Therapy with male pathological gamblers: Between self help group and group therapy—Report of a developmental process

A therapy project was developed for pathological gambling patients and, within a three year period, more than 60 gamblers were studied and treated. Diagnostic evaluation was made according to DSM-III. In addition to individual and family therapy, we designed a voluntary group setting. In this report, we concentrate first on the development of group work, then on some psychodynamic hypotheses about the personality of the gambler. We also try to show the correspondence between these hypotheses and the group process. Pathological gambling is seen as an attempt at self-healing and a strategy of conflict-solving; the slot machine, as an inanimate object, offers a temporary symbiosis with clear limitations; the gambling will come to a guaranteed end, either when all of the money is lost, or when gaming ends at night. Finally, we list some recommendations for the treatment of gamblers in group therapy.This research was supported by the Ärztliche Psychologische Beratungsstelle für Studierende der Universität Göttingen, Chairman: Prof. E. Sperling, M.D.Since one author (J.H.) worked alone in the first period of the project, passages referring to this period are written in the first person singular.This article is an extension of the special issue on Gambling in Europe edited by Iver Hand, M.D.