We tend to look at the reward system of the brain across multiple conditions and addictions and try to figure out whether someone who has an alcohol problem or an eating problem from the brain’s perspective or thinking self-control that actually looks very similar to gambling in casino. Or some people with gambling might look very similar to people with obsessive-compulsive disorder and if we can figure those things out, those similarities and differences, then we can regroup people and then stratify specific treatments to that particular problem. Some people think that they are insensitive to punishment, so losses don’t really register to the reward system. They are insensitive to punishment.
Other people think there is a problem of probabilities and estimation of how likely they are to win based on randomness and probabilities. There’s those kinds of things going on and it seems like also in the rewards system that maybe that there is a little bit of a lower set threshold of a chemical called dopamine potentially where, the more dopamine there is, the more kind of pleasurable feelings we tend to get, and if those levels are low, people gamble to kind of normalise it. On the other hand, there are the properties of the machine. So the machine is designed in a very specific way to maximise habit and addiction and they are reinforcing even when you lose, it looks like a win. To the brain something that even though you lost, if you receive something that looks like a win, it gets reinforced and some of us are more likely to be seduced by that than others.
When counsellors say a lot of things about their experiences of when they interview clients and what’s going on, we can pretty much straightaway say, ‘well that’s really interesting because we think this is how that works’. And then they get excited because now there’s a kind of a biological explanation for something they always knew was happening and so they feel like they are more informed about what’s actually going on. It gives them confidence to work with that concept a bit more.
On the other hand, the more we learn, the more we think that you know people with gambling problems are not the same. We really want to come up with new ways of treating problems that are redefined from a neuroscience perspective. So for some people, we know that they are very much reward seeking. For other people they are punishment insensitive.
We know that, but we can test that from the brain perspective. Sometimes people don’t know, people might not actually have the insight to say, this is why I am doing it but the brain might be able to tell us what they are really responding to in a gambling environment and then we can work specifically with those elements.