Chapter 11

Morbid jealousy

For the emotion of jealousy which is triggered when a • Lack of trust.

sexual partner displays sexual interest in another person,
see Sexual jealousy in humans. • Verbal and/or physical violence towards the partner,
the individual whom is considered to be the rival, or
both.
Morbid jealousy, also known as Othello syndrome or
delusional jealousy, is a psychological disorder in which • Blaming the partner and establishing an excuse for
a person is preoccupied with the thought that their spouse jealous behavior.
or sexual partner is being unfaithful without having any
real proof,* [1] along with socially unacceptable or abnor- • Denying the jealous behavior unless cornered.
mal behaviour related to these thoughts.* [1] The most com-
mon cited forms of psychopathology in morbid jealousy • Threatening to harm others or themselves.
are delusions and obsessions. It is considered a subtype of
delusional disorder.* [1]
Overvaluing an idea, which is defined as “an acceptable,
Some symptoms of pathological jealousy include: comprehensible idea pursued by the patient beyond the
bounds of reason. The idea is not resisted and, although it is
• Accusing partner of looking or giving attention to not a delusion, the patient characteristically attaches utmost
other people. importance to investigating and maintaining the partnerʼs
fidelity at great personal disadvantage and to the distress of
• Questioning of the partner's behavior. the partner”. Overvalued ideas are characterized by being
existent in the individualʼs own thoughts, being egosyn-
• Interrogation of phone calls, including wrong numbers tonic; meaning that the ideas project the behaviors, values,
or accidental phone calls, and all other forms of com- and feelings that are aligned with the desires and aims of
munication. the individualʼs ego, or consistent with the individualʼs
• Going through the partnerʼs belongings. ideal self-image, the ideas are also amenable to reason but
are not resisted.”ix* [2]
• Always asking where the partner is and whom they are
with.

• Isolating partner from their family and friends. 11.1 Definition

• Not letting the partner have personal interests or hob- This disorder occurs when a person typically makes re-
bies outside the house. peated accusations that their spouse or sexual partner is be-
• Controlling the partner's social circle. ing unfaithful, based on insignificant, minimal, or no evi-
dence, often citing seemingly normal or everyday events or
• Claiming the partner is having an affair when they material to back up their claims.
withdraw or tries to escape abuse. Unlike other delusional disorders, people who suffer from
• Accusing the partner of holding affairs when the mar- this disorder have a strong association with stalking,
riage's sexual activity stops because of the abuse. cyberstalking, sabotage, or even violence. It can be
found in the context of schizophrenia and delusional dis-
• Suffering from the lack of reassurance. order, such as bipolar disorder, but is also associated with

49
50 CHAPTER 11. MORBID JEALOUSY

alcoholism and sexual dysfunction and has been reported the categories ofʻpsychoticʼ (delusional) andʻneuroticʼ
after neurological illness. jealousy contained similar proportions (each between
The name“Othello Syndrome”comes from the character in one-third and one-half).* [1]
Shakespeare's play Othello, who murders his wife as a result
of a false belief that she has been unfaithful. Recently some • Delusions: the individual's own thoughts are
workers have asserted that Othello was deceived rather than egosyntonic; they are regarded as true, and not
deluded about Desdemonaʼs alleged infidelity and thus did resisted.* [1] Some authors compare morbid jealousy
not have ʻthe Othello Syndromeʼ.* [3] to a delusional state (e.g. Enoch & Trethowan, 1979).
Beliefs may include the morbidly jealous subjects'
suspicion that 1. he or she is being poisoned or given
some substance(s) to decrease sexual potency by the
11.2 Psychiatric history partner, 2. that the partner has contracted a sexually
transmitted disease from a third party 3. is engaging
• Presenting difficulties: neurotic or psy- in sexual intercourse with a third party while the
chotic jealousy subject sleeps.
• Past psychiatric history: neurotic or
psychotic disorders, deliberate self-harm
and attempted suicide
• Family history: mental illness including 11.4 Causes
pathological jealousy
• Relationship history: incorporating both 11.4.1 Psychological
the current and previous relationship and
taking account of the quality of the relation- There are many psychological causes that go along with
ships and the difficulties experienced morbid jealousy. Some people equate morbid jealousy with
• Forensic history: previous and pending a delusional state.“Delusions of infidelity exist without any
charges and convictions as well as deviant other psychopathology and may be considered to be mor-
behavior which was not reported or did not bid jealousy in itsʻpurestʼform”(Kingham and Gordon).
result in a charge or conviction (including For morbid jealousy to occur oneʼs memories are subcon-
aggressive behavior and stalking) sciously changed and their partnerʼs actions are misinter-
preted as well to the extent that the person is absolutely con-
• Medical history: organic causes which may vinced of betrayal from the partner. It is thought that even
be responsible for the morbid jealousy* [1] some brain disorders might eventually lead to delusions of
betrayal. It has also been recorded by Cobb (1979) “that
morbid jealousy may be present with all types of cerebral
11.3 Forms insult or injury.”* [4] “It has been suggested that morbid
jealousy may potentially arise in response to reduced sexual
• Obsessions: the individual's own thoughts are function”. Cobb (1979) drew attention to the elderly man
egodystonic; they are acknowledged to be senseless, whose waning sexual powers were insufficient to satisfy a
and usually resisted. Jealous thoughts are experi- younger wife.
enced as intrusive and excessive, and compulsive be- Mullen (1990) considered morbid jealousy to be associated
havior such as checking up on their partner may fol- with four features:
low. Egodystonicity (the distress caused by thoughts
that are unwanted and viewed as contrary to conscious
wishes) generally varies a large amount between pa- • An under-lying mental disorder emerges before or
tients and “a continuum from obsessional to delu- with the jealousy
sional, which morbid jealousy has been suggested”(In-
sel & Akiskal 1986). • The features of the underlying disorder coexist with
• Extreme obsessions: much time is taken up by jeal- the jealousy
ous concerns, and there is a great difficulty in putting
the concerns out of the mind. Impairment of the • The course of morbid jealousy closely relates to that
relationship, limitation of the partner's freedom and of the underlying disorder
checking on the partner's behavior may occur. Al-
though a distinction was occasionally difficult to make, • The jealousy has no basis in reality
11.7. ASSOCIATED DRUG AND ALCOHOL USE
11.4.2 Personality
People who are very insecure or even fearful are more likely nia, neurosis, affective disturbances or personality disor-
to become anxious or question their partnerʼs commitment ders.* [9]
to them.“Insecure attachment style correlates strongly with
borderline personality organization”(Kingham and Gor-
don).
11.4.3 Environmental
Some people even believe that someone who is morbidly
jealous might suspect that he or she is being drugged or
given some kind of substance that might decrease their sex-
ual potency, or they might even be under the impression
that their significant other has somehow received a sexually
transmitted disease from another person while the subject
is unaware.* [5]
11.5 Epidemiology
There is no known prevalence of morbid jealousy; currently
there is no community survey tracking its existence in indi-
viduals. As of late, it is considered to be a rare occurrence.
*
[6] Still, many counselors encounter cases of morbid jeal-
ousy. Some clinicians may never be able to treat this con-
dition due to other dominating psychopathologies present
within the jealous person that call for more attention.
Men and women differ dramatically when it comes to mor-
bid jealousy. Men who suffer from morbid jealousy are
more likely than women to use violence and also are more
likely to harm or kill with their hands rather than a blunt
object. Women on the other hand, when using violence,
tend to use a blunt object or knife.* [7] Men focus on the
rivalʼs status and resources when it comes to the threat
of jealousy they fear. Women tend to become more jeal-
ous of a potential threat on their rivalʼs youth and physical
attractiveness.* [8]
11.6 Triggers
For men the strongest trigger is sexual infidelity and with
women the strongest trigger is emotional infidelity. If part-
ner related violence does not stop infidelity from happening
the male mate will sometimes resort to suicide instead. The
final resort to stopping infidelity inside of morbid jealousy
is to commit partner murder. Women are much less likely
to kill their partner, unless it is in self-defense. Morbid jeal-
ousy can occur in a number of conditions such as chronic
alcoholism, addiction to substances other than alcohol i.e.
51
morphine, cocaine, amphetamines. Organic brain disor-
ders i.e. Parkinson's, Huntington's. Also with schizophre-
11.7 Associated drug and alcohol
use
Alcohol and drug misuse has a well-recognized association
with morbid jealousy.“In two studies, morbid jealousy was
present in 27% and 34% respectively of men recruited from
alcohol treatment services”(Shrestha et al., 1985; Michael
et al., 1995). Amphetamine and cocaine increase the pos-
sibility of a delusion of infidelity that can continue after in-
toxication stops. (Shepherd, 1961).
11.8 Assessment
In an attempt to counsel or treat the morbid jealousy of an
individual, proper and thorough assessment must be em-
ployed. This approach is broad in nature, but necessary so
as to provide adequate information that will aid in the pos-
sible reparation of a dynamic containing a morbidly jealous
person. To begin, a careful history should be taken of both
partners if possible; separate and together. It is impera-
tive that a full and detailed psychiatric history and mental
state examination be recorded for the jealous partner; do-
ing so may enable one to distinguish whether the jealousy
is obsessional or delusional in nature. It is also possible that
the jealousy may be the result of a thought that has been
given too much importance. Considering that jealousy is a
very delicate issue, any reference made to it should be ap-
proached carefully and with tact. It must be kept in mind
that the jealous individual may be displacing blame for their
issues onto their partner and their alleged infidelity as op-
posed to their own behavior. If there is any history of rele-
vant or related mental illness and substance misuse it should
be noted as it may possibly be a contributing or aiding fac-
tor. In order to get the best grasp on the issues and begin
positive progression, multiple interviews should be held to
assess the marital relationship.* [10]
After completing the assessment, it is best to deliver infor-
mation about risk with both individuals in the relationship.
Due to confidentiality, the patient should give consent for
this information to be shared unless there is a risk to an-
other individual and it is serious and immediate. This is
the only case in which confidentiality is in invalid. The pro-
fessional should ensure that all necessary steps are taken to
guarantee the safety of a potential victim, keeping in mind
that it is possible that authorities may have to be alerted re-
52 CHAPTER 11. MORBID JEALOUSY

garding the matter. If the professional has reason to believe • Geographical separation of the partners
that there is a high risk of harm to themselves or another
person, the individual who is morbidly jealous should be • Social work involvement for child protection issues
admitted to hospital as soon as possible to prevent any neg-
• Alcohol and substance misuse treatment* [9]
ative outcomes for any parties involved.* [10]

11.10 Risks associated with morbid

11.9 Management
Morbid jealousy encompasses various psychiatric states and
the best way to approach treatment depends on the symp-
toms that are observed in the individual. Therefore, progno-
sis and outcomes vary from person to person and depends
on the situation and the complexities of the interpersonal
relationships being observed. Also, other issues that may
exacerbate the negative aspects of the environment created
by jealous behavior need to be addressed in order to begin
reparations. For example, if alcoholism plays a role in the
behavior in the morbidly jealous individual, treatment of
their addiction can positively affect their progress in trying
to change their jealous nature. While psychotherapy can be
an effective method of treating morbidly jealous persons,
it is not sufficient when the nature of their illness is more
serious.* [11] It is not possible to say that there is one form
of treatment that is superior over all those that are currently
available. * [12] Even though this may be true, cognitive be-
havioral therapy is the treatment that has proven to be most
effective. * [13]
Medical
• Treatment of the primary psychiatric condition
• Antipsychotic medication
jealousy
11.10.1 Confirmatory behaviors
When suspicions of the partnerʼs fidelity arise, they quickly
become all that is thought about. Certain behaviors such
as, interrogation of the partner, repeated telephone calls
to work and surprise visits, stalking behavior, setting up
recording devices in the home or work, or hiring a private
detective to follow the partner, are all common in trying
to determine if there is truly infidelity or if it is just per-
ceived. Individuals that are jealous may take drastic mea-
sures such as searching the partnerʼs clothes and belong-
ings, look through diaries and other communication meth-
ods (email, text messaging) even as drastic as examining
bed sheets, undergarments and even genitalia for evidence
of sexual activity.
11.10.2 Harm to self
Suicidal thought is unfortunately common in morbid jeal-
ousy, especially because of its association with depression
and substance abuse.

• Antidepressant medication
11.10.3 Risk to others
Violence can occur in any relationship tainted with jeal-
Psychological ousy, either normal or morbid jealousy. In a recent study
of jealousy by Mullen & Martin in 1994, 15% of both men
• Psycho education for the affected person and the part- and women reported that at some time they had been“sub-
ner jected to physical violence at the hands of a jealous part-
ner.”Culturally, jealousy may be even used to “justify
• Behavioral therapy violence towards partners.”Victims in a homicide case are
most likely to be current or ex-partners, in both female and
• Cognitive therapy male perpetrators. When a partner repeatedly denies infi-
• Individual psychotherapy delity this may provoke anger and extreme violence. On
the other hand, the partner that is suffering may give up
• Insight oriented psychotherapies and give a false confession, which in turn most likely will
provoke rage in the jealous individual. In the US a sample
• Family therapy was taken of 20 participants with delusional jealousy. 19
were male and Silva (1998) found that 13 had threatened
• Couple therapy to kill their spouse because of their perceived infidelity. Of
the 13 males, 9 actually attacked their spouse. Out of the
Social 20, a weapon was used by 3 of them, and 12 had harmed
11.13. SOURCES 53

their spouse. A presence of paranoid delusions and hallu- [9] Morbid Jealousy: The Green Eyed Monster. http://www.
cinations of injury to the spouse were most often associ- ijpm.org/Mod5.pdf
ated with violence. This suggests that individuals that suf-
[10] Kingham, Michael; Gordon, Harvey (2004). “Aspects of
fer from delusional jealousy that partake in violence may morbid jealousy”(PDF). Advances in Psychiatric Treatment
be solely driven by psychotic phenomena. A higher risk of 10: 207–215. doi:10.1192/apt.10.3.207.
assault was associated with alcohol consumption.
[11] Shephard, Michael (1961). “Morbid Jealousy: Some
clinical and social aspects of a psychiatric symp-
11.10.4 Risk to children tom”. Journal of Mental Science 107: 687–753.
doi:10.1192/bjp.107.449.687.
Children that live in a household with a parent that suffers [12] DeSteno, D. A.; Valdesolo, P.; Barlett, M. Y. (2006).“Jeal-
from morbid jealousy may suffer emotional and/or physi- ousy and the threatened self: Getting to the heart of the green
cal abuse as a direct result of the actions made by the par- eyed monster”. Journal of Personality and Social Psychol-
ent. Children may also accidentally overhear arguments ogy 91: 626–641. doi:10.1037/0022-3514.91.4.626.
or witness physical violence between their parents. They
could even be potentially accidentally injured during as- [13] Kellett, Stephen; Totterdell, Peter (2013). “Taming
saults. The morbidly jealous parent may employ a child or the green-eyed monster: Temporal responsively to cogni-
tive behavioural and cognitive analytic therapy for mor-
more than one to spy on the other parent. Unfortunately it
bid jealousy”. Psychology and Psychotherapy: Theory,
is not out of the questions for a child to see a homicide or Research, and Practice 86: 52–69. doi:10.1111/j.2044-
suicide where their parent is the victim. 8341.2011.02045.x.

11.11 See also 11.13 Sources

11.12 References • Enoch, D. & Ball, H. (2001) The Othello Syndrome.

In Enoch, D. & Ball, H. Uncommon psychiatric syn-
dromes (fourth edition) pp50–73. London: Arnold.
[1] Kingham, Michael; Gordon, Harvey (2004-05-01). “As-
ISBN 0-340-76388-4
pects of morbid jealousy”. Advances in Psychiatric Treat-
ment 10 (3): 207–215. doi:10.1192/apt.10.3.207. ISSN
2056-4678.
11.14 Further reading
[2] http://www.freethoughtlebanon.net/2012/10/
pathological-jealousy-its-symptoms-and-definition/
• Easton, J.A., Shackelford, T.K., Schipper, L.D.
[3] Crichton, P. Did Othello have 'the Othello Syndrome? Jour- (2008). Delusional Disorder--Jealous Type: How In-
nal of Forensic Psychiatry & Psychology. 1996;7(1):161- clusive are the DSM-IV Diagnostic Criteria? Journal
9. Available at http://www.informaworld.com/smpp/ of Clinical Psychology, 64, 264-275.
content~{}content=a789212336~{}db=all~{}order=page
• Easton, J. A., Schipper, L. D., & Shackelford, T. K.
[4] Cobb, J. (1979) Morbid jealousy. British Journal of Hospital (2007). Morbid jealousy from an evolutionary psy-
Medicine, 21, 511–518. chological perspective. Evolution and Human Behav-
[5] Kingham, M. and Gordon, H. Advances in psychiatric treat-
ior, 28, 399-402.
ment. Aspects of morbid jealous. http://apt.rcpsych.org/
content/10/3/207.full.pdf+html

[6] Enoch, M.D (1979). Uncommon Psychiatric Syndromes.

Bristol: John Wright. pp. 25–40.

[7] Easton, Judith, and Todd Shackelford. Morbid Jealousy and

Sex Differences in Partner-Directed Violence. Human Na-
ture 20.3 (2009): 342-350. Academic Search Premier. EB-
SCO. Web. 27 Oct. 2011.

[8] Easton, J.A., Schipper, L.D., & Shackelford, T.K. (2007).

Morbid Jealousy from an Evolutionary Psychological Per-
spective. Evolution and Human Behavior, 28, 399-402.