Rahul is 24 years old and is employed as a partner in his mother’s business. He is the middle child with
an older sister and younger brother. His mother runs the family business and his father has problems in
drinking. He was brought by his wife for problems with gambling and excessive lying.
Rahul has problems with betting and gambling. He also has problems with excessive lying and hiding.
History of the Presenting Complaint
Rahul lives with his family who is located in Chennai. He is addicted to gambling and tends to lie about it
and hides it from his wife and family. His routine is disrupted during the cricket and football season. He
sleeps late and wakes up late. Watching the games have triggered his betting tendencies. He also plays
poker online or on the phone. He has lost a lot of money by gambling. His interaction with his family has
decreased and his wife is getting frustrated with him because of the lying and also because he does not
stand up to his parents or explain her issues to his parents. He is not able to be assertive in his
communication to anybody including his subordinates (like driver). He feels like running away or
disappearing because he feels he cannot do anything right and he does not know himself anymore.
Past Psychiatric History
Past Medical History
Rahul’s father had a history of abusing alcohol. He was addicted. His father has had a second wife which
the family knows about. His parents question his wife a lot and this upsets her. The family environment is
stressed. His father has encouraged him to ask him for money in secret so that he can gamble.
Rahul grew up in a dysfunctional home. His current relationships with his parents and siblings are
strained. He is recently married. He has had a history of engaging in gambling since his studies abroad.
Since then he has been betting and gambling and losing lots of money via online gambling. During the
cricket and football season, he meets his friends and gambles. Has lost big amounts of money and lied
saying it was to buy gifts for his wife. The couple does not have any savings of their own; they live with
his parents and look to them for support. He is not assertive in his communication and is losing
His addictive habit was making him lose structure in his daily life. He was having problems with his
parents. Rahul was continuing to play poker on the internet and mobile. His interaction with his family was
decreasing. He recognized that his behavior was wrong but claimed that he could not help it.
• Rahul was asked to maintain a structured daily routine
• He was asked to engage in affirmative self talk to cut down his impulsive behavior.
• Alternative entertainment to divert his mind was suggested (to attend dance classes with his
Rahul’s sugar level had gone up. He was put on insulin. He has refrained from getting into playing poker
online. During his vacation in May he planned to go to Shimla. The couple had not started dance classes
yet, but Rahul was going to the gym regularly. His sleep routine, diet routine and daily structure has
• Was referred to a psychiatrist for medication to manage his impulsive behavior.
Rahul visited the psychiatrist who conducted some tests and put him on Depakote 250 and Xet ck12.5
Rahul played poker with money and lost 3 lacs in the process. He lied to his family saying he bought his
wife a bag and a watch with that money. His credit cards kept getting swiped for big amounts of money.
His wife was worried that there will be left with no money. He was fidgeting with a rubber band throughout
the duration of a session and did not maintain continuous eye contact. He was unable to be assertive to
his driver to give him instructions to come to work early. Rahul took everything as a personal attack and
felt like he couldn’t share anything with anyone.
• Explained what addiction is, helped him understand the process of his behavior.
• Rahul was asked to write self defeating thoughts and positive thoughts. This was given as
• Relaxation music was suggested before going to bed.
Rahul had been exercising and his sugar levels were back to normal. He felt like running away from life.
His wife verbalizes when she is unhappy and this affected him. Rahul met an instructor about confidence
building classes and had been listening to music for relaxation. He joined a cricket league and is enjoying
it. He told himself that he cannot give up so easily.
• Explained and helped Rahul write self defeating and counter thoughts pertaining to specific
• He was asked to try keeping away from food he found tempting for to days so that he could
International Journal of Dermatology© 1999 Blackwell Science Ltd. Tretinoin-iontophoresis in atrophic acne scars[Pharmacology and Therapeutics]Schmidt, Jolanta B. MD; Donath, Peter MD; Hannes, Johanna MD; Perl, Sylvia MD; Neumayer, Renate MD;Reiner, Angelika MDFrom the Department of Dermatology, Division of Special and Environmental Dermatology and Institute ofClinical Pathology, Universit
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