What to do if you are worried someone is drinking too much, according to a therapist

According to a new survey one in four of us are worried that a person close to us is hitting the sauce too hard. It’s something that Lola Borg sees time and time again in her therapy practice, so what does she tell her clients when someone they care about is becoming a problem drinker

It can be more common for therapists to hear from people who notice problem drinking in those close to them, than to hear patients talking about their own issues with alcohol (Getty)

Watchful. That’s what you become when you suspect someone close to you is drinking too much. I’m a therapist in London and I have plenty of clients who worry about their own drinking, but considerably more who worry about someone else’s – maybe a partner, a parent, or a teenager – someone who seems to be hitting the sauce more.

“It’s like I’ve self-recruited into MI5, an episode of Slow Horses,” said one client about his wife. “I’m now forever watching intensely what she does. I do mental calculations of how much she has drunk at a night out. Did she drink beforehand? I clock how much she buys and where the bottles go – I’ve been known to fish them out of the bin to count them. It causes a lot of arguments, understandably, and she doesn’t cut down, she just gets more secretive.”

A recent survey claims that some 25 per cent of us in the UK – one in four – worry that someone we care about is tippling too hard or too often. That’s a hell of a lot of drinking to monitor. One in six, according to the same survey, also worries about the drug intake of someone they care about. The collective evidence suggests we are awash with drink and drug-taking, with deaths from drinking at an all-time peak in the UK and older generations proving to be the most enthusiastic consumers (while 18- to 24-year-olds are more likely to favour abstinence).

In my practice, in London, among certain groups, especially among Gen X, partying hard and drinking to crazy levels is absolutely seen as a norm, so are these figures surprising? Not so much.

How this excess gargling plays out in relationships and family life can range from tricky to devastating. Clients talk about being confronted with someone who looks the same on the outside, but whose behaviour is erratic and unpredictable. A person they thought they knew but don’t.

Early warning signs can easily get overlooked or not tackled (denial, as the saying goes, is not just a river in Africa). There is the actual being drunk, of course, followed by moodiness and hangovers. But it could also be that, say, nipping to the shops takes a puzzlingly long time. They disappear. They’re late, they become unreliable, secretive, they might avoid situations where drink isn’t available. One client gave in to the family pleas to buy a dog simply as an excuse to go to the pub.

Then the drinking itself becomes unpredictable – one time they might be delightful and another will curdle for no apparent reason. One client came to me, at the very heavy suggestion of her boyfriend: after making her way home after what was meant to be one drink after work, she fell from the top to the bottom of a tube escalator. She was unharmed but chastened enough to listen. More likely, though, attempts to tackle the subject are met with anger, denial, resentment, counter arguments, trivialising: “Oh don’t be so dramatic/ spoil my fun/what about you?” etc.

In Sex and the City, Miranda’s friends had to tell her she was becoming a problem drinker (HBO)

Drinking veers into the problem lane when, as perfectly illustrated by my client above, it becomes chancy or unpredictable, or when even after the intention of ‘just one or two drinks’, all bets are off. FYI, the UK safe limit for alcohol is 14 units a week for all adults but according to the WHO, there is no ‘safe’ amount that does not affect health. Someone who consumes over 50 units a week is a considered heavy drinker. The line between drinking too much and drinking alcoholically is always a fuzzy one, but basically alcoholics need a drink to function, to get through life.

Put simply, a “problem drinker” is when drink becomes a problem – for themselves and those around them. This too can often lead to all kinds of behaviour they might not even recognise in themselves when they are sober – stroppiness, picking fights, appalling time keeping, letting down colleagues, family and friends, missed work or social occasions.

The question to ask yourself about your drinker, is what is driving this rise? Looking dispassionately at what is taking place in their head isn’t easy. Has it just started, this drift to the booze? Did some event or stress precipitate it? What else has happened? A lurch into hitting the sauce may be after a loss of some kind, not necessarily a bereavement, though certainly that too. Loss of status is a common trigger, and retirement is a peak time – the loss of who you once were.

The line between drinking too much and drinking ‘alcoholically’ is a fuzzy one (Getty)

So firstly, think of the drink as a symptom rather than the problem. A question I often ask is, Just what is gained by drinking? Social acceptance, escape, temporary oblivion, recapturing someone they once were, alleviating boredom or stress? It could be any one of a million reasons and is usually not one factor, more a cluster or constellation that tips a drinker into unacceptable limits.

One past client, for example, drank to levels that worried her family when she was alone, but in company, could stick to mineral water. Culture plays a role too. Those who grew up in heavy-drinking families or societies learn by osmosis that problem solving is addressed by reaching for the bottle. And we know that having one or two parents with an alcohol problem increases the risk dramatically of emulating the pattern – but I must stress, this is a risk and not a certainty.

Statistics seem to bear out that Covid was a huge trigger for a rise in alcohol consumption. As the comedian and actor Stephen Mangan pointed out at the time, during lockdown we became either “hunky, chunky or drunky”. Tippling at home became the norm and has stayed that way. But my sense is that we have never quite fully connected back up socially since, which is one factor in the rise of all kinds of behaviour I see, including higher consumption of drink, drugs, porn – you name it. Addiction, it’s said, can be at its very heart about a lack of connection. I see a lot of people at risk of isolation, especially those who work from home, in tech or who can be digital nomads, and not rooted or tethered anywhere.

What I also see is a focus that moves squarely onto the drinker, who is stubbornly slow to get help and sometimes will only do so when a relationship is on the edge or family breakdown becomes a reality. Which is what makes it so horribly painful for all of those around them. Because dealing with someone who drinks too much brings us bang up against the fundamental issue with human behaviour – you cannot control what someone else does, however much you want to.

Broaching the subject of drinking with a friend who has a problem can be difficult – so best to do it when you’re both sober (Getty)

So, what the hell do you do with someone close to you who you are worried about?

• Stop depending on them. Heavy drinkers are unreliable. Make watertight or alternative plans, say for social events, that means if they are off the rails, you can manage.

• Stop covering up. Often drinkers do not realise the effect of their actions because partners or family members protect them. Don’t. Let them realise the consequences of their actions.

• Get help. Al-Anon is the organisation for those with a problem drinker or addict, find a local meeting. Or find a professional to talk to.

• Talk to them, but the rule is, never do it when they are drunk. Say something like, “I’m worried about you …” rather than launching in with a series of furious accusations. Keep it short.

• Suggest they get help. Expect an initial denial, but they might think about it. For problem drinkers, a sympathetic GP if you have one might be a first step. Some people find that apps such as Reframe help and of course (I would say this) therapy. Suggest it. There is a reason they are doing what they are doing, never forget that and they need to understand that to change it. For a drinker who is at totally destructive levels, AA can be amazing and unlike rehab, it’s free.

Lola Borg is a psychodynamic psychotherapist with practices in Hackney and Marylebone