Towards a relational framework for pathological gambling (Part II): Congruence


In an illustrative clinical case study, congruence is depicted as the fifth circuit in a relational framework to extricate gambler and spouse from pathological gambling and its after-effects. Congruence couple therapy poses interventions in four dimensions of the couple experience: (i) intra-psychic; (ii) interpersonal; (iii) intergenerational and (iv) universal-spiritual. Congruence is operationalized as awareness, attention, acknowledgment and the alignment of the four dimensions. The philosophical underpinnings of this concept-based model are laid out with clinical vignettes. The couple reported improved relationship quality with a reduction of gambling urges and maintained abstinence. The couple relationship serves as leverage for both gambler and spouse to reconnect with themselves, with each other, with their intrinsic worth and dignity and with their family of origin experiences. As such, congruence couple therapy goes beyond the level of the individual and intra-psychic to reconstruct key family relationships in both past and present, and to rebuild spiritual resources to fortify the couple's capital for sustained recovery.

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