Compulsive gamblers who want to stop losing and reclaim their lives, jobs and relationships must start by ‘unpacking’ their thinking. Mark Dempster shares his threefold approach with clients, from casinos to money markets.

Many of the gambling addicts whom I treat have been or are working in the financial sectors – bankers, traders, accountants and sales. They come from high-pressure jobs dealing with high-risk decisions every day, with the possibility of large rewards in bonuses. I have sometimes wondered whether such an environment breeds gamblers or whether gamblers are attracted to that kind of profession.

That is a chicken and egg question that should not really concern a therapist like me when working with a client. What makes the gambler is less important than what he or she needs to do to stop gambling and find a new way to live. That is the crux of it: finding a new way to live. The gamblers I work with do not come to me because they have a problem with lottery tickets. Not that a gambling problem of that nature is of any less significance.

The gamblers who knock on my door for help have got somewhere near the infamous rock bottom, if they have not already hit it months before: they have routinely gambled away their salary, remortgaged the family home, gambled the savings and taken on more debt than they could ever hope to win back.

Their illusionary ‘luck’ is down, too. Desperation and gambling are strange bedfellows. As any trader will tell you, desperate people do not make wise decisions when it comes to risk. Hence there is a spiral downwards and gamblers have no idea of how to get out of it. The only option is to find a new way to live.

The approach I take to working with these clients in helping them to establish this new way to live is three fold, as described in the headings on these pages.


By the time clients come to me, they want to be leaving my office having pressed a stop button. Yet the next day they will be faced with the same temptations, the same problems, the same thinking that made them gamble in the first place. So the first thing I do is to establish Bottom Line Behaviours – the ‘no-no’ things and what must be done when they present themselves. It is an action plan which establishes places and situations to avoid, people to avoid, what to do with the bank cards, the bank account, what decisions to defer – and identifying a panic button, somebody to call when it gets tough. This is vital. Establishing accountability with these bottom-line behaviours means they are more likely to be adhered to by the client.


It is strange to think of a therapist as a financial consultant. My accountant would certainly protest at the idea. But, with gambling clients, this is exactly what I am in the first instance. Financial trust and accountability is the key to rebuilding relationships with family and employers. This means establishing what clients owe and to whom. It means looking at what moneys clients have coming in and what they have going out: a base line budget. Lastly, it means communicating, where possible, with all those people to whom money is owed and being completely honest about payback.

There is no point in making commitments that could lead back to the poker table. Immediate transparency for the client will be as painful as pulling a week old plaster off their skin – but it will feel a lot better and freer when its done.


The first two parts to my approach help to challenge the delusional thinking of the gambling addict. It is a start for them to see in black and white the jigsaw puzzle of the mess and chaos caused by the idea that they ‘can’t lose’ or that they just need a bit more ‘skill and luck’. But it does not cure the thinking. I must work with the client to unpack this thinking, look at where it comes from, and provide evidence to counter it. Now we have an action plan on bottom-line behaviours and are making progress on trust and accountability with financial matters, we have the time to work on the thinking.

We need it – because after years of lying and stealing to fund an addiction that canot be blamed on a substance, there is a lot of shame to work through. The idea that ‘I should be able to control this’ needs to be smashed, while using therapy to rebuild self-esteem, repairing self-concept and learning to understand impulse control and triggers from a disease perspective rather than one of human failure.

Professionally, I have had great success using this approach with many clients. This is not to say that every gambling addict is the same; I work to establish my clients’ individual and immediate needs based on their situation. But the treatment plan almost always includes the approach I have outlined. One such client – anonymised in the case history below as ‘David’ – demonstrates this approach in practice.


The client. David was 38 years old when he came to me. He was a senior manager at an international bank.

History. David had been gambling since he was 14. It started with fruit machines in arcades and by the age of twenty-five he had had 16 bookmakers and accounts with 18 casinos.

Consequences. Despite being a high earner, David was losing every penny to gambling. His job was compromised: leaving work to go to the bookmakers five times daily, spending half the working day preoccupied by gambling. He had a fiancé – but sold her engagement ring to fund his addiction when he ran out of cash. He went from thinking about committing crimes to get money to suicidal ideations.

By the time he came to me, David was desperate for help. The following paragraphs show real-life exercises in the threefold approach we adopted.

Bottom Line Behaviours:

Established the triggers – people, places, things, feelings

Created a treatment plan including self help support (Gamblers Anonymous)

A strategy for each potential trigger

Agreement of the bottom line behaviours – what David will not do and how he will not do it.

Financial Trust and Accountability:

Established the size of the problem – how much, who to and where are the gaps in information

Where possible, communicated with family

Made a realistic base line budget and agreed strategies for the management and transparency of finances.

Re-building the Internal:

Examined the impact of gambling addiction on David’s life and those around him

Examined loss of relationship with gambling

Addressed psychological recovery (self-esteem, self-concept), behavioural recovery (behavioural patterns), social recovery (social relationships) and physical recovery (nutrition, sleep, exercise).

The Outcome.

David successfully recovered from his gambling addiction, bar one slip. He is now married, has his own consultancy business and has a substantial deposit saved to buy a house.

My article published on Addiction Today: