direct electronic deposit anyway, but there were a few stubborn holdouts. In every case, I learned that the holdouts cashed their paychecks at their favorite casinos that awarded them a few free drink coupons, or some free pulls at a special slot machine, for doing so. Of course, much of their pay stayed right there in the casino.

In interviewing casino workers, it turned out that they, too, sometimes cashed their checks in casinos. A significant percentage of casino employees' pay, it seems, stays right there in the casino. Without exact figures, suffice it to say this practice must certainly reduce labor costs.

Please do not think that all casino workers are problem gamblers. Most are hard working, productive people in spite of rather dehumanizing work. Many, many compulsive gamblers gravitate to casino towns, some hoping to become professional gamblers and some hoping to support themselves and their compulsion by working in the industry. I think that few in this group become regular employees. Problem gambling among regular casino workers is frequent enough, however, to encourage strong employee assistance programs similar to those for alcohol and drug abuse, which are already in place in most large casinos.

On the plane back to Cleveland, old case histories did not enter my mind. I had come to the understanding that official diagnostic guidelines for any mental illness are a necessary evil, and that they should never be confused with life on the street, where the images are very different.

As yet, behavioral science has uncovered no average or typical gambler personality. We just list the most common symptoms without really understanding how gamblers think, feel, and judge the world. Psychological test results have established no clear differences between gamblers and other kinds of addiction problems, such as alcohol and drugs. Nearly all abusers tend toward impulsiveness and depression. They all tend to be overactive, restless, impatient, manipulative, angry with authority, and self-centered. They usually have conflicts with social norms and standards.

Robert Custer, M.D. listed what he called the soft signs of the compulsive gambler. My clinical impressions agree with his: gamblers—at least the ones who yell loudest for our help—tend to be bright, extroverted, success-oriented, tireless, hard working, extravagant, competitive, and impulsive. These personality characteristics, however, can be found in many other groups, both addicted and non-addicted. So there is no particular pattern of characteristics we could say determines in some absolute way whether or not any individual will become a compulsive gambler.

What is common among people with addictions is the pain and disability they inflict on themselves and others. Pathological gambling is diagnosed not by personality traits, or by how much is lost, or by which of the many different games the gambler plays. The diagnosis hinges on pain and disability. These are measured by the loss of home, family, employment, financial security, friends, confidence, self-respect—by everything most of us hold dear.

Beyond the pain and disability there are some common mental symptoms that science has yet to inventory and measure.

Briefly, pathological gambling is a mental disorder because of an obsessive preoccupation with gambling, and a cycle of mood changes that take the gambler from euphoria to depression and back. These symptoms, constant in every example despite variations in other aspects of the profile, emerged without fail in every case.

Gamblers are unpredictable, lovable, childish, frustrating, charming, risk-loving, and often romantic. We view gamblers as the brightly colored, somewhat mysterious, strutting peacocks of society; we all secretly wish we had their apparent freedom and courage. How boring, by comparison, our own dull lives devoted to regular work hours, children, routine responsibilities, and getting the bills paid on time.

When professional mental health workers first come to work with compulsive gamblers we are often, like gullible young brides, impressed with the drama of their careers. What fascinating and challenging patients! Like egotistical young brides, we say that our devotion and strength will cure these interesting people. We think we can make the misery go away without changing the call or the color of the peacock.

Hundreds of tragic stories and too many years later, the last thing I want to hear is one more yarn about extravagant gambling. These sad and pitiful addicts ultimately turn into unlovable and repulsive failures, having become self-absorbed and isolated in their obsession. Without some deep desire for change from within, improvement is virtually unheard of.

I really prefer to listen to stories about recovery from gambling, stories about the difficulties people encounter in their efforts to outgrow gambling and rise above their self-imposed misery. Like the long-suffering spouse of any compulsive gambler, I have seen both the price one pays for acting like a peacock, and the price for trying to change one. I would always rather be talking about ways in which the gambler can evolve into some higher species.

The gambler wants you to see only his or her good points, the things that attracted you in the first place. Before you can help the gambler see that the emperor is naked, you must learn to see him that way yourself. I try to keep my own attitude toward gamblers fiercely realistic. Any gambling beyond minor recreation is repulsive, stupid, and irrational. Gambling truly is a fool's behavior, no matter how bright or romantic the gambler may seem. Gambling is at best a trivial pastime; at worst, it is a tragic disorder of the mind. My attitudes, sometimes shared by others in the field, come from years of contact with gamblers who want the pain to go away without having to make the necessary and profound personality changes. They have paid and will pay any price to gamble, but they seldom are willing or able to understand that abstinence also has a stiff price.

I neither hate gamblers, nor am easily discouraged by the enormous difficulty we encounter in trying to help them. What I do hate is that people use gambling to alter the ways in which they think, act, and feel. I despise what that does to people, both to gamblers and to those connected to them. And I have come to understand that, although the gambler seldom cares to discuss it, the price of abstinence is normalcy. To abandon the dream world of gambling is a frightening prospect for the gambler, for without these fantasies life seems intolerable.

Normal, ordinary people are what gamblers must become. We are sparrows, not peacocks. Many of us are deeply content with our dull brown feathers and our daily routines. Responsibility gives meaning and strength to our lives, satisfactions unknown to gamblers who remain in action. Impulse control gives us discipline and endurance. We no longer admire peacocks. We are proud to be what we are. We know maturity. This is, above all, what we must be if we are to help problem gamblers, and maturity is really all we have to offer them. That is enough.

Pity the poor peacock that contributes nothing of substance, neither egg nor drumstick. He struts and rends the air with piercing cry, and when he is gone leaves only a bright feather to pin to the wall.

Life must be more than that.

To understand this one must experience and master far more than the official American Psychiatric Association's list of pathological gambling symptoms. For a more descriptive, if less scientific summary, I often return to another group of gambling experts who have been effectively diagnosing and treating the problem since 1957. In fact, I did just that on the flight from Reno back to Cleveland.

I struck up a conversation with a middle-aged lady, and for about an hour we discussed jobs, children, and travel. When she asked about my line of work, I said without hesitation that my work was as a psychologist, my specialty of the moment problem gambling.

“Oh, how interesting,” she said. “My son's getting his Ph.D. at Rochester in psychology. I’ll tell him about you. I think he and his wife will be working with children, however. She's a social worker. So,” she asked in bemusement, “how do you tell a problem gambler from somebody who’s just out for a good time?”

I went fishing in my brief case and found a creased and tattered copy of the Gamblers Anonymous Twenty Questions. There were illegible notes scribbled around the edges, but I offered it to her without comment. She spent quite a long time reading them.

The Gamblers Anonymous Twenty Questions

1.    Did you ever lose time from work or school due to gambling?

2.    Has gambling ever made your home life unhappy?*

3.    Did gambling affect your reputation?

4.    Have you ever felt remorse* after gambling?

5.    Did you ever gamble to get money with which to pay debts or otherwise solve financial difficulties?

6.    Did gambling cause a decrease in your ambition* or efficiency?

7.    After losing did you feel* you must return as soon as possible and win back your losses?

8.    After a win did you have a strong urge* to return and win more?

9.    Did you often gamble until your last dollar was gone?

10.    Did you ever borrow to finance your gambling?

11.    Have you ever sold anything to finance gambling?

12.    Were you reluctant* to use ‘gambling money’ for normal expenditures?

13.    Did gambling make you careless* of the welfare of yourself and family?

14.    Did you ever gamble longer than you had planned? *

15.    Have you ever gambled to escape worry* or trouble?

16.    Have you ever committed, or considered* committing, an illegal act to finance gambling?

17.    Did gambling cause you to have difficulty in sleeping? *

18.    Do arguments, disappointments or frustrations create within you an urge to gamble? *

19.    Did you ever have an urge* to celebrate any good fortune by a few hours of gambling?

20.    Have you ever considered self-destruction as a result of your gambling? *

My traveling companion asked, “What do these asterisks by certain words mean?”

“The asterisks,” I told her, “are there to point out that gambling problems are caused by, and later affect, thinking, feeling, values, attitudes, and beliefs. Although pathological gambling is classified as a mental disorder, I need to keep reminding myself of that in order to be helpful. Otherwise, it’s easy to get caught up in family, legal, and financial problems and forget that a therapist's job is to help people change their minds. Keeping the focus within is difficult when the client is convinced the problems truly lie with other people, places, things, or circumstances.”

“Well now,” she mused, “that's an interesting way of talking about psychotherapy, getting people to change their minds.”

Now on a soapbox, I continued by telling the nice lady, “In my opinion, then, at least 13 of GA's Twenty Questions refer to an altered state of feeling or thinking. For that reason, these Twenty Questions, more than the official medical diagnostic guidelines, outline how thinking and feeling are affected by gambling. The medical guidelines are an attempt to put things into statistical format, which avoids the private and unscientific inner life of the gambler. This is just not useful in therapy. Recovering gamblers know what we mental health people must never forget: Gambling is primarily a mental disorder. It is an illness of thought, an aberration of the mind.”

I finally arrived home and did my best to assure people that yes, in fact, I had had a wonderful time. Never mind that wonderful means something different to each of us. Some of us like taking a ride through a make-believe Castle of Horrors in an amusement park. Some of us collect coins. I collect monsters of the mind.

As my work with pathological gamblers went on, I continued my best efforts to describe the landscape of the gambler's mind as precisely as possible. That I could not always document my findings in statistical tables, graphs, or charts has not discouraged me. I did my best to map the territory. If I can help others go there, too, and return safely, then my maps will have been useful.