It’s 730 pm on a Friday, and a dozen or so men and women are gathered in a pre-determined cafe in the lively central business district of Makati, in the Philippines. They could easily be mistaken for a casual group of friends starting their weekend together. There are a handful that have obviously just gotten off work. Most of them wear trendy sneakers on their feet. But then, they recite the famous prayer: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” You know that this is no ordinary rendezvous. Rather, it’s a meeting of recovering addicts — it’s Gamblers Anonymous.
Their stories are uncomfortable to hear, and sometimes horrifying. A stay in a psychiatric ward is not uncommon for these men and women. Neither is a stint at rehab. The tales are astounding: one has up to $700,000 in debt just from gambling. Another lost over $1,000,000. These are no small sums by far; in a developing country such as the Philippines, these numbers are shocking.
The stories don’t end there: one pawned their parents’ home. Cars disappeared — they would drive to the casino and walk home. Jewelry, gone. Inheritances, wiped away. “The refrigerator just walked out on us,” noted one addict’s mother in a separate meeting.
A broad range of 0.1–5.8% of the world’s population suffers from pathological gambling. While the Philippines certainly isn’t alone, the prevalence of gambling in the country is quite surprising to the outsider. In rural areas, schoolchildren wager on spider fights; cockfighting is one of the nation’s favorite pastimes. A mah jong game is common during family get-togethers. And just like its neighbors in Macau and Singapore, the Philippines has seen a boom in what is known as an integrated resort.
It’s a resort, not a casino
An integrated resort is a pleasure palace for the entire family: here, one can shop, eat, perhaps go to a mini-amusement park, book a corporate meeting, watch a show, stay at a luxury hotel, and of course, place bets in the slots or tables.
While it can serve as a weekend getaway for families, it’s all designed for the ultimate gaming experience. Add-ons such as international shows, state-of-the-art indoor amusement parks and world-class restaurants can certainly attract everyone; in truth, they’re supporting the main income generator: the casinos. About two years ago, the men and women that meet in that café were regulars, even VIPs. They ate at five-star restaurants; they drank the free-flowing Champagne. They placed their bets regularly: dizzying amounts at an even more dizzying pace.
According to an article in The New Yorker, the rationale behind the designs of these sleek destinations were perhaps pioneered by Las Vegas casino magnate Steve Wynn, and his designer, Roger Thomas. Prior to them, casinos were designed with one objective in mind: to keep the player unaware of the passage of time, and to keep him playing. Former gambling addict Bill Friedman has been credited with the traditional design of casinos, with various familiar principles outlined in his textbook, Designing Casinos to Dominate the Competition: “low ceilings beat high ceilings”; “gambling equipment as the décor beats impressive and memorable decorations”, and so on.
That all changed with Wynn and Thomas’s first project, The Mirage. It’s an extremely expansive resort with roughly three thousand rooms, a tropical theme, intricate carvings and an exploding volcano in its exterior. With the Mirage, other themed resorts started popping up: Luxor (with its pyramid shape); Paris Las Vegas (with an Eiffel Tower); Caesar’s Palace (with its Roman theme).
The breakthrough project, however, according to the same article, was the Bellagio — in which Steve Wynn spent over three hundred million dollars for the interiors and an expansive art collection. In this project, they made a psychological bet: that players would more likely “place risky bets in a place where they feel…relaxed” and that casinos “should seduce them with a sense of magnificence.” The bet paid off; and studies did indeed show that players were more likely to spend more in a place with grander designs.
Today, these modern resorts attract millions of tourists each year to gambling meccas such as Las Vegas and Macau. Cities such as Singapore and Manila have seen a rise in arrivals and local tourism, with the building of iconic structures otherwise known as integrated resorts.
Gambling IS as addictive as drugs, because science says so.
In the years prior to updating the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), the American Psychiatric Association (APA) classified gambling (or ludomania) as an impulse-control disorder, a behavior that puts it in the same vein as pyromania or kleptomania. However, further neurological and biological studies of pathological gambling have caused the APA to reclassify it as an addiction — putting it in the same chapter as drug addiction and alcoholism. This allows psychiatrists, psychologists, counselors and other practitioners to recommend more effective treatments for patients.
A chemical known as dopamine is released in the brain’s reward center and is responsible for signaling the rest of our body to further enjoy even the simplest pleasures in life: food, drink, affection, sex, and the like. But when stimulated by narcotics, alcohol, or in the gambler’s case, an appetite for risky ventures, the amount of dopamine released by the brain’s reward system increases up to ten times as much.
The article in Scientific American further reads:
Continuous use of such drugs robs them of their power to induce euphoria. Addictive substances keep the brain so awash in dopamine that it eventually adapts by producing less of the molecule and becoming less responsive to its effects. As a consequence, addicts build up a tolerance to a drug, needing larger and larger amounts to get high. In severe addiction, people also go through withdrawal — they feel physically ill, cannot sleep and shake uncontrollably — if their brain is deprived of a dopamine-stimulating substance for too long. At the same time, neural pathways connecting the reward circuit to the prefrontal cortex weaken. Resting just above and behind the eyes, the prefrontal cortex helps people tame impulses. In other words, the more an addict uses a drug, the harder it becomes to stop… Just as substance addicts require increasingly strong hits to get high, compulsive gamblers pursue ever riskier ventures. Likewise, both drug addicts and problem gamblers endure symptoms of withdrawal when separated from the chemical or thrill they desire. And a few studies suggest that some people are especially vulnerable to both drug addiction and compulsive gambling because their reward circuitry is inherently underactive — which may partially explain why they seek big thrills in the first place.
But how do you know?
The DSM-5 of the APA says that to be diagnosed as a pathological or compulsive gambler, one must display at least five of these symptoms:
• Committing crimes to get money to gamble.
• Feeling restless or irritable when trying to cut back or quit gambling.
• Gambling to escape problems or feelings of sadness or anxiety.
• Gambling larger amounts of money to try to make back past losses.
• Losing a job, relationship, education, or career opportunity due to gambling.
• Lying about the amount of time or money spent gambling.
• Making many unsuccessful attempts to cut back or quit gambling.
• Needing to borrow money due to gambling losses.
• Needing to gamble larger amounts of money in order to feel excitement.
• Spending a lot of time thinking about gambling, such as remembering past experiences or ways to get more money with which to gamble.
About an hour’s drive away from the bustling streets of Manila, four recovering gambling addicts, together with two counselors, live together in a shaky co-existence. The situation is similar to the introduction to a joke: what do you get when you make four addicts live together? However, there is no punchline in the Halfway House on Bliss. The goal is simple: to stop gambling.
They take turns doing chores, from cooking to cleaning. They sometimes work out or swim in the community center nearby. But they also go to 12-step meetings, do journaling, and conduct confrontation sessions known as “leveling”, in which they literally “level” with one another on their behaviors, both good and bad. The Serenity Prayer is recited almost every day.
The program is 90 days long. The “graduation” is a presentation of one’s timeline, which hopes to answer the questions: how did the events of my life lead me to gambling? How did gambling affect the rest of my life? Reagan Praferosa, the program director (and a recovering pathological gambler himself), gives the graduating patient an intense questioning to prepare them for their final day of reckoning: the family meeting. The emotional and psychological toll of being confronted by those one has hurt can be insurmountable; but it’s necessary to recovery.
“It’s an open facility,” Mr Praferosa notes. The house overlooks the city of Manila, and its residents are never on lockdown. For them, it’s certainly a peaceful, albeit temporary, getaway from their once-chaotic lives. It’s an opportunity for them to reboot , to start anew. And once they “graduate” from the program, many often find themselves in the secret circle of recovering addicts, there in that designated cafe, every Friday night at 730.
As with all recovery programs, recovery from gambling addiction is never linear. There are those that relapse; there are those that develop what they call “cross-addictions,” or addictions to other substances. However, there are also a great many that have been “clean” for quite a long time, relying on group therapy, psychiatric visits, exercise, spirituality, or a combination of both. Mr Praferosa says, “It’s really a matter of what the patient needs. The first step, really, is to recognize that they have a gambling problem.”