book review

By S. Hale Humphrey-Jones and Melvin A. Slawik. (2005). Austin, TX: Langmarc Publishing, 120 pp., ISBN: 1-880292-955 (paperback only). Price: $12.95 USD, $15.95 CAN.

Reviewed by Joanna Franklin, Baltimore, Maryland, U.S.A. E-mail: ncpgambling@aol.com

One More Time is a short collection of composite (truncated) vignettes. The authors state that the book is "not a scientific work" but rather "written in a conversational manner." The book's goal is to highlight elements of gambling problems using various scenarios followed by an "Authors' Note" or a few words from the authors "based on our experiences with gamblers over the past eight years."

The book is divided into 12 different stories about individual women and men with gambling problems, plus 5 additional stories about couples with gambling problems. Short sections on "Assessment" and "Treatment" and an "Authors' Overview" complete the book.

The authors' efforts to engage the general public in understanding problem gambling with short, tightly focused discussions of some key elements of problem gambling have succeeded on some levels. Clearly the one- and two-page composite stories make it easy for even those with limited time to read several of the stories.

Unfortunately, in any effort to be concise, something has to be sacrificed, and the authors have chosen to compromise facts, detail, and some accuracy of interpretation to convey their general points about problem gambling. Speaking in absolutes and oversimplifying have left the reader with a great many generalizations that are not helpful to the uninitiated.

Each of the stories says a little about a particular aspect of problem gambling. The first one, called "Susan," is about a machine gambler chasing her losses and neglecting her young son. The story, though short, touches on several aspects of slot machine gambling meant to paint a compelling picture of the progression of this disorder. The authors reach back 21 years to Robert Custer's (1984) description of a three-phase progression of the disorder. The authors could have better served readers with the more current description of the four phases in the progression (Rosenthal, 1992) and by noting that today we believe not all gamblers, especially escape gamblers, necessarily go through the same progression with their gambling. Story number two describes the escape quality of gambling for a corporate wife whose anger toward her disapproving husband helps escalate her gambling. From one story to the next, we visit with middle-aged women looking for support in male-dominated Gamblers Anonymous meetings, such as a widow who loses everything and is bailed out by her adult children. The authors generalize: "…[S]eniors do not have the option of recovering the damage done by gambling." This narrow and less than hopeful message is coupled with a brief description of failed harm reduction and the misery of being old, abandoned, and isolated with only casinos as a source of comfort. I am not sure depressed clients would be helped by this truncated view.

During the whirlwind tour of women problem gamblers we next visit a "caretaker" in a brief scenario. She has cared for others for many years and feels "it's my entitlement" to gamble. In this chapter the authors try to help the reader identify with feelings of overwhelming stress and temptations to gamble coming from all sides. In another troubling generalization they state, "many women believe that they do not deserve to be treated with respect and dignity." Readers should not take this as a reliable assertion about women and gambling, but rather as a statement about some women gamblers with issues around codependency and limit setting. In another short scenario a female gambler commits a felony to fund her gambling habit. The authors' notes focus on shame and guilt for a page and a half, sharing short definitions and advice on bravery and courage. These words of reassurance may offer some support to those who can identify with the oppression of shame and guilt in the short story.

Section 2 contains stories of male problem gamblers. Jack is the stereotypical sports bettor who is used to illustrate the dated original three (as opposed to the more current four) phases in the 1985 description of the progression of the disorder. The statement "[M]ales frequently experience an emotional distance at times referred to as alexithymia" is based on no factual evidence at all and seems to be a misuse of the term (see Taylor and Bagby, 2000). The pluses of the book's ease of reading and engaging short stories is now outweighed by the generalizations and oversimplifications that paint an inaccurate picture of the disorderand the people who suffer with it.

A more serious concern arises with Vince the track bettor. The authors write about antisocial personality disorder (ASPD) and label it narcissistic personality disorder. What at first promises to be a look at both disorders becomes confusing and contradictory, and then appears to be out-and-out wrong. If by "con men" the authors are referring to ASPD, then to suggest that most con men suffer from narcissistic personality disorder seems to indicate all male action gamblers are narcissistic, and this is just not true. Again, the gross simplification of "poor self-esteem leading to anti-social and/or narcissistic personalities" misinforms and confuses.

The brief examples from the Gam-Anon program are well described but painted as possible traps for the unaware and loving Jennifer, wife of Vince. She has missed the "warning signs" of the personality disorder and is trapped in a futile effort to support a husband with an ASPD, all to her own detriment. The case of Danny gives more misinformation. The authors state, "ASPD is found in a high proportion of gamblers." What does a "high proportion" mean? Likewise disturbing is the claim that "the gambler operates from a purely hedonistic level." Stating in a categorical tone that "any skill involved is more delusion than a reality" leaves out the truth about probability and odds. In some games there is indeed a skill factor. The authors move so quickly from their definitions of the negative influences of passive entertainment to Victor Frankl and Man's Search for Meaning that the helpful words on the importance of "connectedness" seem disjointed and a last-minute undervalued addition to the chapter.

The story of Max goes on to clearly illustrate the authors' misunderstanding of the use of harm reduction in gambling treatment. The inaccurate statement, "In most cases the plan [harm reduction] acts to increase insight into the fact that abstinence may be necessary" illustrates the limited understanding the authors have about the nature and intent of harm reduction. They also seem to use Max's death as their own exclamation point to stress their dislike of this approach in gambling treatment.

The section on couples continues to intrigue the reader with interesting stories, but then also to under-inform or misinform the reader. Bailouts are described, and complications from co-occurring disorders leave a picture of frustration and hopelessness.

The assessment chapter again has some facts missing: the South Oaks Gambling Screen (SOGS) has 20 scored questions; the NORC Diagnostic Screen (NODS) has by no means "replaced the SOGS among most treatment provider groups." The Lie–Bet Screen (Johnson et al., 1988) is its own brief instrument as published by its authors. GA's questions and steps are listed but there is no mention of Gam-Anon's. There is a quotation from the GA Combo book, but without quotation marks the paragraph seems to be written by the authors—clearly an oversight by the editor.

Many general concepts are conveyed clearly, and the authors' general support and care for problem gamblers is convincing. However, the authors provide so many errors and introduce so many incomplete or confusing notions that the strength of their "short and sweet" approach has turned their well-intentioned effort into a poorly executed one. The book was not served with a solid editing that would have helped tremendously by giving clearer descriptions of its real messages, and nor was it served by its grammatical and typographical errors. This book will do little to help anyone trying to better understand problem gambling. Pathological gambling is a confusing disorder as it is. This anecdotal volume is too simplistic and too full of questionable conclusions and incomplete analysis. With the intention of creating something simple for the lay reader, the authors have missed the mark by oversimplifying and omitting too many or giving very short shrift to the facts. Unfortunately, it does not make a noteworthy contribution to the literature on compulsive gambling.

Custer, R.L. (1984). Profile of the pathological gambler. Journal of Clinical Psychiatry, 45 (12, 2), 35–38.

Johnson, E.E., Hamer, R., Nora, R.M., Eistenstein, H., & Englehart, C. (1988). The lie/bet questionnaire for screening pathological gamblers. Psychological Reports, 80, 83-88.

Rosenthal, R.J. (1992). Pathological gambling. Psychiatric Annals, 22(2), 70-72.

Taylor, G. J., & Bagby, R. M. (2000). An overview of the alexithymia construct. In R. Bar-On & J. D. A. Parker (Eds.), The Handbook of Emotional Intelligence (pp. 41-67). San Francisco: Jossey-Bass Inc.

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This article was not peer-reviewed.

For correspondence: Joanna Franklin, President, Maryland Council on Problem Gambling; Coordinator of Training, Pennsylvania Council on Compulsive Gambling; Occasional trainer for the Delaware Council on Gambling Problems, 503 Maryland Ave., Baltimore, Maryland, 21228, U.S.A. Phone: 410-375-1421, e-mail: ncpgambling@aol.com

Competing interests: None declared