Numerous programs have been instituted to address the widely recognized problem of binge drinking in college students, with some excellent results. Yet binge drinking is commonly still viewed as a socially acceptable form of relaxing and bonding with peers, often with the stated goal of getting as drunk as possible as quickly as possible. The apparent disconnect between students' intelligence, verbal acuity and often impressive self-knowledge and their continued participation in this potentially self-destructive behavior can puzzle and frustrate clinicians. Although a number of studies have suggested that alexithymia is a contributing factor in binge drinking, little has been written about integrating this information in therapeutic interventions. This article explains and provides an extended clinical illustration of how understanding the problem of alexithymia can enhance interventions designed to address binge drinking in college students.