The experiences of elderly women suffering from gambling disorder.

The demographic revolution is one of the hallmarks of the 20th century, with a steep rise in life expectancy and the average age of the population. The aging process presents many challenges. On the one hand, it can be a period of growth and personal development, while on the other, it can be a time of survival and mourning for change and loss. Elderly women, who constitute a growing segment of the general population, struggle in their later years with physical, functional and psychological disabilities.

Gambling is seen as a common social activity among elderly people. The gambling industry has succeeded in attracting elderly people in general and elderly women in particular. For some, it has gone beyond entertainment, leading to loss of control and financial disaster, and potentially to a decline into gambling disorder.

The goal of the present study is to understand the perception of identity and the therapeutic experience of elderly women who suffer from gambling disorder, based on their telling of their life stories. The focus is the attempt to answer the questions raised by the study, among them, the unique characteristics of these women, and the place of the gambling experience and of therapy at their age. Despite the broad awareness of the phenomenon, there have been insufficient empirical studies in the field in general, and in Israel in particular. Consequently, because of the dearth of research in this area, the preferred methodology was a qualitative study, based on an analysis of life stories within the narrative paradigm (Spector-Marzel, 2010; Josselson, 1995; Rosenthal, 1993). Narrative that focuses on the subjective experience, and the interpretations of the elderly person herself, can empower elderly women who suffer from gambling disorder, to make their voice heard, assist in the exploration and establishment of their identity and help understand the phenomenon in the broader social context.

The study was carried out through semi-structured, in-depth interviews with 15 women, aged 60 and over, who had been diagnosed with gambling disorder, that were at least 60 years old when they sought treatment, and are being treated or have been treated in the past for gambling addiction at one of the centers of Efshar, a nation-wide association that treats alcohol abuse and gambling addiction.

Emphasis was placed on the method of the purposeful sample, in which the study population is meticulously selected to serve the purpose of gathering the most relevant information for the central questions and the goal of the study. Analysis of the interviews employed two methods: The first, the quadrilateral model (Lieblich, Tuval-Mashiach and Zilber, 2010), allowed for a holistic approach that relates to content and form. In addition, categorical-content analysis was used to identify main themes. The second method was based on the narrative selection mechanism model.  (Spector-Marzel, 2010).    

Analysis of the findings revealed four narratives of female identity, and four themes which constantly reappeared in the different interviews. The first theme, which was common to every one of the interviewees, dealt with the therapy experience. This theme described the difficulties the women experienced, from the preliminary stage of seeking treatment (which most had been forced to do), to the experience in the course of treatment, with its fear of intimacy and exposure, and of ambivalence regarding the process of change and giving up gambling.

The other three themes were as follows: The reason for gambling; intimate relationships and the attitude of elderly women to old age. In contrast to the first theme, the other three themes indicated differences among the interviewees. Based on the differences, four archetypes were identified: (a) The exceptional woman, different from the rest; (b) The woman in the closet; (c) The wasted woman; and (d) The woman on the edge. Each of the archetypes has a narrative with a distinctive central characteristic related to female identity.

The exceptional woman, different from the rest, has a dramatic and romantic narrative, in which the heroine encounters challenges throughout her life, and meets them through skill and strength of character. She has a strongly independent female identity: from an early age, she preferred the unconventional path. She is a woman with special attributes – ambitious, and anxious to be a trailblazer and to belong – yet she perceives herself as normative. Her gambling activity gives her a place to demonstrate her uniqueness, to throw off constraints, and to belong. In her old age, she remains active and feels energetic. The increased desire for belonging is satisfied by her connection with a group of women who imbue her with strength and female power. 

The archetypal woman in the closet describes a tragic-romantic narrative of suffering, the outcome of long years of concealment. At the heart of her female identity are secrets and lies, repression, and masking of her wounds and pain. For her, in the absence of a consolidated self, gambling represents a defense, a facet of her false identity. But old age offers her a place for growth and development, and an increased desire to discard her masks and come to terms with her real self.  

The wasted woman archetype describes a narrative of tragedy that sees suffering as fundamental and unavoidable, leaving no place for development in the future. At the center of her female identity is a lifetime of missed opportunities, and a sense of suffering accompanied by depression, pain and frustration over her wasted life. Through gambling, she seeks to avenge herself on those closest to her, to assert control, and to restore her self-confidence. Old age, for the wasted woman, is sad and meaningless, since she is unable to escape from the cycle of suffering and emptiness.

The final archetype is the woman on the edge. Her narrative, too, is tragic, and speaks of desperation, helplessness and hopelessness. She describes herself as impulsive, and a risk-taker. Her gambling has become extreme, threatening her sanity and even her life. In her old age, she describes herself as an irresponsible girl who has difficulty controlling her urges, and hence finds herself in extreme situations.  

In certain ways, the four archetypes may be seen as moving on a continuum of the three themes that indicate differences among them. With the transition from the first archetype (the exceptional woman, different from the others) to the fourth one (the woman on the edge), the women are increasingly distanced from the social norm, the emotional intensity increases, and with it the level of risk.

The importance of defining the archetypes lies in emphasizing the disparity and individuality of the female identity, creating a challenge and an opportunity for renewal with respect to accepted perceptions. The importance derives from the concept that there is no one truth, and from the need to make space for the exceptional. It is therefore necessary to view the group of elderly women who suffer from gambling disorder as a unique, heterogeneous group, with needs and a voice of their own.  

Findings of the study that relate to the theme of the therapy experience indicate that most of the women experience difficulty with the process. They exhibit resistance and denial, and break down in the early stages, when the addiction is still strong. In so doing, they fail to complete the process of change that is so important and meaningful for women in old age. An important finding of the study showed that the women experienced the therapy as beneficial: It offered them acceptance, recognition of their pain, and the beginning of a process of change that cannot be taken for granted at their age. 

The awareness to the existence of  female identity among elderly women suffering from gambling disorder, of the place that the gambling experience and the therapeutic experience holds for them at this time in their lives, and of each woman’s individual characteristics as related to their turning to therapy, is significant. It can benefit the women in raising their motivation to seek therapy, the supervisory services in consolidating strategies for intervention and therapy, the therapists in enriching their knowledge and offering them the most appropriate professional therapeutic solutions, and research bodies in encouraging further in-depth studies in the field.