The jealousy is a complex emotional state, a common feeling, more or less accepted as the historical and cultural contexts.
We can define it as the perceived threat of the loss of a meaningful relationship, with an imaginary or real rival, which manifests itself with emotional, cognitive and behavioral components.
The jealousy brings a mix of emotions such as anxiety, worry, sadness, anger, hate, regret, shame, bitterness and envy that can be seen on a continuum from normal to pathological.
Healthy and pathological jealousy
Healthy jealousy
Some forms of jealousy are considered “normal”, or socially accepted, in relation to the proportion of the reaction in situations of possible infidelity. In these cases, the person maintains the management of their emotions without being overwhelmed. Eventually he changes his beliefs and behaviors as he gains new information.
Pathological jealousy
On the other hand, it can take on pathological nuances, deviating from “normal” jealousy when the emotional experience becomes abnormal. That is, of an unusual intensity, persistent, with incoercible emotional and cognitive contents. This also when rationally they can be considered absurd or, finally, when beliefs become “impermeable” even in the face of any confrontation with reality.
In this case, jealousy begins with an intense activation reaction, called a “flash of jealousy”, caused by a (real or imaginary) change in the partner’s behavior. This is followed by a paroxysm of painful emotions, accompanied by misinterpretations and the search for evidence.
Pathologically jealous people engage in specific behaviors, such as accusations and interrogations, repeated phone calls, checking phones, and correspondence. But also surprise visits, persecutory behaviors, bans on the partner to see their friends, go out alone or wear certain clothes, rummage through clothes and personal effects. Until the inspection of the underwear in order to find overwhelming evidence of the partner’s infidelity.
As a result these individuals can isolate themselves and develop a range of symptoms (sense of helplessness, isolation, extreme passivity, etc.) and experience anxiety and depression which can also promote alcohol or drug abuse .
Diagnosis of pathological jealousy
Obsessive jealousy symptoms
Pathological jealousy has some characteristics that differentiate it from normal jealousy.
To be such it must be excessive , intrusive and unjustified . Suspicion and paranoia become defining traits. The pathological jealous is pervaded by doubt and the uncertainty is intolerable.
Furthermore, it must create a strong compromise of the couple relationship in which reassurance is ineffective and the control of the partner’s behavior becomes obsessive.
Pathological jealousy and nosology
At the diagnostic level, pathological jealousy does not have a specific nosological entity. It is often portrayed as part of obsessive-compulsive psychopathology or as a jealous-type delusional disorder .
It can also be a component of numerous psychopathological disorders, such as substance addiction or alcoholism , schizophrenia , depression , organic disorders (Alzheimer’s, Parkinson’s, brain tumors, etc.), or it can be a side effect of drug treatments.
Differential diagnosis
In so-called obsessive jealousy , unlike delusional disorder, the person knows that he has no evidence of infidelity. Despite this, he cannot stop intrusive thoughts and controlling behaviors, yet recognizing jealousy as unacceptable, alien and shameful.
On the contrary, in the delusional disorder with themes of jealousy, the veracity of the suspicion is not questioned. There are often false memories, bizarre interpretations of the partner’s behavior, and attempts to extract a confession.
The pathological jealousy (or obsessive) is often likened diagnosed, and then (when it is not present the component delusional) within the obsessive-compulsive spectrum disorders, identifying the intrusive thoughts, repetitive and irrational about infidelity of partners such as obsessions and controls or the partner’s search for reassurance as compulsions.
However, although the phenomenology may in theory be similar to that of obsessive-compulsive disorder ( OCD ) , it is not correct to diagnose this symptom manifestation as OCD .
Paranoia and suspiciousness in obsessive jealousy
Some key points lead us to support this position, which is not always shared. The theme of thoughts, in fact, even if we call them “intrusive”, is not typical of obsessive-compulsive disorder, it is rather more similar to the so-called paranoia , since at the base of the thoughts there is the suspicion that the other is malevolent or threatening .
The thoughts in this case are due to a strong suspiciousness , more or less egosynthonic, which does not come to have the form of delirium and which keeps the person “functioning” in the various areas of life, but with a strong polarization of thought towards suspicion or the doubt of infidelity.
The personological nucleus, however, remains the diagnostic discriminant to be strongly taken into consideration when we are faced with a symptomatological manifestation such as obsessive jealousy .
Obsessive jealousy and personality disorders
Borderline Personality Disorder and Jealousy
In Borderline Disorder , for example, the excessive fear of abandonment is nuclear , which can lead to abnormal reactions in the face of a real or imaginary estrangement of the significant person due to one’s unlovingness. This can lead to terrifying fantasies of abandonment, greatly exacerbated by the imaginary presence of a more desirable or more lovable “rival”.
There may also be traits of excessive suspiciousness and intolerance to strongly negative emotions. These are often managed with impulsive behaviors aimed at lowering the emotional intensity, but potentially dysfunctional for the subject.
Paranoid Personality Disorder and Jealousy
Also in Paranoid Disorder we can find manifestations of pathological jealousy, however linked to the perception of the other as deceptive and to a profile of pervasive suspicion towards others in general.
Dependent Personality Disorder and Jealousy
Finally, in Addictive Disorder it is possible to find strong fears of separation that can lead the patient to experience an intense state of alarm at the thought that the significant other may move away (perhaps due to the presence of a “rival”) and direct his ideation towards terrifying fantasies of betrayal and abandonment.
Treatment of obsessive jealousy
The research shows that in the diagnostic setting and in the treatment it is important to pay attention not only to the phenomenology of the symptom but also to the cognitive components and the personological substratum.
The psychotherapy is the treatment of choice to solve the causes of obsessive jealousy.
The research highlights the effectiveness of cognitive-behavioral psychotherapy which, through the use of cognitive and behavioral techniques, aims at improving self-control and managing the cognitive-emotional component of jealousy.
In particular, the Schema Therapy approach has proven effective in the treatment of obsessive jealousy. This approach is aimed at recognizing and eliminating the dysfunctional patterns believed to be at the basis of insecurity towards the partner.
Finally, in cases where there is a complementarity between the behaviors of the partners, it is advisable to take a couple path that involves learning a series of strategies also in the partner in order to avoid jealousy from being fueled and maintained by his own behaviors. .
