Int J Ment Health Addiction DOI 10.1007/s11469-012-9403-4 Linking Gambling and Trauma: A Phenomenological Hermeneutic Case Study Using Almaas’ Transformation of Narcissism Approach Gary Nixon & Jason Solowoniuk & Lauren Julia Boni & Ruth Grant Kalischuk # Springer Science+Business Media New York 2012 Abstract The purpose of this article is to examine the phenomenon of pathological gambling and addiction from the perspective of writer and teacher A.H Almaas. By drawing on his Diamond Mind approach we trace the origin of addictive behaviors and pathological gambling to narcissistic wounding, which constitutes the loss of connection with the Essential Identity. A phenomenological hermeneutic methodology was applied in the research process in which Penny, the subject of this case study, willingly shared her life journey through addiction. A thematic analysis clustered into 5 themes revealed a link between her experiences of childhood trauma, addiction, pathological gambling, and the manifestation of fundamental narcissism. Keywords Childhood trauma . Being . Narcissistic wound . Great betrayal . Pathological gambling . Empty shell . A.H Almaas Trauma and the Female Problem Gambler There is a paucity of research that addresses the connection between trauma and female pathological gambling with issues of trauma being raised but the explicit connection not being illuminated (Boughton and Brewster 2002). For example, in a study of 22 families, Grant Kalischuk and Cardwell (2004) developed a grounded theory that situated trauma as a factor in problem gambling for both males and females. Similarly, in a sample of 111 pathological gamblers, (Kausch et al. 2006) identified a relationship between gambling and trauma, however the role that trauma played in the development of pathological gambling was not determined. Meanwhile, (Atifi et al. 2010) found that “dating violence, marital violence and severe child abuse victimization were associated with increased odds of gambling problems” (Atifi et al. 2010). Petry and Steinberg (2005) studied childhood maltreatment in male and female treatmentseeking pathological gamblers, recruiting participants from seven treatment sites (N0149; G. Nixon (*) : J. Solowoniuk : L. J. Boni : R. Grant Kalischuk Faculty of Health Sciences, University of Lethbridge, Lethbridge, Alberta, Canada e-mail: [email protected] Int J Ment Health Addiction 77 females and 72 males). Measurements included assessing gambling behavior, childhood trauma, and psychiatric symptoms. The authors found that gender was specific to the intensity and types of childhood maltreatment experienced (Petry and Steinberg 2005). For instance, female gamblers had higher scores related to sexual/emotional abuse and physical neglect. In addition, childhood maltreatment was associated with age of onset and severity of gambling problems. According to Strachan and Custer (1989) and Lesieur and Rosenthal (1991), gambling has been categorized as a means for dealing with trauma and trauma-related abuse (via escape), especially among females. Interestingly, among 365 females gamblers from across the province in Ontario, Boughton and Brewster (2002) found that 46 % of women reported experiencing physical abuse as adults and 28 % reported experiencing sexual abuse as an adult, while another 30 % of married participants reported current physical abuse in their relationships. Despite determining that gambling was a means for the individual to escape from life stressors, the mechanism by which trauma played a role in the development of problem gambling continues to remain under-investigated (Boughton and Brewster 2002). An obvious gap exists in the current literature with respect to the role that trauma may play in the initiation, development, and progression of pathological gambling among women (Petry and Steinberg 2005). Some illumination into the exact role trauma plays however may be gained by also exploring the writings and concepts of A.H. Almaas in relation to experiences of narcissistic wounding and disconnection from essential being occurring through trauma (Almaas 2001). Thus, this article will examine the association between trauma, gambling, and narcissism via an in-depth case exploration supported by Almaas’s transformation of narcissism theory. Woundedness and the Development of Narcissism Almaas (2001) argued that, as human beings, we have a natural desire to be to truly, authentically ourselves. Although this drive may be conscious or unconscious, we value the experience of being able to express ourselves spontaneously and authentically. However, in Almaas’s (2001) view, the moment we lose this sense of being centered in who and what we are, we become anxious and egotistically preoccupied with ourselves. Under these conditions, we then crave an inordinate amount of approval and failing to receive such recognition we become prone to intense feelings of unworthiness (Almaas 2001). On the one hand, the desire to be authentically “oneself” has been described as a state of self-realization which “is a manifestation of a certain human development, a development tantamount to the full maturation of humanness which a human being may attain or arrive at” (p. 5). On the other hand, the failure to be recognized as “oneself” or the failure to know oneself intimately leads one to become narcissistically disturbed perpetually leaving the individual in a state of arrested development (Almaas 2001). Almaas’s (2001) work focuses on the phenomenon of narcissism—specifically, its development and resolution. Narcissism, according to Almaas, originates in early childhood and is a common factor in the psychological make-up of most human beings. It develops through the feeling of alienation that occurs as one begins to lose sight of one’s essential identity and identifies with relatively superficial aspects of the self. Almaas (2001) attributed this primarily to involve two capabilities of the self: The first is the capacity of the mind to form concepts and structures of concepts in response to experience. The second, is the capacity of the self to identify with different Int J Ment Health Addiction aspects of experience, particularly with images in the mind and with habitual emotional and physical states. (p. 15) Almaas (2001) stated that the root of narcissism is the soul’s estrangement from its true nature; hence an understanding of narcissism is necessary in order to resolve this issue of estrangement. Borrowing from Object Relations theory, ego structures are said to be based upon identification with impressions from the past. Almaas (2001) observed that the experience of ego can never be entirely free of narcissism: The conventional dimension of experience, which is deeply patterned by these structures (whether healthy or pathological), includes an intrinsic narcissism. Everyone knows that he has some measure of selfishness, self-reference, a need to be seen and appreciated, a deep wish for esteem and admiration from others, and some distortion in his self-concepts. (p.26) Almaas (2001) referred to this condition of everyday life as fundamental narcissism. In working toward self-realization, this fundamental narcissism, which stands in the way of realizing essential presence, becomes increasingly exposed and may intensify for a time as it is confronted. In understanding fundamental narcissism, Almaas (2001) stressed that certain environmental factors are at play as a child matures. For instance, as a child grows, he or she may not be seen or related to, may be misunderstood and alienated, the loving quality of relating might be missing, there may be a lack of or inadequacy of support, inappropriate demands may be made, or there might be a lack of parental or primary caregiver attunement. So, there can be a spectrum of abusive circumstances. As a result of these circumstances, characteristics which are common to all forms of narcissism develop and progress throughout early development, proportionate to the individual’s overall history. Consequently, in more favorable circumstances, narcissism may take the form of fundamental or everyday narcissism, while under less optimal conditions more severe forms may manifest, ranging from a narcissistic personality disorder to borderline, to paranoid/schizoid states. The Transformation of Narcissism Almaas’s (2001) described a method of inquiry that leads the individual to realize, through direct experience, that one’s identity is not a permanent independent self. Almaas further explained that the process leading to the realization of the essential being, naturally applies increasing pressure on the conventional self-identity, the central narcissistic structure. Furthermore, he also observed a general sequence of experiences of realization through which the individual progresses. Each of these movements involves an increasing awareness into the false structure of the narcissistic self and subsequent natural arising of presence free of memory or image. Almaas (2001) broke this process into 18 distinct steps, but for purposes of this paper, the first five steps will be summarized with the remaining steps only briefly expounded upon. Working through self-images (our identity) reveals to awareness that our held notions of who we claim to be is merely a “psychic structure patterned by images from past experience” (Almaas 2001, p. 303). Here, the person realizes the first two steps of the Almaas process, firstly, he or she has been a “fake”—a phony having sold out in an effort to win the approval of others—and, secondly, is the discovery that the self is an “empty shell.” Almaas (2001) explained that the awareness of the empty shell is “the direct awareness of the structure of self-identity when it is not being defended against” (p. 306). As the process of working Int J Ment Health Addiction through issues of narcissism unfolds, a third phenomenon, which Almaas (2001) calls the narcissistic wound is revealed. The dissolution of narcissistic structures increases the individual’s awareness of vulnerability, bringing about a greater reliance on what Almaas (2001) has termed mirror transference (influence and projections from the external world) in an attempt to maintain the familiar sense of self. This exposes and threatens the integrity of the shell resulting variety of intrapsyhic responses, including heightened anxiety, an inexplicable feeling of dread, and a preoccupation with irrational fantasies of ill health or injury. It is here, we see Almaas’s fourth major phenomenon narcissistic rage. The individual may literally lash out in rage and hatred, all in a desperate attempt to resurrect the rapidly disappearing narcissistic self. According to Almaas (2001), an individual literally feels wounded, both emotionally and physically, as though there were an actual physical cut or gash in the heart. The sensation of this physical pain is inseparable from that of the emotional distress, culminating in a single profound emotional rip. This gash, Almaas explained, is a cut in the shell, the structure of self-identity, as it begins to disintegrate. In the normal experience of identity, experiences of narcissistic injury are defended against, however in the process of exposing the structures of self-identity these defenses are not available, permitting a “tear in the being of the self” (Almaas 2001, p. 312). If we continue to surrender and not resist, the tear will expand until the shell dissolves, shattering our usual sense of identity, and affording a glimpse into the vast fundamental presence of our essential identity. Here we are led to Almaas’s fifth process the Great Betrayal (Almaas 2001). Initially, as this betrayal comes into our consciousness, we construe it as a betrayal by the idealized or mirroring other—either in the present by our spouse, children or friends, or in the past, by our parents, and teachers, and we may respond with indignity, anger and rage at having been treated unfairly and abandoned. Given a glimpse into our essential identity, however, we humbly recognize that we turned away from ourselves. In doing so, we began to act and eventually created a self-based on how we believed others wanted us to be and or we walled ourselves off hiding our presence away from the light because our environment and those inside it were toxic and injurious. The recognition of the Great Betrayal sets up the fall into the Black Chasm of Being in which the person learns to embrace life from a place of essence (Almaas 2001). This serves as the transition point into embracing Being, and potential selfrealization. The journey beyond this milestone calls for a discussion beyond the scope of this study. For our purposes, it is significant to learn how Almaas’s (2001) insights into the development and transformation of narcissism (leading up to Great Betrayal) provide a theoretical link between childhood trauma, narcissistic coping, and the development of pathological gambling. We will now turn to look at our phenomenological-hermeneutics approach to research. A Phenomenological-Hermeneutics Case Study Approach For phenomenology’s founder, Husserl (1973), phenomenology was a method of research that returned to the lived world, the world of experiences, which he saw as the starting point of all science (Jardine 1990). Phenomenology asks, “What is this or that kind of experience like?” Phenomenology can further be described as the explication of phenomena as they present themselves to consciousness, as consciousness is the only access human beings have to the world (Van Manen 1990). Phenomenology is not focused on finding the causal relations of phenomenon, instead, phenomenology attempts to describe phenomenon. Int J Ment Health Addiction Phenomenology is a way to explore our human nature to become more aware of who we are (Van Manen 1990). The core of phenomenology is the intentionality of consciousness, in seeing that consciousness always has an object (Osborne 1990). Husserl believed the phenomenological researcher’s task was to analyze the intentional experiences of consciousness in order to perceive how a phenomenon was given meaning and to arrive at its essence. In Husserl’s eye’s, phenomenological research was focused on finding the pure description of lived experience (Van Manen 1990). Husserl referred to phenomenological reduction as the fundamental resource that allowed for a pure description of a phenomenon. Here, the researcher attempts to articulate predispositions and biases thorough a process called bracketing (Osborne 1990). As a result, the object of phenomenological description is fully achieved through a direct grasping (intuiting) of the essential structure of phenomena as they appear in consciousness (Van Manen 1990). The phenomenological aspect of this approach focuses on the lived experience of the case study participant’s experience of trauma, and the resulting narcissistic response including the development of a gambling addiction. As stated above, a key component of the phenomenological approach is intentionality, and here the intentional object will be the experience of trauma and the subsequent development of pathological gambling behavior (Osborne 1990; van Manen 1990). Hermeneutics The research approach used in this study acknowledges the hermeneutical refinement of phenomenology. Heidegger (1962, 1982) is accredited with developing a form of hermeneutics to clarify under what conditions understanding occurs. Whereas Husserl advocated for ‘bracketing’, which is the suspension of all biases and beliefs regarding the phenomenon being researched prior to collecting data about it, Heidegger suggested that presuppositions are not to be eliminated or suspended as he rejected the possibility of and necessity for a transcendental standpoint that grounds knowledge and experience (Palmer 1969). We are already each one of us a “being-in-the-world” (Heidegger 1962). The hermeneutical phenomenology perspective recognizes that all understanding, phenomenological and natural science, is interpretive (Madison 1990). Hermeneutics does not mean interpretation in terms of correctness and agreement; instead hermeneutics carries its deeper traditional overtones of bringing out a hidden meaning, of bringing out what is unknown into the light of day (Palmer 1969). Interpretation is not a matter of sticking a value on a naked object, for what is encountered arises as already seen in a particular relationship (Palmer 1969). In support of Heidegger this research refutes Husserl’s claim of presuppositionless interpretation, as Heidegger believed that interpretation was never the “presuppositionless grasping of something given in advance” (Palmer 1969, p. 136). Further to this notion of interpretation, Ricoeur (1970, 1981) pointed out that interpreting text is not to realize or understand the intentions of the narrator, but to understand the meaning of the text itself. When following text beyond the situation and the intentions of the author, the text discloses possible modes of being in the world that can be appropriated. Utilizing this approach, we can come to new understandings as we understand the text in a way that dramatically changes our perspectives. Understanding a new perspective is impossible unless we are able and willing to abandon our positions and risk our assumptions (Madison 1990). In doing this Int J Ment Health Addiction research, we were surprised by how the following case study seemed to mirror Almaas’s transformation of narcissism, calling for an interpretation of the case using his theory. Case Study Method The use of the case study method is recognized as a valid research approach when a thorough, in-depth study of a phenomenon is of interest (Patton 1990). This is particularly fitting when the experience of that phenomenon has not been rigorously researched (Polit and Tatano Beck 2008) as is the case with the interplay of trauma and the development of female problematic gambling behavior. It is also seen that one person’s experience may be so fertile and rich with meaning that it stands alone as a powerful, unique expression of the phenomenon under study. This unique expression can pave the way toward illuminating unrecognized aspects of the larger phenomenon. Thus, reliance upon a single case is highly appropriate when the individual under study represents a “revelatory” case (Yin 2003) and when that case can maximize what can be learned about the phenomenon (Stake 1995). It is believed that we have such an illuminating case, that we will now turn to discuss the experiences of study participant. Penny: The Case Study Penny is the central figure in this study. She is a very dynamic, animated and charming 58year-old woman who has lived most of her life in central and southern Alberta. Penny grew up in a very abusive household, and suffered immensely from neglect and trauma as a child. She witnessed alcoholism and addiction in family members who were close to her. Incest and sexual molestation were also present in her early environment and were acted out on her by older male caregivers and contemporaries. The bulk of Penny’s adolescent and adulthood years were spent preoccupied with a variety of addictions from alcoholism, sex addiction, work alcoholism, and finally to pathological gambling. Penny described her gambling addiction as the most “cunning and powerful disease”. Narcissistic Wounding and Loss of Basic Trust In the first theme we examine Penny’s key childhood experiences that contributed to her narcissistic wounding and loss of basic trust. This theme captures her ego development from infancy to adolescence in years 0-12. (Almas 2004) identified narcissistic wounding as the disruption of normal ego development during childhood. He explicitly identified eight factors that disrupt normal ego development. Three of the eight factors identified by Almaas are prominent in Penny’s lifeworld and will be discussed at this time. They are: (1) inadequacy of early holding environment (2) caretaker’s narcissistic blindness, and (3) trauma and abuse (Almas 2004). Inadequacy of the early holding environment denotes a “lack of a supportive and nourishing human environment” (Almas 2004, p.157). When there is a lack of responsiveness, love, and care from primary caregivers, there is inadequacy of psychological nourishment to the child. A healthy holding environment is crucial as the child cannot yet “depend on its own resources to feel supported and upheld in regard to his [or her] sense of being himself [or herself]” (2004, p. 195). The child requires a secure environment in which there is an “external solid presence of confidence, Int J Ment Health Addiction certainty, strength and reliability” (2004 p. 195). Penny did not have a secure early holding environment and often felt vulnerable or under threat. She recalled: I can remember the screaming and yelling…I know that my dad drank a lot, partied a lot, chased women and my mother drank back then, too… there was a lot of…how can I say…I think I was afraid of my dad… and there was a lot of tension…. I know there was…between my mom and dad. And I would look at my father and I wanted to impress him and I always thought my sister was more pretty than me and he loved her more than me. I was jealous at a very young age. And he was like a stranger from afar to me somehow. I wanted his approval so bad and I was kind of scared of him, too. Penny’s early environment was unstable and fraught with volatility. Penny described her insecure attachment to her father as a tension between desperately wanting his attention and feeling unsafe in his presence. Her narrative revealed her longing to win her father’s approval and to receive her father’s love and attention freely and without condition. In addition to her difficult relationship with her father, Penny described herself in childhood as “a loner”. She was unable to “connect” with her brother and found herself “estranged” from her sister. She remarked: “I just remember feeling very alone.” Almaas (2001) provides a description on the effect of the inadequacy in one’s holding environment that mirrored Penny’s experience. He wrote, “when our environment betrayed us and abandoned us, with varying degrees of insensitivity, we felt alone and abandoned with no one relating to us” (p. 319). It came to be, that Penny’s young identity was constructed through the experiences and interactions she had with her parents and family members. She internalized the “good” and “bad” images of her object relationships and these images became part of her own self-representation. A second barrier to Penny’s healthy ego development was her caretaker’s narcissistic blindness. Caretaker’s narcissistic blindness refers to the caretaker’s inability to see the child’s essential identity, their presence, or more accurately, see the actuality of the child as Beingness. Almaas (2001) described Being as the whole self, or the soul. For Almaas (2001) the loss of soul is equivalent to the loss of an authentic self and the loss of wholeness. Almaas (2001) used the term soul to mean “the dynamic, alive presence of the self as distinguished from the structures of the self which pattern this presence” (p. 14). Almaas’s (2001) perspective was that when the soul is identified with anything other than essential presence, it is bound to acquire narcissistic traits. In contrast to the narcissistic traits developed in adulthood, Almaas (2001) described infants as having primary self-realization, which is “undivided, uncompartmentalized and whole” (p. 38). Primary self-realization is the optimal unconscious state of Being. The state of unconscious self-realization is an undifferentiated matrix in which the child is more in touch with the ground of Being. Since the child’s ego is at the beginning stages of its development, and because it has not completely solidified, the child is not conscious of its own self-realization. With the development of the psychological ego the child might begin an unconscious movement away from Being, depending on what the guardian recognizes and reinforces in the child. If the child’s essential identity is not acknowledged, the child might begin to disassociate from essence, at which point it will adopt or develop superficial self-representations that are mirrored by its parents, constituting its narcissistic wounding. To this point, Almaas (2001) wrote that when a part of the soul is not “recognized, acknowledged, related to, and valued, when it is not positively seen, it will not develop” (p. 281). Int J Ment Health Addiction In Penny’s case, her caretakers did not acknowledge her essential identity; it was not modeled or mirrored to her. This lack of mirroring constituted her parent’s narcissistic blindness, which was their inability to recognize Penny’s essence. Almaas (2001) wrote: The manifestations of the soul that are inadequately mirrored remain in the dark recesses of unactualized potential. The child tends not to experience them as part of her self, or not value them. She might even view them as a threat to her connection to her parents. (p. 285) Thus Penny sacrificed the wholeness of her Being in order to remain aligned with her parents. Penny lamented: “I saw a cute little rat in the woodpile and he [Penny’s father] and my brother went out and killed it with a shovel… I hated them doing it, I did it anyway because I wanted my dad’s approval.” The final of the three factors in Penny’s childhood that contributed to narcissistic wounding are abuse and trauma. Abuse and trauma are devastating and damaging occurrences in any child’s upbringing and they can disrupt healthy ego development. With respect to fundamental narcissism, abuse and trauma can entrench the effects of an already poor holding environment and intensify pain associated with caretaker blindness. Almaas (2001) maintains that the soul is incapable of tolerating the direct impact of traumatic experiences. He argues that the soul will dissociate from the experience as a way of coping with the trauma. This disassociation is a defense mechanism and is achieved by “totally blocking it [the trauma] out of consciousness or by retaining the memory while becoming numb to its emotional and feeling significance” (2004, p. 171). Penny experienced the sudden and tragic death of her father in a car accident when she was 8 years old. Here is the following account: …this thing with my dad was just too big to handle and I just…it was just too much. And already I don’t think I was very good at feeling my feelings and that was it. That was an owie. I didn’t want to feel. Penny further reports: I went over to this gal’s house to play and her father said to me, what does your daddy do for a living? And I remember freezing again. And I can still remember my fists clenching and I just said, my daddy’s dead. And I remember tightening up my whole body so I wouldn’t cry. Like I had made the decision never to cry. According to Almas (2004) disassociation of the latter kind, impacts one’s “inner ground of the soul” (p. 171), as repression limits and lowers the intensity of one’s awareness. It was as if Penny’s soul has been disturbed cementing narcissism into her emotional body, which acted to cut herself off from the fullness of her Being. Penny did not only experience the pain of her father’s death, but she also endured sexual abuse from an older male figure in her life, as well as physical abuse from her mother. Correspondingly, Penny discussed her disappointment from the lack of positive and protective father figures in her life. She remarked, “My father left me. And my next father went to jail. And my next father was a pervert. And I had never had love and protection from a man.” In the aftermath of Penny’s trauma and abuse, it appears evident that Penny’s narcissistic wounding left her with a loss of basic trust. Loss of basic trust is the position where we view the world as cold, hostile and alien (Almaas 2001). Such a defensive posture leaves the individual to identify with increasing contents churned up from a fissured mind. Adding greater burden to a self who is already fragile and its remaining trust in the world dims, held behind a mask of suspicion. Int J Ment Health Addiction Narcissistic Supply: Adulation, Addiction and the Need to be Seen The second theme in Penny’s narrative captured her life from young adulthood until her late thirties between the ages of 13–37. During this period, Penny struggled with a variety of addictions and attention seeking behaviors in an effort to gain narcissistic supply. According to Almas (2004), Penny’s insatiable need to be seen and appreciated resulted from a “shaky identity” requiring “an inordinate amount of attention to support and stabilize it” (2001, p. 117). The abuse in Penny’s early environment had disrupted Penny’s “inner homeostasis” (Almas 2004, p. 159), which was her ability to regulate her inner dynamics such as frustration, fear, danger, and most importantly self-worth. To compensate for this vulnerability, Penny turned to her environment to elicit praise, adulation and regulate her self-worth. She recalled: I always felt that nobody really liked me. And I would try and try and try to get attention by doing crazy things like…by being funny or even by…like I remember I caught my hand in the spokes of a bike one time… Like any way to get attention. At the core of the narcissistic personality is extreme self-hatred, self-directed aggression and ultimately self-destructive yearnings (Almaas 2001). Penny projected onto her peers a sense of hostility and brokenness because that is what she felt at her core, and at the same time, she had a deep wish to be admired by others (Almaas 2001). Here lies the narcissistic paradox, where the individual oscillates between hating oneself, while equally projecting outward an identity that demands admiration. Penny reported: In school, I would hold my arm up… I would throw it in the air; almost put my shoulder out of joint, because I knew the answer. I wanted to make sure they asked me so I could show everybody that I was smart because I felt like nothing. I was dying for attention. My intelligence was one thing I got noticed for. In the forthcoming passage, Penny reveals the simple but important dimension to gaining validation, this time by being the winner at family games. I just liked to win. I really liked to win. And even playing games, like Monopoly and that, and I am remembering…I liked winning. I did not like losing. It [winning] made me feel superior. You know, it gave me a big rush. Despite this seemingly innocent disclosure, it is perhaps a foreshadowing to her gambling addiction and provides an insight into the power and adulation she later experienced from gaming. Another narcissistic trait Penny exhibited in her youth was narcissistic envy. It began with jealousy Penny held towards her sister for receiving less attention from their father. She remembers, “My dad used to always put her on his knee. I hated her because I thought he loved her more than me. I was really hung up on looks. The prettier one got the attention”. Individuals who had more power, who were more attractive or had greater status and achievement were targets for Penny’s bitterness; in effect one might conclude that Penny hated people because she envied them. Almass (2001) wrote, “one hates anyone who has (or seems to have), a rich inner life or external acclaim and feels pain about not having what the other has” (p. 163). To stave off feelings of jealousy, envy, and the pain of not being seen, Penny began drinking in her youth. She boldly remarked, “I would drink to get obliterated.” During her adulthood years, Penny’s drinking took on new a meaning. She drank to not only feel “fabulous” but also “omnipotent” compensating for a lifeworld that was desolate inside and Int J Ment Health Addiction out. Following her addiction to drinking, Penny upped the ante and her love affair with alcohol shifted toward an adoration for men, single or otherwise. Penny remarked, “Sex was a power trip”. The act of dominating others sexually perpetuated the omnipotent image Penny had of herself. As a result, Penny was able to reassert control over her inner emptiness and for a short while, placate the haunting memories brought about from early childhood neglect and abuse. In her mid-twenties, Penny became a successful music manager for a number of popular rock bands in Alberta and western Canada. As the self-professed “rock queen of Alberta” she exerted a high level of control in her work and exuded a desperate need for security in her work role. She commented that the power and success was like no other high she ever felt. The authoritative position Penny held, as well as the popularity and esteem she received from others, became a very addictive form of narcissistic supply. She noted: I started to become successful I started to get on a high like I had never been on in my life… it was a frantic, crazy pace. I was working 24–7. I got a full-time housekeeper for my kids and I had…it was like [gambling in a lot of ways]. I was just going 24–7. Worried that she could lose her highly lucrative job and the material security it provided Penny desperately clung to her work. She stated, “I just didn’t dare take a break”. Penny appeared to have an obsession with becoming. Understood from the perspective of gambling Penny was caught in the vertigo of seduction or more aptly she was enamored with being in the action. According to Almaas (2001) Penny had a fixation with her externally defined identity. This external identity was dependent on her success as a rock agent. The more severely attached to our identity the more we will deny our underlying feelings of helplessness and negate our need to connect with other human beings (Almaas 2001). As result, the self becomes more heavily dependent on its projections of grandiosity to keep its specialness alive, all the while, warding off feelings of being invisible and apparently unlovable. Penny remarked: I just thought that if I could get enough money… I would never need anybody again. I could just sit at the top of my little castle and tell everybody to go screw themselves… and the grandiosity. I wanted people to know I didn’t need them. I showed no fear. Narcissistic Emptiness: Empty Shell and the Black Chasm Our third theme captures Penny’s life between the ages of 37–41, during which time she lost her identity as a revered rock agent. The terms “empty shell” and “black chasm” are the subject of introspection and refer to the narcissistic emptiness Penny experienced once her makeshift identity was threatened and began to be brought into the light of day. Narcissistic emptiness is a term that describes a moment or moments of insight in which the individual glimpses the falseness of their entire self-system. These insights bring about the experience of “existential dread and terror” (Almaas 2001, p. 315), which can lead to the rediscovery of Being. It must be noted that Penny is in the initial stages of identifying and dissolving the empty shell and thus her insights, although impactful, remain ongoing. Quite literally the empty shell is the “self-emptied of its essential core” (2001, p. 306). The narcissistic emptiness experienced when the shell begins to dissolve, is referred to by Almaas as “the black chasm” (2001). The black chasm is the space between our identity that was developed through historical time and the essential self. In this space the illusions of our constructed Int J Ment Health Addiction identity collapse and we feel torn asunder, thrown into a vacuous space of emptiness and nothingness. Penny first began to feel the disintegration of her identity when she lost her vocation as a revered music executive. She was left with no choice but to give her company over to the “big corporate giant.” Within months of resigning she experienced another devastating blow, the death of her sister. Penny’s world was shattered, the trauma from her sister’s sudden death was destabilizing and her identification with being a “somebody” in the world began to crumble. She reflects, I got a lot of status, a lot of reputation; I did have the best bands in the province. I really did. I had a lot of respect. I was very, very successful…I remember writing suicide notes. I was absolutely devastated, as devastated as I’ve been with any addiction, because I was losing it and I knew that I couldn’t do it anymore…I was just being swallowed up. As an empty shell, Penny was without an inner life. After all, the shell comprised all of Penny’s admiration and reverence from external sources. Penny’s job loss severed a main artery rendering the shell thin and brittle giving rise to Penny’s experience of existential dread. Essentially, the dissolution of the shell reveals a disconnection of the self from its essential core. It is in this black emptiness that Penny began to feel lost, disorientated, without purpose and meaning. Almaas describes this state as “purgatory” or a “transition inbetween stages” it is the “gap between our essential nature and who we take ourselves to be” (Almaas 2001, p. 334). In the next passage Penny discloses her return to alcohol as a means to sooth her depression and feelings of emptiness. Penny remembers: I left the bar that night and I had been so depressed and so down and the drinking wasn’t even helping anymore and I just wanted to sleep or go out at night and drink…I was just in terrible, terrible shape. I was lost. I was no longer the rock and rock agent… inside of myself, I felt nothing of myself. The nothingness Penny experienced is an indication that her soul is “becoming aware of its inner existential emptiness” (Almaas 2001, p. 225), however Penny could not tolerate the fall into the black chasm of being and stand face to face with who she wasn’t. Instead she turned to gambling, as alcohol could no longer repair the thinning shell nor could it help her escape the haunting feelings that threatened to drown her into Being. Narcissistic Rage and Gambling Pathology Our fourth theme captures Penny’s descent into pathological gambling, which was fueled by her ongoing collapse of identity, thinning of the empty shell, and subsequent rage at not being able to control the trajectory of her subtle plunge into and out of the black chasm of Being. The years of Penny’s gambling span a 12-year period. According to Almaas (2001) narcissistic rage is an intense reaction that stems from the inability to derive an adequate supply of mirroring from one’s environment to maintain a sense of identity. In other words, narcissistic rage is a “defense against narcissistic vulnerability” (p. 328). Penny experienced the disorienting state of narcissistic emptiness in the last theme and the not so soft touch of the black chasm as her self-structures began to thin. The simple lack of non-identification (I am not a revered rock agent) caused Penny to feel psychologically empty. It is here where Penny serendipitously found gambling. For Penny, gambling began innocently; but soon after hitting 7’s on an electronic gaming machine (EGM), she learned she could feed her fragile and vulnerable identity. The money Int J Ment Health Addiction Penny incurred from gambling gave her both power and security: “The money was more security to me than anything. But I have to admit… All these people are fussing over me and these lights are going off…I loved letting them see me win.” Penny’s early wins were deceiving and despite realizing that she could not make a career out of gambling, gambling remained a powerful an elixir for recognition and admiration. Traditionally, chasing losses in gambling is a means by which the gambler attempts to recover their losses from previous gambling ventures. However, in Penny’s case, she was chasing after wins and losses in an attempt to regulate her self-worth and or stave off devaluation from on looking gambling patrons. “I remember people would wait behind me and I was just…like I just hated them seeing me lose”. Driven by the rush and the attention she received Penny’s frequency of gambling ventures exponentially increased from week to week. She noted losing an average of “twenty grand a month.” In less than a year, Penny’s gambling had become an obsession and she was unable to do anything but gamble. She remarks: I gambled weekends…. I would go sometimes at ten in the morning and not get home until three the next morning. I was bleary-eyed, hated going to the bathroom. I’d run in there and spray all over the bathroom because I was afraid somebody would steal my machine. And I would sit there and sit there and sit there and sit there and just…I remember at first I had a little limit for myself of eight hundred dollars a day. And I remember the first time I lost seventeen hundred dollars in a day. Gambling became a vicious circle for Penny offering her intrapsyhic security when she won while perpetuating her narcissistic vulnerability when she lost. Regardless of which direction the pendulum swung, it served to keep Penny’s gambling in full tilt. Eventually the euphoric and dysphoric cycle depleted Penny’s psychological resources and she spiraled into a narcissistic depression. Penny attempted to quit gambling on a few occasions and reported staying “straight” for a couple of months at a time. Penny eventually found her way to Gambler’s Anonymous (GA) and for a short time her narcissistic striving and life seemed to stabilize. Penny went about taking care of bills and paid off larger creditors by remortgaging her home, but the “beast” she had created inside was insatiable. Wincing, Penny reported: “The second I got that mortgage…my wheels couldn’t spin fast enough to get me there… I went through about twenty thousand dollars of that thirty-five thousand in real short order.” In the forthcoming vignette, Penny addresses the destructive origins behind her drive to gamble, narcissistic rage, revealing it’s macabre nature: Part of my gambling was to annihilate myself. Part of my gambling was that hate inside of me… I was so prone to anger, and I had a lot of violent dreams. I couldn’t get past the hate and my rage. Even people, I would push them away. I pushed everybody… the gambling, which at first was so attractive just turned into a nightmare of self-abuse. At the lowest and most vulnerable point in her gambling addiction Penny reports being “dragged off” to a psychiatric ward by a friend, “I was barely conscious.” She continues: Big Al came up and dragged me off a machine one night and they put me in the psyche ward. I said I was going to kill myself. I remember dreaming that night that I was putting quarters in the bedposts at the end of the bed. The poles that stick out they have slots in them and I was putting loonies in the slots. I remember waking up that morning and realizing where I was and going, ‘oh my god, oh my god.’ I stayed for a week. Int J Ment Health Addiction Narcissistic Helplessness and the Great Betrayal The final theme captures Penny’s shift toward healing, and her recognition of what Almaas refers to as “the Great Betrayal” (2001), occurring between the ages of 55 and 58. The Great Betrayal is the betrayal of one’s true self as essence. At the most essential level, this betrayal entails the loss of Being, when the most “fundamental truth of the soul has been betrayed and abandoned” (Almaas 2001, p. 319). In the case of Penny, significant “objects” (i.e. parents, guardians) betrayed and abandoned Penny in childhood. She, in turn, betrayed herself by not fully being herself. In other words, by abandoning her essential identity Penny aligned herself with what others expected of her, wanted of her, and rewarded her for, instead of attending to innermost Being (Almaas 2001). Thus in this theme, we will explore Penny’s conscious movement into Being, where Penny acknowledged the need for help and how she began to take responsibility toward recovering her primordial presence. The first milestone toward healing occurred when Penny disclosed the details of her gambling addiction to her doctor. Her confession is a symbolic surrender, a sign that Penny was ready to address her narcissistic helplessness and allow the empty shell to reveal its hollowness. During this time, Penny returned to GA in an effort to bring her gambling under control, however, her recovery from gambling addiction is still a matter of concern to this day. One difficulty has been her narcissistic pride. For instance, Penny reported that despite group meetings offering some support she perceived herself as more “troubled”. Feeling that other members would not possibly understand the depth and devastation of the losses she suffered. Penny recalled being discouraged, “I remember distinctly thinking that nobody in that room had ever lost more money than I had and if they even had a friggin’ clue, like how much worse I was than them, they wouldn’t believe it.” In her difficulty relating to the rest of the group, Penny requested a private session with the meeting leader to vent her frustrations. Penny warmly remarked: I went in for the one on one and I ranted and raved about my mom and how she didn’t love me enough. She beat me. And how my dad had died. And for an hour all I did was scream and yell and cry and carry on and on and on. Penny’s emotional release was an opening for transformative possibilities. She was able to challenge her deeply rooted pain and dive into the shame and disappointment from her past. She was able to get in touch with the emotional depth and complexity of her wounding. Here Penny moved into a new way of being reconnecting with her emotional body. A far cry from her past where her tendency was to “lick her wounds” when confronted with painful emotions. As Penny continued to work on processing her Great Betrayal, she revisited her painful childhood and began to take responsibility for how her addictions impacted her family. Deeper inquiry led her to explore the walls that held her Great Betrayal in place and she spontaneously experienced a series of dreams, which she called “visitations”, visitations of young child. It took me two full years to realize that that child wasn’t actually a little two year old on the end of my hand—that was me. Scared, bony, pathetic and so afraid. That was me. And here I thought I was a big shot and grandiose and all this and I was a scared little kid. Drawing on the theoretical framework of Almaas, the child might be understood as her souls’ return and request for healing. The child brings Penny many gifts, including Int J Ment Health Addiction forgiveness for others. She says “this child came to me and she ended up taking me on a journey of forgiveness for my mother.” Having begun the journey in reconnecting with essence, Penny was now ready to explore the deep sadness over the loss of her father that she had been carrying since the age of 8. I don’t think I had ever cried as an adult over my dad dying. And the tears just kind of jumped off of my cheeks and I had been in recovery for a little while and …I was just so shocked that I could just cry—just like that. And I went home and I was laying there in the bed downstairs and I was thinking about my dad and all of the sudden it was like this big vortex…I slipped into it. And whoever I was… Was gone and I was just love. I get goose bumps telling you about it because it was the most…I don’t know how long it lasted. It could have been ten seconds; it could have been five minutes…all I felt was this incredible love. Through the release of Penny’s buried pain over her father’s death she is led to have what Almaas (2001) referred to as an “essential experience”. Penny describes slipping into a “vortex” where she experiences “incredible love.” It is in this experience that Penny taps into her essential identity and her soul tastes its experiential significance. Almaas identifies these transcendent moments of pure love, bliss and healing as essential experiences wherein one experiences “selfless inner spaciousnesss” (p. 303). Spaciousness is experiential and psychologically it is “the space which allows the essential presence to surface into consciousness” (Almaas 2001, p. 69). In this moment of selfless inner spaciousness, letting go arises spontaneously as does healing. Here, Penny is returning to her “pure condition” (Almaas 2001, p. 25). She recalls: I remember that night was the first time I ever felt any kind of tenderness toward myself and I was very aware of that. I was like, you know, maybe I could learn to love myself. Maybe, just maybe. That kindness to myself, it felt like it was the first time in my life I had ever been kind to myself. And I realized that I needed to do more of that and I needed to get open more but it was like pulling teeth. It was the hardest thing I had ever done. The self-love that was ignited in Penny is the precise medicine for the narcissistic wound. The narcissistic wound, which severed her from the ground of Being, is repaired through love. The intimacy she feels with herself and the kindness towards herself are characteristic of the effects of this presence. Almaas (2001) writes, “When we experience ourselves directly we experience ourselves in its primordial purity, without veils, without obscurations (p. 25). The sojourn into and out of the Great Betrayal is centered on a fundamental shift in consciousness, what some call a “spiritual awakening”. The effect of which has helped Penny dismantle and begin to transform her addictive patterns. It has kindled a genuine feeling of self-worth and has redefined the way Penny sees herself in the world. Almaas (2001) poignantly notes, “The more we know the truth of who we are, the more we can be authentic and spontaneous, rather than merely living through self concepts of ourselves” (2001, p. 8). Conclusion and Discussion The chief implication of this research is to inform health care practitioners and counsellors of an alternative approach to understanding and addressing pathological gambling and Int J Ment Health Addiction addiction issues in clients. By considering the theoretical and philosophical assumptions proposed by A.H. Almaas, we learn that addiction is symptom of fundamental narcissism and loss of Being. Therefore one might approach and treat clients from a unique vantage point that requires rethinking current treatment methods and interventions. A noteworthy therapeutic implication for counselors revealed through Penny’s case study is that healing comes from essential experiences. It is revealed in Penny’s narrative that she is able to connect to herself at a fundamental level and discover genuine self-love through essential experiences. Consequently, counsellors are encouraged to educate themselves with respect to Presence and Being and approach resolving addictions issues by exploring these experiences with their clients. The inquiry into essential experiences might aid to thin the shell of the ego-structured personality (the empty shell), in order that the client might experience his or herself as presence; involving a far deeper reality of the self than the contingent identities one holds onto in the world. In Penny’s narrative she concludes, “Gamblers have to really get with the program and have a spiritual awakening before they realize that they can’t do any form of gambling.” For Penny, it was the spontaneous arising of presence that helped her realize what drove her addictive behaviors and how gambling provided both an escape and mirroring of falsity that drove her further in oblivion. The final implication of this work, that is perhaps the most profound and necessary consideration, is transforming the lens through which health care professionals and counselors view clients who suffer with gambling and addiction issues. By adopting the perspective of A.H. Almaas (2001), one might then view every human being as having an inherent drive towards healing and a desire to discover their true self in Being: In every soul there is an inherent drive toward truth, an inherent desire to feel fulfilled, real and free. Although many people are not able to pursue this desire effectively, the impetus toward the realization of the self is in all of us it begins with the first stirrings of consciousness and continues throughout life whether or not we are directly aware of it. This impetus spontaneously emerges in consciousness as an important task for the psychologically and spiritual maturing human being. 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