When I first talk to people about couples therapy, I usually ask: “Do you drink alcohol? Does your partner?” and if so, “How much?” I also ask whether they use other mind-altering drugs and intoxicants. Please understand — I’m not opposed to having a good time. Some people can drink in moderation without ill effects. But I want to know whether drinking or drugs may be spoiling your romance. With alcohol especially people may not make the connection between drinking and relationship problems. They may not be ready to let go of a partying lifestyle. Or they may prefer to deny problems with alcohol rather than feel shame or guilt about some of the terrible problems they’re having.

Here are some of the situations you typically see where people are having alcohol problems in their relationship:

“We just got home from a party. We had a few drinks and a great time. Now we’re bickering again over nothing!”


“I know we’ve got problems, but it’s hard to cut back because all of our friends drink.”


“We went out for a romantic dinner and shared a bottle of wine. We were relaxed and felt close. Then we went to a club and had a few more. Now she’s losing control again and flirting with a stranger. Why does this keep happening? Does she really love me?”


“Things were great before we had kids. But I’m worried. We’ve had some bad fights. And I can’t seem to reach him anymore. Every night he drinks a few beers and just sits in front of the TV.”

How Do You Know if Alcohol Is the Problem?

Maybe you don’t know, because blaming only alcohol may be too simplistic. You may be surprised to read this, but usually relationship problems have several contributing causes. Many relationship issues can become much worse “under the influence” of alcohol. And alcohol affects relationships in several ways:

  1. as a drug;
  2. as cultural ritual; and
  3. psychologically.

Alcohol’s Drug Effects

In my practice, I’m perplexed at how often people with obvious drinking problems push back when I suggest they may be self-medicating and might consider a psychiatric medication instead. If I suggest an antidepressant, for instance, they say they’re very uncomfortable with the idea of taking a drug! Alcohol is a drug, of course. By definition, a psychoactive drug chemically changes perception, thinking, and emotionality.

Alcohol also has more unwanted side effects that many prescription medications. Although its chemical effects include calming nervousness, when it starts to wear off, people get more anxious. This and its dehydrating side effect may cause insomnia or make it worse, and make it harder to sustain sleep. Sufficient doses of alcohol also prevent the dreaming sleep that helps us process emotions at night. Even “happy drunks” who drink often find that over time they become more depressed. And although very moderate drinking can have positive health effects, heavy drinking gradually breaks down body and mind.

Here’s an effect most people don’t know: Steady or binge drinking affects brain chemistry long after alcohol has left your body. Psychological testing is distorted as much as two weeks after not drinking — one author advises against testing a “wet brain.” But quitting “cold turkey” can be very dangerous, causing potentially fatal seizures.

Alcohol and Cocaine

Some people take intoxicants in combination. One of the most common of these is alcohol and cocaine, where alcohol may be the gateway to cocaine as the drug of choice. Psychologically, people taking this combination often experience serious problems with regulating their emotions and actions and wreak havoc on their relationships. Physically, this is like driving your car with the gas pedal to the floor and your other foot on the brakes, and it risks even more devastating chemical addiction. People with this pattern are at much higher risk for serious health problems, troubles with the law, entanglements with criminals and gangs who traffic in cocaine, and the financial cost of a cocaine habit.

Cultural Myths about Alcohol

Several cultural myths about alcohol lead people to minimize its drug effects. Here are a few of them unmasked.

  • Alcohol is natural, so it can’t be harmful. Alcohol is created in an age-old process of fermenting sugar with yeast. If it’s a naturally-occurring chemical, our bodies must be able to accommodate this, right? Well, consider other modes of food spoilage. If sugar is broken down by other organisms, such as salmonella, our bodies don’t handle this too well. Alcohol is a potent chemical that can kill in excessive doses.
  • If it’s legal, it can’t be that dangerous. Consider the legal sale of cigarettes and the role of tobacco in heart and lung disease and cancer. We don’t need to go back to Prohibition, but let’s face it, some people have troubling controlling their ability to keep alcohol consumption within safe or healthy limits — especially those who self-medicate other problems or whose genetics make them more vulnerable to alcohol addiction. Heavy drinking makes people much more vulnerable to auto accidents, and over time, it can destroy the liver and cause Korsakoff’s dementia, where one can’t store new memories. And drinking doesn’t need to be continuous to cause dementia. We now know that binge drinking accelerates the onset and severity of dementia later in life.
  • I can’t imagine celebrating without champagne! Alcohol has taken a central place in celebrations for thousands of years. At weddings, people drink toasts to the happy couple. In our culture, drinking has become a rite of passage into adulthood, when one reaches the “legal age.” People watch sporting events with a beer in hand. Are you able to celebrate without drinking? If not, what does this say about the power of familiarity? What kinds of social pressures would you face if you chose not to drink? And what about when those celebrations are ruined when drunken relatives embarrass themselves at weddings or when fights break out at sporting events?
  • In vino veritas (in alcohol is truth). Most of us have seen someone who, after a few drinks, becomes much more emotionally expressive and may say or do things that reflect wishes they had previously hidden. Some incorrectly interpret this disinhibition effect as showing one’s true self. But “true self” is more nuanced and subtle than this. Its expression requires the interaction of many aspects of personality, including the person with a fully functioning brain who plans, organizes, weighs consequences, and chooses among conflicting wishes. To further disprove the contention that the unmasking effects of alcohol reveal one’s true self, consider the fact that alcohol may sometimes unmask positive feelings and sometimes negative ones. This is one of the reasons that couples who drink in order to better connect can easily get caught up in intense arguments.

Psychological and Social Impacts of Alcohol

Let’s face it. People like to drink alcohol for its positive effects. If you’re anxious, a drink can help you relax. Bored? You can enjoy a gourmet experience. Hurting? You’ll go numb. Shy? You’ll be less inhibited. Lonely? Other drinkers are your instant friends — and “social” binge drinking often starts in high school or college. This habit often continues into early adulthood and is hard to break, because many people have known no other ways to gather socially. Also, your job or identity can link you to alcohol. This is a common issue for restaurant staff, or in any job that requires selling, networking or travel. Other situations can trigger the urge to drink excessively, such as holidays or anniversary dates of important personal events, or longing for a lost love.

People familiar with computer programming know that you get junk data unless you process both zeros and ones. Similarly, frequent alcohol and drug use to feel better filters out negative experiences but robs us of needed perceptions. Consider what it would be like to turn off the pain receptors in your feet. You wouldn’t notice much difference at first, until you step on a sharp object without knowing it and make the injury much worse. We need access to unpleasant feelings to alert ourselves to situations that need correction.

Although alcohol in moderation doesn’t create problems for some people, for many, moderate or binge drinking has unwanted psychosocial effects, even after alcohol has left their system:

  • Irrational thinking, including such cognitive distortions as black and white thinking and emotional reasoning
  • Defensiveness, such as denial; blaming; escape and avoidance of uncomfortable situations; isolation and withdrawal
  • Aggression, including intense and violent temper; unwanted sexual advances; physical fights, sexual abuse or assaults
  • Lack of integrity, such as broken promises; underfunctioning that leads to codependency; driving under the influence (DUI) — a serious danger to self and others; infidelity; refusing to take responsibility; and facilitating other addictions, like pathological gambling
  • Mood problems, including depression, anxiety, anger and irritability, low self-esteem, increased risk of suicide and homicide
  • Family problems, such as arguing, bickering, stonewalling, withdrawal, and generally poor communication; neglectful, emotionally abusive, codependent or stagnant relationships; infidelity or not coming home; poor sexual performance; financial distress
  • Career difficulties, including failure to advance, conflicts at work, job loss
  • Worsening of other mental health issues, such as anxiety, phobias, panic attacks, depression, bipolar disorder, mood swings, attention deficit/hyperactivity disorder (ADHD), paranoia, personality disorders, schizophrenia, poor anger management

Getting Help

Alcohol problems can range from mild to severe. After reading about the many potential problems, you may see that it’s hurting your relationship. People easily underestimate alcohol’s effects, especially if they haven’t had a healthier relationship than the one they’re in. Also, some people haven’t had an extended period of not drinking since their teen years or earlier. Alcohol problems can be addressed in a variety of ways: through psychotherapy; medical consultation and treatment, such as outpatient and inpatient detoxification (“detox”); residential rehabilitation (“rehab”) centers; Alcoholics Anonymous and Al-Anon and alternative programs to these; church and community organizations; or friends and family.

Take Courage and Find an Approach that Works for You

If you believe that alcohol may be spoiling your romance or causing some of the other problems discussed here, take courage, and reach out for help. There’s no single way that works for everyone, but if you truly want help and look for it, you can find an approach that’s likely to work for you.


Arden, J. B. (2002). Surviving job stress: How to overcome workday pressures. Franklin Lakes, NJ: Career Press.

Backer, K. (2008). “Binge-drinking culture may cause dementia epidemic, experts warn.” In The Independent. Retrieved December 16, 2008 from http://findarticles.com/p/articles/mi_qn4158/is_/ai_n30967162.

Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The Consumer Reports study. In American Psychologist, December 1995 Vol. 50, No. 12, pp. 965-974. Retrieved December 16, 2008 from http://tinyurl.com/c48shp