The little gambling monkeys in the laboratory

Prof: We are about to investigate this really rare condition x! But as everyone knows, in clinical trials, the rate of subjects returning for follow up is always low. And in this rare condition, we can’t get enough people to do randomized controlled trials! Instead, we have to do it by case studies! How do we make these people come back so we can keep studying them so we can prove our theory and academic credibility?!

Psychologist: Well, people only tend to be interested in something when they perceive that there will be a benefit for themselves. Sometimes, giving some financial bonuses can be a good incentive.

Prof: We don’t have the funds to bribe people! Application for funds is always so competitive! It was very difficult for us to even receive funds for this particular project because the condition is so rare that no one sees it as something of big enough impact on society!!

Psychologist: Well, the other way I can think of is by addiction!

Prof: Oh yeah? Sounds very interesting!!

Psychologist: Let’s take the example of gambling addiction! Gambling requires three elements be present: 1) consideration (consideration includes anything of value, cost, entry fee, and donations), 2) chance and 3) prize. By its very nature, gambling represents an opportunity to win money, and, subject to the potential size of the prize, to change one's lifestyle. The prospect of winning large prizes generates excitement by allowing participants to dream and fantasise about the impact that such a windfall would have on their work, finances, leisure, and capacity to support immediate family members. Smaller wins are also exciting since these provide a gain to the player and enable further gambling in pursuit of larger wins.

Importantly, the form of gambling and the environment in which it takes place are conducive to social interaction and this adds substantially to its inherent enjoyment. Hotel, club, casino and on-course venues are recreational locations that offer a range of entertainment options (food, beverage and shows). Within these contexts, gamblers can readily meet, interact socially, and test their luck and skill in pleasant and safe surroundings, leading to enhanced social integration and stimulation, self-esteem and a positive sense of recreation/leisure. Gambling is also a means of overcoming boredom.

The capacity for gambling to narrow one's focus of attention (Anderson & Brown, 1984) and produce dissociative states (Jacobs, 1986) may account for the reason why many individuals use gambling as a maladaptive coping strategy to deal with problems, emotional distress and stress/tension.

https://www.psychology.org.au/publications/inpsych/2010/december/gambling/

How do addictions work? In the brain, pleasure has a distinct signature: the release of the neurotransmitter dopamine. The reward circuit in the brain includes areas involved with motivation and memory as well as with pleasure. Addictive substances and behaviours stimulate the same circuit—and then overload it.

Repeated exposure to an addictive substance or behaviour causes the area of the brain involved in planning and executing tasks to communicate in a way that couples liking something with wanting it, in turn driving us to go after it. That is, this process motivates us to take action to seek out the source of pleasure. Over time, the brain adapts in a way that actually makes the sought-after substance or activity less pleasurable. At this point, compulsion takes over. The pleasure associated with an addictive drug or behaviour subsides—and yet the memory of the desired effect and the need to recreate it (the wanting) persists.

http://www.helpguide.org/harvard/how-addiction-hijacks-the-brain.htm

Prof: That’s a lot of ramblings! How is this relevant to this research project?!

Psychologist: Well, well, well, here is where things get fun! Gambling represents an opportunity to win prize, to change one’s lifestyle, right? Now, this rare disfiguring condition affects males in their 20s-30s… and as a result of their disfigurements, they look like ugly monkeys and these males tend to be very socially isolated. What do men of this age need then?

Prof: …. interpersonal affection!!

Psychologist: Yes, what a Prof!! How distressing is it, that they see other young men of similar age going out with hot chicks and getting married? So let some of our nice little empathetic ladies in the research team be that incentive!! If these men perceive that they can have a chance with these ladies, it will act as an addictive enticement!

Prof: What the heck? Giving away our ladies? You gotta be kidding!! That’s illegal!!

Psychologist: Nononono, of course we’re not going to give these ladies away. We’d make the study subjects meet us in a very inconvenient location so that they had to make quite a bit of sacrifice to get to. But this is going to be a happy dopey place, inducing the release of lots of dopamine in their brains which facilitates the addictive process, where the study subjects can happily meet with each other as well as our warm attractive ladies! Then these men can test their luck and skill in pleasant and safe surroundings, leading to enhanced self-esteem and a positive sense of recreation!

Prof: Oh yeah? Sounds interesting!

Psychologist: But remember, “test your luck” means the ladies should give these men a feeling like they’ve got a chance, but when these men actually try asking our ladies for a date, the ladies can reject them, but go on to give them their contact details, so that they still see a tiny glimmer of hope! And occasionally text them from time to time to remind these men the existence of both the project and the ladies!

Prof: Now I am getting the picture…! Sending them crashing down like when the gambler loses big money!! And with that tiny glimmer of hope, they just keep coming back like silly little monkeys!!

Psychologist: Oh yes, what a smart Prof you are!! Silly little monkeys indeed!!!!

Prof: And what a great psychologist you are! I would never think up of this without your help!! Hahahahahaha!!!

Notes from the book “Turning points: An Extraordinary Journey into the suicidal mind”

Suicidal behavior:

With very few exceptions, suicide is present in every culture. There are those who perceive their existence as so frustrating, unrewarding and meaningless that they are induced to “fall by their own hand”. In most cases their reasoning is flawed, the product of an emotionally troubled mind. If we want to avoid the irreparable, we need to interfere with this process as soon as possible. Very frequently, the subject themselves perform this operation; sometimes their proxies (a partner or friends) intervene; on other occasions general practitioners or counselors do so. Crisis intervention is a key concept in suicide prevention: it assumes that acute suicidality lasts for a maximum of several hours, or a few days. Once the crisis is overcome, subjects may regain control of their lives. Unfortunately, sometimes nobody intervenes, despite the fact that most suicidal people communicate, more or less directly, their intention to die. In approximately half of all suicides, the victims have consulted their GP in the months prior to death.[1]

Hypothetically, if we were able to stop the suffering, whatever its origin, very few people would ever contemplate suicide. Death is just the medium to avoid the continuation of the unbearable. Present-day society considers the choice of dying to be acceptable in only very few situations. For example, it can be acceptable to sacrifice one’s own life to save the life of others, or to die for one’s own country.[2]

The more suicidal behavior is adopted as a problem-solving strategy in crisis situations, the more this ‘solution’ is imitated. For example, if a mother attempts suicide in a moment of personal difficulties, the probably of a child following her example is very high, far bigger than in a family without such an experience.[3]

The suicide attempters:

Trevor, one of the suicide attempters described by De Leo, seemed to lack premeditation or preparation for the fatal moment. He was heading to a disco and going home just for a quick change of clothes, and then suddenly decided to pull the gun on himself. This is the way many suicides do actually happen. Most probably the idea of suicide was in Trevor’s mind for quite some time, ready for enacting in a particular moment of despair. De Leo learn from those who survived their suicide attempt that such ideation can become operational in the space of a few minutes, even seconds. The ambivalence that Trevor describes during his suicide attempt is typical of most suicidal acts: he prepares to die but would like to be rescued by his friends.[4]

We also see inspiring stories of women who were sexually abused by multiple close perpetrators, who actually became counsellors and great healers to others after they overcame their crisis.[5]

Sergio, one of the suicide attempters described by De Leo, described the following feeling as he was preparing to jump off his tallest silo, “Life has nothing to say and nothing to give to me anymore. I had no curiosity for anything, anymore. All I had was emptiness, darkness, and total disconnection.”[6] Then something incredible happened when he jumped off, “I immediately thought that I did not want to die… And then it came to my mind, all the energy and effort that I put into that property during my entire life… That property was everything to me and, honestly, was not bad at all. Maybe I could be useful again. In that precise moment I wanted live, with all of my being. But to die, I began my fall face down. Now I had to try to redirect my body. If I succeeded, I thought that, maybe by landing on my feet, I could eventually survive.”[7]

Compared to women, men lack the capacity to cope with a lonely life, a life where they are often separated from their children and living in financial constraints. Australian statistics provide chilling evidence that separation from an intimate is the most frequent life event in the year preceding suicide. Men are not protected by the network of social relationships that characterizes the female world. Men are mostly alone; and even if they have a few good mates, they talk very little with them, and certainly not about those things that are torturing their hearts. Thus, their instinct is to ‘isolate’: they don’t like to show vulnerabilities or defeats. Research shows that men often think that their peers would not understand their private suffering; and that, if confessed, this could make them seem weak – a ‘loser’. They already feel ashamed and their self-esteem has taken a battering.[8]

In many of the cases described, the suicide attempt actually gave a dramatic shift in thinking and they are happy to be alive[9].

Maria, one of the suicide attempters, does not know if she really wanted to die; probably not. What she knows for sure is that she wanted to stop suffering, to escape from an unbearable situation, where her anxiety was ‘like a devil that bites you inside, that squeezes your lungs’. This is a term coined by famous American psychologist, Edwin Shneidman, as “egression”, the desire to get rid of suffocating feelings and ‘psychic pain’. Shneidman explained that in many cases suicidal subjects do not want to die but rather to stop their psychological pain.[10]

Those left behind:

Life of those left behind will never be the same. Their narratives are characterized by disbelief, resentment, insomnia, irritability, anxiety, depression, anger and feelings of guilt. Equally painful is the stigmatization by other people: when a suicide occurs the entire family is assumed to be ‘contaminated’ and can spread dangerous suicide-inducing germs. Diane, a survivor left behind by her mother, describes a life lacking a ‘limb’, and she demonstrates an amputee’s adaptation, as she says, like someone who has been deprived of an important part of him/herself. She can still achieve, but her life requires extra effort, extra resilience. Her legacy is that ‘the sorrow remains and will always remain’, together with ‘a profound sense of misfortune and sterility’.[11] Francesca, a mother left behind by her son, describes that “When you deeply love someone, a piece of you is inside that person. And if this person goes away, that piece is lost forever. It is not with you anymore. You don’t own it anymore”.[12]

De Leo, Diego. Turning points: an extraordinary journey into the suicidal mind, Queensland: Australian Academic Press, 2010.

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[1] Diego De Leo, Turning points: an extraordinary journey into the suicidal mind, (Queensland: Australian Academic Press, 2010), 10.

[2] De Leo, Turning points, 12.

[3] De Leo, Turning points, 14.

[4] De Leo, Turning points, 60.

[5] De Leo, Turning points, 47,70.

[6] De Leo, Turning points, 89.

[7] De Leo, Turning points, 94-95.

[8] De Leo, Turning points, 106.

[9] De Leo, Turning points, 88, 97, 116.

[10] De Leo, Turning points, 149.

[11] De Leo, Turning points, 157.

[12] De Leo, Turning points, 173.