Common wisdom suggests that addicts who refuse to get help are in denial about the depth of their problem. Or, their self-esteem has been damaged to the point that they don’t believe they are capable of stopping their self-destructive behavior. Or perhaps they have just given up and are using their addiction as a slow form of suicide. But in certain instances there may be another factor involved. Some addicts who refuse to ask for help may be convinced that quitting their bad habits will make their lives worse rather than better. Why give up an addiction, these people ask themselves, if they are going to come out on the other side feeling bored, miserable and deprived? These “victims” of dependency recognize their lack of control and know their lives are not filled with sunshine and rainbows. But they still believe the benefits of their actions outweigh the costs, and this may be enough to remove their incentive to seek treatment and rehabilitation. At first consideration, this type of logic undoubtedly sounds insane. And, from a big picture perspective it is, since these people are clearly underestimating just how much damage addiction will do to their lives if it is allowed to run amok. But many human beings are better at living in the present than they are at projecting a brighter future, and addicts who feel like they are getting something positive out of their bad habits may conclude that quitting is not worth the trouble.
When people repeatedly take risky actions in search of benefits, psychologists say they possess a high degree of reward sensitivity. This means their anticipation of positive reward brings them so much happiness and excitement that it overwhelms any fears of negative consequences, leading them to repeat behavior that seems outrageous or destructive from the perspective of others. In 2013, a team of researchers from two Ontario universities, Carleton and Guelph, teamed up to test the hypothesis that pathological gamblers might be adverse to seeking treatment for their addictions because of high reward sensitivity. They theorized that some problem gamblers might be focusing exclusively on the fun and satisfaction they gained from betting—and at least occasionally winning—while ignoring gambling’s immense downside and its effect on their lives. According to another 2003 study, only about 18 percent of problem gamblers ever even consider seeking treatment to overcome their addictions, and naturally the number who actually do so is much lower (about 10 percent). Problem gamblers often run into significant financial difficulties that would seem to give them a higher-than-average incentive to seek help for their compulsive behavior. And yet statistics indicate that they are actually more reluctant than those who suffer from other types of addiction to ask for professional help. To see if this might be related to elevated levels of reward sensitivity, the Canadian research team recruited 92 self-confessed pathological gamblers to participate in their study—some of whom had been in treatment and some of whom had not. These volunteers were asked to fill out a series of questionnaires designed to measure the connection between their emotional responses and their gambling habits. Their answers would then be analyzed in order to ascertain what motivated some to seek treatment and some to continue their apparently self-destructive behavior, even after it had become clear that this behavior was compulsive and was having a negative impact on their lives. As the researchers anticipated, there was an inverse relationship between high reward sensitivity and the willingness to seek treatment for a pathological gambling condition. In other words, the more focused a gambler was on the possible benefits of her activity, the less likely she was to take steps to overcome her compulsion to gamble. But the details of this connection turned out to be somewhat different than what had been expected. According to past research findings, the two main reasons people gamble are for the excitement that accompanies winning and for the social interaction. Surprisingly, it was the latter factor that proved decisive in the Canadian study. Problem gamblers who were disinclined to seek help were the ones who gained the greatest satisfaction from the social aspects of their activity. Being with and interacting with other people, sharing an activity that all find exciting and enjoyable, was something these problem gamblers believed they’d miss so much that living without it seemed unthinkable. While gamblers may gain great satisfaction from winning, the Canadian researchers could find no evidence to suggest that was enough to prevent anyone from seeking treatment. When contemplating the reasons addicts are so reluctant to ask for help, it is easy to fall back on comfortable clichés about denial or poor self-esteem. But as this 2013 Canadian research project into problem gambling shows, the situation is often more complicated. Addicts must have the resolve to fight and the motivation to do so if they are to overcome their addictions. But if they are conflicted or uncertain about what their post-gambling existence will be like, they may be reluctant to enter rehab in the first place.
An Exciting Life Without Gambling
In the case of pathological gamblers, the opportunity to interact with fellow enthusiasts and to form meaningful social bonds provides a fairly powerful motivation to continue their activity even after it has started to cause havoc in their lives. Nevertheless, these addicts will face a bleak future if they never find a way to overcome their dependency, and those who care about them and can see the path of self-destruction they are on should do everything in their power to help them see the light. Somehow they must be convinced that life without gambling can still be filled with fun, excitement and satisfying social connection—which, of course, it can. Whatever its supposed rewards might be, gambling is hardly the only activity that offers them. The important thing—for loved ones and for addiction specialists as well, once therapy actually begins—is to acknowledge the reasons pathological gamblers do what they do, and to offer understanding and encouragement as they learn to redirect their motivations in a more positive and sustainable direction.