Social isolation and alcohol use: lessons from The Queen's Gambit – psychiatry in television

The Queen's Gambit is a 2020 Netflix miniseries that follows Beth Harmon, a fictional orphan chess prodigy battling to become the world's best player while simultaneously struggling with alcohol and drug dependency. Although some have argued that the depiction of Beth's recovery from addiction is unrealistic, these criticisms fail to acknowledge the detailed presentation of the factors that lead to Beth's substance use and subsequent sobriety.

Throughout the series, Beth's substance use has consistent triggers: shame, anxiety and isolation. These three factors combine to create a perfect storm following Beth's second defeat to World Champion Vasily Borgov. Regarding shame, Beth's defeat damages her self-image, which depends heavily on being the best. The damage to her self-confidence also results in feelings of anxiety due to her upcoming rematch against Borgov. Her subsequent alcohol use can be seen as an avoidant coping mechanism to deal with these feelings of shame and anxiety. Beth demonstrates features of vulnerable narcissism, and shame can indeed mediate the effects of vulnerable narcissism on addiction. These feelings cause Beth to shun the chess players who previously supported her, leading to social isolation. These problems spiral, leading to Beth's most serious period of dependence yet.

Beth's recovery stems from several events that resolve these three factors. Seeing the accomplishments of Jolene and Annette, characters who lack Beth's natural talent but still have worked hard to meet their goals, leads Beth to realise that her alcohol use is wasting her gift. Subsequently Beth sees that Mr Shaibel (the janitor who first taught Beth to play chess) has a wall of newspaper cuttings dedicated to her entire chess career, and she breaks down in tears. The pride shown by Mr Shaibel affects Beth in two ways: it adds to the feeling that her alcohol use is wasting her talents, but is also crucial for the restoration of her positive self-image. This allows her to overcome her feelings of shame and anxiety and once again be driven by a desire to win. The crux of Beth's recovery is support from Jolene – throughout the series Beth consistently manages to maintain long periods of sobriety as long as she is not alone. While Beth's alcohol cravings continue under the stress of the final, the support from Beth's fellow chess players is shown to be crucial for her maintained sobriety and ultimate victory.

In summary, Beth's recovery is not unrealistic, but rather is consistent with the resolution of many of the factors that led to Beth's substance use. A fairer judgement would be that Beth's addiction is less representative of those with more severe problems, and a merit of this presentation of substance use is that it may be relatable to more viewers. Watching The Queen's Gambit can give viewers an opportunity to reflect on how isolation may affect their own substance use, and reinforces the key protective role of social support.