Recent Developments in the Treatment of Nonpsychotic Morbid Jealousy: Introduction

Abstract

" . . . trifles, light as air, Are to the jealous, confirmations strong As proofs of holy writ." Othello, Act III iii, 323-5. Jealousy is a complex syndrome that fascinates the literary world and arouses the interest of social scientists, psychologists and psychiatrists. It is believed to be an innate part of a human condition influenced by culture. It is thought to be prevalent in cultures that favor sexual monogamy. In its mild form it can be viewed as evidence of love and care; some writers would call it possessiveness. When the emotional and behavioral aspects are beyond control, when jealousy torments its victims, harasses the partner and probably others, then it becomes morbid. Research workers had difficulty agreeing on a definition. This may be related to the differences in theoretical background, and the population subject to that particular study. Sociologists studying sexual or romantic jealousy will include the reaction to actual infidelity. To the clinician this may be viewed as normal jealousy, and the absence of a rival would be an essential aspect for the definition of morbid jealousy. The clinician would divide morbid jealousy into psychotic and neurotic forms. The present issue deals mainly with the neurotic forms of jealousy. Other classifications reflect the different theoretical backgrounds of the authors. The prevalence of the problem is unknown. Most studies report higher prevalence among men, yet the method of collecting the sample may influence the outcome (Tarrier, Beckett, Harwood, & Bishay, 1990). Shepherd (1961) provided a detailed account of the diversity of the clinical presentations. Tarrier and colleagues (1990) viewed the manifestations as responses in cognitive, emotional and behavioral domains. The central feature of morbid jealousy is the intrusive thoughts/suspicions about the partner's fidelity. In psychotic forms of morbid jealousy, the central delusions of infidelity are held with absolute conviction; in nonpsychotic forms they resemble automatic thoughts (Bishay, Tarrier, & Petersen, 1989) and are accepted without challenge. The clinical picture is further extended by the efforts of the patient to substantiate the clinicians' suspicions. Different attempts were made to identify etiological factors. Delusional forms were described in patients suffering from psychotic illness, organic brain disease and head injury, and affective disorders. The interaction of the jealous thoughts and the functional illness is complex and cannot be viewed as cause and effect. Different schools of thought offered psychopathological models. Some emphasized personality predisposing factors. The psychoanalytical literature emphasized the role of early mother fixation, repressed homosexuality, the Oedipal situation and the pathological castration complex. The behaviorists equated jealous thoughts and checking behavior with the ruminations and rituals of obsessive compulsive neurosis. Ellis emphasized the role of the culture and society as well as the individuals need for a partner's love, together with a pervasive feeling of inadequacy if that love is lost. A cognitive behavioral model (Tarrier et al., 1990) considered the central feature to be the individual's tendency to make systematic distortions and errors in the perception and interpretations of events and information. Activated schemata about the sexual behavior of other members of the opposite sex and the individual's lack of attractiveness play a role in maintaining these cognitive errors. Chemotherapy is suggested as the main treatment in the presence of an associated psychotic or affective illness. For the nonpsychotic forms of morbid jealousy individual and interpersonal approaches as well as communicationnegotiation skills were used. …