Welcome back to our ongoing interview with Dr. William G. McCown, the author of Best Possible Odds, as well as several other books on psychology, including his latest, Treating Gambling Problems. Dr. McCown is currently the Dean of the University of Louisiana at Monroe and is considered one of the foremost researchers into pathological gambling in the country. Our focus with this interview is problem gambling prevention. Let’s get right back to it.

A: Impulsive, expansive people are often at high risk. So are those who are depressed and have bitter life circumstances. We don't know how many people we can successfully identify. We need really good research to be able to predict who will develop gambling or other addictions. However, even if we had that research and could use that knowledge, we have no assurance that people would respond to the warnings.

FK Comment: This sounds to me like an area that needs more research. Until that research gets here, I intend to keep adding things that help avoid problem gambling to my regular gambling advice. The surprising thing is that the information is intimately related, or in some cases the same information.

Q: The psychological community has known for some years now about cognitive bias & distortion and, thanks to the amazing work of Amos Tversky and Daniel Kahneman in heuristics, we even understand what causes a lot of them. What part does cognitive distortion play in problem gambling, can it be detected, and is there anything to be done about it?

A: These psychologists had Nobel prize winning research. They showed that there are scores of situations where the shortcuts that we naturally use to think, are often illogical and potentially work against us. An example: we tend to emphasize the place where something occurred, not its probability. Think about your gambling winnings and tell me this isn’t so?

Let me give you a personal experiment that might be relevant. Many years ago, I took a small group of scientists into a roadside casino. None of these people had ever played the slots. Prior to their entrance, I let them know that slot machines were entirely random. Then, I gave them enough money to gamble for one hour and told them that at the end of the time they would report on how much they enjoyed the experience. The real purpose of the experiment was to determine whether this highly educated group would see false patterns in these random machines. And yes, that is exactly what happened. About 70% of them, if I remember correctly, believed that certain machines were hot and paid off more than others. These were people that knew the laws of probability and had been instructed about randomness. One person even thought that this was a psychological experiment to find the hot machines. In addition, when I told them the real aim of the experiment, they still would not agree with me that games of chance are simply that-chance. The importance of this is that even scientists educated in advanced statistics tend to make cognitive errors, especially when they're winning.

FK Comment: OK, and these were scientists! I can’t say I’m surprised. All the research says, "Seek and ye shall find, anything but the truth". My own solution to this human deficit has been to try to get people to avoid doing anything involving randomness in-head.

Q: Do you think that a lack of cognitive errors is what differentiates a winning gambler from others?

A: Well, it may. Almost all problem gamblers have some cognitive biases that the rest of us don't have. I've never met a problem gambler who admits to losing in the long run. Well maybe Pittsburgh Phil did, but they are few and far between. People believe that something, whether it's luck, their skills, the Divine, or whatever, will make them special, and enable them to beat the laws of probability. Now everyone knows that in casinos there are a few games that can be beaten. There are also situations where you can beat the slots if you have a very high bankroll. However, success in these areas demands much more effort than even attentive players can put forth. It usually isn’t fun.

FK Comment: One interesting extension of this near 100% correlation between cognitive biases and problem gambling, is that even if one practices total abstinence from gambling, if they quit cold-turkey, without going through behavioral therapy, they almost certainly still have other issues of which they are unaware. Please note: No one ever knows they have cognitive biases, the condition precludes self-awareness.

A: It is a very serious problem. The classic notion is that there are two types of chronic gamblers. One is those who want thrills and action, while the other is made up of people who seek relief from personal problems and bad feelings. Women, by the way, are more likely to be in that last group, but men are catching up. Often, these "relief gamblers" are anxious or depressed. They often start with the penny slots and work their way up to the big time. These people need different treatment than more typical pathological gamblers. The confrontational approach taken by some self-help groups may drive these people to a breakdown or even suicide. Fortunately, groups like Gamblers Anonymous are beginning to be respectful of the fact that the second group of gamblers needs more empathy and understanding.

FK Comment: I’ve had some personal experience with such folk. I wish there was more I could do, but from what you are saying, confrontation could be dangerous. I will take that under advisement.

A: The bottom line for people should be if you like something that is potentially unhealthy, do it in moderation. If you can't moderate your behavior, then you have to quit. This goes for exercising, drinking, eating, and maybe even some jobs. We all know people who exercise to excess. I know a woman who runs 30 miles a day, regardless of the weather. She's addicted and if she doesn't exercise, she gets very agitated and depressed. This is an example that we need moderation in all things. This is just the way we were designed.

FK Comment: Hmm…I wonder if one can take moderation to excess? OK, not a serious question.

Q: We've talked a lot about the negative side of things. What would some positive mental attitudes be that might insulate us from gambling problems?

A: Well, if you have knowledge of the underlying mathematics of gambling and can consistently apply it, you are at very low risk for gambling problems. You may also be at risk for not having very much fun. When I used to go to the track, and I went way too much by the way, I would see people with spreadsheets and calculators, obsessed with their numbers. Usually, their winnings were meager. They never had any enjoyment in the process. They never enjoyed the thrill of winning. For them, gambling was a chore to eek out the most minimal of profits.

I suggest people shake it up a little. Get involved in a variety of games. If you just play the slots, move around as much as possible and try different inexpensive machines. The idea is to break the connection between the place and the idea of winning. If you’ve just hit a memorable jackpot, leave immediately, take a break, and don't go back to a casino for a month if you can help it. If you can't, then maybe you have a problem. If you are doing sports gambling, limit the time you spend watching highlights or listening to news talk shows. Monitor yourself closely about your gambling behavior and ask friends and family for their feedback. Listen to them. Moreover, when in doubt, give up gambling. If the idea is horrific to you, if you feel you can't live without gambling, then you more than likely have a problem.

A: I'm very glad to note that this is an area where we've made some real progress. This year Congress dedicated funding for gambling research. To date, though most of the research was paid for by grassroots organizations and people working closely with the gaming industry. In Canada and Australia, taxes on gambling have been dedicated to gambling research. A couple of states have followed that model. But, like everything, we need more funds to do the type of large-scale research that can show us who develops gambling problems and why.

Regarding advances, we now know the gambling treatment works. There is no question. A major component of successful treatment seems to be the cognitive behavioral aspects. These are changing the pathological gamblers way of thinking, feeling, and relating. Old-style Freudian treatment probably makes people worse.

FK Comment: In summary, major breakthroughs in treatment. Early detection and prevention are still the areas screaming for more work.

A: I can’t give an accurate preview because diagnostic criteria seem to be changing all of the time. As long as DSM-V is based on real evidence, real science, these frequent changes are good. Is there a negative side? We will have to see. However, many insurance companies look for any excuse to avoid funding the treatment of problems. This is in no one’s best interest. Therapy is very expensive, but not as expensive as a few days in the hospital following a suicide attempt.

FK Comment: Keep me posted, and as soon as you hear something, I’ll get it out to my readers.

Q: What should people do if they have a friend or loved one with a gambling problem?

A: My opinion is that you have to confront them, though usually fairly gently. Those big and flashy interventions that they have on TV usually backfire. When confronted, someone’s initial reaction will likely be to think that you're crazy and then they will think that you are picking on them. None of us likes to change. Nobody likes to hear very serious bad news. Therefore, this response is natural.

I want to emphasize that there are a number of great resources on the Internet. They can help open doors to recovery. People can and do get better. Sometimes, but not always, pathological gamblers have to hit a bottom. Let's hope the family and friends can keep that from happening because the results often aren’t pretty.

FK Comment: I’m glad to hear you say, "Hitting bottom isn’t always required" or else there wouldn’t have been much point to this article. I would also like to stress what the Dr. said about irritation being the normal response to new information. If you are reading this article now and it is anything more than just interesting, it could be this natural defense mechanism in play.

A: I look very forward to being on the show and working with you in the future, thanks Frank you are truly one of life's fascinating people! In addition, in case people don’t know, Frank, you have a heart of gold.