Pathological jealousy: how to get rid of Othello syndrome

Problems associated with pathological jealousy have existed at all times and among all nationalities. Abnormal excessive causeless jealousy is a phenomenon that occurs in abundance in personal relationships, both in psychiatric practice and in court cases.

Pathological jealousy is not only a negative personality quality that directly harms its owner. This negative obsessive experience deprives the subject of control over his actions and provokes destructive antisocial behavior, which poses a real danger to others. It should be pointed out that untimely work to eliminate this quality can deprive a person of a full life, bringing him to the dock or making him a permanent patient of psychiatric clinics in departments with strict supervision.

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What is pathological jealousy: signs

The peculiarity of hypertrophied abnormal jealousy is such that the jealous person suspects without having evidence, and suffers for no reason. His experiences are obsessive, overwhelming and irrational. Jealousy completely takes over a person’s thinking and gives no peace day or night. Modern Othello is jealous, not understanding the reasons for his experiences. Jealousy does not allow the subject to control his behavior. A person gripped by this feeling commits stupid, reckless acts, not realizing the consequences of his actions. At the same time, a person’s behavior often creates a crisis in relationships, causes serious problems and causes inconvenience not only to other people, but also harms him.

Othello syndrome is a common term for jealousy in popular literature. This name is usually used to denote jealousy that has crossed the boundaries of normal feelings about one’s other half. However, pathological jealousy rarely acts as an independent symptom; it is often accompanied by delusional ideas, intrusive thoughts and antisocial behavior pattern.

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A typical sign of abnormal jealousy is the appearance of delusional components in thinking. The mistrust and suspicions of a sick person are devoid of any logic or basis. He cannot find a single argument that proves his half is unfaithful. At the same time, a person consciously makes efforts and spends time to find arguments confirming the betrayal of his life partner.

He becomes a detective, trying to find evidence of his husband's infidelity. A jealous person inspects his pockets, checks messages on his phone, and brazenly accesses his partner’s social networking pages. Some subjects suffering from pathological jealousy arrange real surveillance of their beloved. They accompany him to the office and meet him from work, and check the location of the companion during the working day.

Such individuals do not even allow the thought that their other half may have their own personal interests and needs. It is incomprehensible and strange for them that their husband has parents, friends, is passionate about sports and loves theaters. At the same time, the slightest absence without warning is regarded as an act of treason. The jealous person arranges a real interrogation of the “offending” person, not disdaining obscene language and sometimes going as far as assault.

Othello does not allow either flirting or coquetry, and he interprets other people’s glances at his partner as a deliberate conspiracy and conscious betrayal of the chosen one. A jealous person can install listening equipment in the house or equip the apartment with a video surveillance system, intending to uncover and expose extramarital affairs. Some people go to extremes: they use threats, blackmail, violence, trying to hear a sincere confession from their partner.

The delusional ideas that arise in a jealous person are very diverse, bright and fantastic. A jealous person may suspect that his companion is deliberately adding drugs to his food that impair potency, or even deliberately adding toxic substances to his food in order to poison him. Some people are convinced that their partner is cheating while they are sleeping. Therefore, they make an effort to stay awake at night and keep an eye on their chosen one.

Another sign of delusional jealousy is groundlessness and causelessness. It should be emphasized that pathological jealousy arises only out of the blue: the appearance of this obsessive feeling can be served by very dubious, and often completely erroneous, evidence of infidelity. This symptom distinguishes this pathological experience from the normal feelings of a person, when he is jealous only if there are convincing arguments confirming the fact of betrayal. At the same time, a healthy, adequate subject changes his point of view if it turns out that the information provided turned out to be false information.

A characteristic sign that jealousy has turned from feeling into pathology is obsession. Ideas about dishonesty and betrayal of a partner do not allow the subject to think about anything else. Horrible pictures appear in his head, colorfully describing the details of his partner’s betrayal. The obsessive idea of the infidelity of a life partner does not leave the sick subject even at night. His dreams entirely reflect his emotional experiences.

A sign indicating that pathological jealousy has reached the proportions of a psychotic state is the inadequacy of the person. An individual is capable of any illegal actions. The self-imposed attitude that the chosen one is dating another gentleman can lead to the jealous person thinking through plans to punish his opponent. He can plot against him, organize his beatings, damage his property, and in extreme cases, order his murder or decide to commit such a crime himself.

Thoughts about a spouse’s infidelity are provocateurs of anger, conflict, aggressive behavior and instigators of physical violence. Very often, a pathological jealous person is convinced that his chosen one provokes other people: she flirts with them, smiles sweetly, makes eyes at them. In such a situation, Othello may decide to punish the “unfaithful” lady. And since he is incinerated by the desire to be the only “master” of his companion, without whom he simply cannot live, the jealous man decides to cripple her so that the chosen one, confined to a wheelchair, cannot even think about other men.

A jealous person is often accompanied by suicidal ideas. Thoughts about suicide arise in a jealous person because he experiences a debilitating sense of guilt and remorse for aggressive actions towards his chosen one. The inability to eliminate one's obsessive experiences and change behavior pushes a person to take his own life.

Pathological jealousy poses a serious danger to the physical and mental health children raised in a jealous family. Such children often witness scandals and beatings. There are often cases when children themselves received unintentional injuries during such showdowns. A jealous person may also force their child to spy on the other parent. The result of such an abnormal period of growing up is various psychological problems and mental disorders in children.

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What causes pathological jealousy: reasons

If in nature, at the genetic level, there is rivalry between competitors for the possession of the most attractive partner, then jealousy is an acquired quality by a person. Most often, jealousy is formed gradually, based on flaws and weaknesses in the characterological portrait and reinforced by conscious or unconscious elements of personal experience.

The foundation for the emergence of pathological jealousy is a person’s sense of his own insufficiency. Most jealous people are hypersensitive to current events. These are impressionable and anxious people who are afraid of new situations and afraid of change.

The thinking of pathological jealous people is characterized by distortions and errors in the perception and interpretation of events and information. At the same time, they focus on the triggering event, analyze factors for a long time, build and convince themselves of erroneous assumptions.

Jealousy often takes root in a person’s childhood. A child who witnessed extramarital sexual relations of one of his parents and saw the subsequent showdown firmly fixes this event in his memory. As a rule, when parents divorce, children are the first to suffer. An immature person may misinterpret the reason for the separation of parents and believes that in order to preserve family relations You need to hold your partner firmly. An unhealthy model of relationships arises in the subconscious of a young person, in which the concept of love becomes equivalent to feelings of jealousy.

Jealousy is also reinforced by existing social foundations. In many cultures, the man plays the dominant role and the woman is seen as a subordinate object. Such traditions consider a kind of sexual “possession” of a lady to be the norm. The pressure of conservative views leads to the fact that any attempts by a woman to show her autonomy and independence are regarded as evidence of her infidelity.

Pathological jealousy can be the result of a person's decreased sexual capabilities. Moreover, with an objective decline in sexual function, pathology can start against the background of a one-time fiasco during an intimate meeting with a partner. Especially in situations where the companion behaved incorrectly when faced with a fiasco of a man. Having failed, a person convinces himself that he is insolvent and cannot be of interest to his partner. The inferiority complex in men is aggravated by thoughts about the insufficient size, in their opinion, of the penis. They convince themselves that they are not able to give pleasure to a lady, therefore, they cannot be interesting to her.

However, the desire to be loved and to have a loved one nearby requires him to take some measures. Doubts about one’s worth lead to the fact that a person begins to defend his “property”, that is, he tries with all his might to keep his partner. And since he cannot demonstrate his love in bed, he comes to the conclusion that his companion will definitely seek satisfaction on the side.

Another reason for pathological jealousy is tragic personal experience in relationships with the opposite sex. A person who has experienced a separation from a loved one not on his initiative becomes not only cautious in the future, but also very suspicious. The fear of once again experiencing the suffering of a breakup leads to the fact that the subject begins to be unreasonably jealous. Reinforces jealousy and excessive gullibility of a person. Rumors from neighbors, acquaintances, ill-wishers, and envious people help to doubt the infidelity of the other half.

The relationship between the occurrence of delirium has been proven adultery and alcohol abuse. Many jealous people regularly drink alcohol, and some even suffer from chronic alcoholism. Drug use can also aggravate destructive experiences.

How to get rid of pathological jealousy: providing help

To overcome pathological jealousy, various medicinal and psychotherapeutic treatment methods are used. To get rid of delusional ideas and correct behavior, a person is prescribed antipsychotic drugs. To eliminate a depressive state, it is advisable to use antidepressants of the SSRI class. It should be noted that the use of pharmacological agents in the treatment of men and women plays a secondary role. Medications affect the visible components of the pathology, but they are not able to influence the cause. Therefore, there is a high probability that destructive obsessive experiences will again capture the person after some time, causing even greater suffering.

For morbid jealousy, treatment with cognitive therapy shows good results. This technique successfully eliminates the traits of obsession in the patient’s thinking. During psychotherapeutic sessions, the client learns skills to control and manage their behavior. During psychotherapy sessions, he masters ways to relieve psycho-emotional stress. Another problem solved with the help of psychotherapy is the formation adequate self-esteem at the patient. Accepting one’s personality, recognizing existing characteristics, and understanding one’s needs help a person achieve harmony with the world around him.

Unfortunately, psychotherapeutic techniques eliminate only the rational components of pathological jealousy, without affecting the more complex aspects of a person’s worldview and thinking. Since the cause of such destructive experiences often lies in negative personal experience, then to eliminate it it is necessary to “return” to the past and work through traumatic moments.

It is possible to impartially examine personal history and discover the circumstances that served to build the foundation for dysfunctional thinking only with a temporary change in the state of consciousness. Eliminating censorship of consciousness and gaining access to the deep layer of the psyche occurs by immersing a person in a hypnotic trance - a state similar to half-asleep. Complete relaxation, removal of clamps, elimination of obstructive barriers allows you to find information about past events, memories of which a person cannot consciously reproduce.

During a hypnosis session, the patient, as if from the outside, studies his past and re-experiences traumatic situations. However, this time facing stressors does not cause discomfort and tension for him. The hypnologist helps the client re-evaluate the drama that occurred and reduce the importance of previously significant events.

During a hypnotic session, a kind of elaboration of a person’s personal portrait occurs. The carried out suggestion motivates the patient to transform harmful character traits into positive and useful qualities. frees a person from inferiority complexes and gives strength to reveal personal potential. After a course of treatment with hypnosis, a person receives complete freedom, freed from prejudices, misconceptions, and erroneous attitudes. He becomes a strong and independent person who does not require constant external confirmation of his worth.

Another positive aspect of hypnosis treatment is the complete elimination of problems in the patient’s intimate life if the difficulties were caused by psychogenic reasons. After hypnosis sessions, a person gets rid of the fear of the opposite sex and is no longer afraid of intimate contacts. Confidence in one’s own capabilities provides a particularly bright and rich intimate life. In turn, sexual satisfaction and the joy experienced from the fact that the partner is satisfied with the meetings help the person to become even more convinced of his need and relevance.

The undoubted advantage of hypnosis is the absence side effects and no risk of developing drug addiction. Hypnosis treatment procedures are comfortable for both men and women. Hypnosis sessions do not involve pressure or moral violence. Meetings between the doctor and the patient are confidential information, thus the absence of the threat of disclosure is another advantage for getting rid of pathological jealousy as quickly as possible.

Does being jealous mean loving? A very dubious truth! Often jealousy has nothing to do with love. But it is always connected with sex. Jealousy is an erotic feeling. And multicolored, like envy.

A man with faded, seemingly erased features who came to the editorial office introduced himself:
— I am a jealous person with 20 years of experience! Masha is my second wife. The first one ran away to the other. I decided to get married again when Masha and I already had a daughter. (Is it mine? Now I think not!) Everything changed after the registry office: the wife began to flirt recklessly, smiling invitingly at everyone. To reduce the number of reasons for jealousy, I forced Masha to quit her job. Now she helps me at my own company. It seems to be in sight all the time, but somehow manages to cheat on me.

This story was told to the journalist by a man who called himself Ivan. He passionately wanted to get rid of doubts and decided to subject his wife to a lie detector test. The most interesting thing is that he achieved his goal. But this did not save me from jealousy. After a detector study, which showed that his wife was quite honest with him, he concluded: she had already managed to bribe doctors and order fraudulent results.

So to what extent and depths can jealousy torment the soul? Is there a cure for it? After all, as practice shows, not only those who are jealous suffer from jealousy, but also the jealous ones themselves.

There is white jealousy

Let's conditionally assign appropriate colors to the types of jealousy. Just as white color absorbs all the tones of the spectrum, so normal, that is, white, not painful jealousy is woven from a whole palette of traits that can subsequently give rise to mental illness: aggressiveness, suspicion, dangerous behavior. The paradox of normal jealousy is that this negative feeling, which makes a person suffer, is given to us for our good.

There is a lot of value in jealousy. Biologically, this is a healthy instinct that mobilizes the best abilities to defeat a competitor in order to obtain better offspring. Socially, jealousy protects the family. Jealousy is justified psychologically as a slight psychosis, a shake-up that makes emotional life less monotonous. And finally, jealousy is beneficial intimate relationships, activating and refreshing them.

Research has shown that men are much more likely to be jealous. They sometimes commit suicide out of jealousy. Treason is a powerful blow to pride, a sense of ownership, and a death sentence to the sexual abilities of a male. After all, as they argue (and sometimes rightly!): a woman in bed with her lover can be hotter. With her husband, habit or female marital chastity often interferes with her. The passion of a wife in the arms of another causes unbearable pain to her husband, which is aggravated if he himself had a mistress. He involuntarily identifies the uninhibited behavior of his secret girlfriend with the similar behavior of his wife in his rival’s bed.

Blue jealousy

If the weak psyche of the jealous person cannot cope with the torments of Othello, the imaginary or real cuckold plunges into neurosis. He begins to see the world as monotonous. And not at all pink, but dark blue! Modern color psychologists associate this color scheme with increased anxiety. How can one distinguish a normal jealous person from a pathological one? Ordinary jealousy enhances love: the husband discovers in his wife virtues that were little valued before. At the same time, he exhibits intimate activity. Although he does not feel increased sexual desire, he only tries to “outdo” his opponent. A normal jealous person calms down if his wife denies cheating or declares that she cheated by accident and is not going to sin again. A normal jealous person does not even talk about imaginary paternity (that is, the idea that the children may not be his father simply does not occur to him). And this gives me hope...

Jealousy is green

Alas, an obsession gradually develops into an overvalued one. Jealousy turns into green hopeless melancholy. For example, a husband is blissful in Crimea, observing the free morals of his neighbors in a boarding house. One night, to the sound of passionate moans outside the room’s wall, he is struck by a realization: after all, my wife was also resting without me! And it is unknown who is now visiting her at home... The next day, the unfortunate man, without finishing his vacation, takes off, flies home and throws a terrible scandal at his wife.

Usually the syndrome of overvalued ideas blooms on the ruins of neurosis. In approximately two cases out of seven, internal psychological defenses are triggered, and the patient recovers on his own. Although, as a rule, “overvalued” jealousy is treated with medications.

Red jealousy is terrible

Any nonsense is already psychosis. Delusions of jealousy are an erotic type of persecution mania. Suspicions completely take over the consciousness, it is impossible to convince the patient. His reasoning is often absurd. It is absolutely clear that the man is talking nonsense: in five minutes his wife gave herself to a fellow traveler on a trolleybus, the number of her lovers is growing like an avalanche, reaching huge numbers.

The essence of delusion is the conviction that the wife is fundamentally vicious. She is capable of any kind of debauchery, even incest. This is red jealousy - bright, absurd, uncontrollable...

Jealousy is purple

Delirium of small magnitude is the most insidious variant of the disease. A person behaves reasonably in all areas of life: he succeeds, leads, defends his dissertation, but in terms of jealousy he turns out to be impenetrable. The purple delirium of jealousy is very well thought out. One reflection clings to another, making up a whole system of constructions. The wife washes herself in the shower - she washes away traces of sin. Did she receive a compliment? Her depraved appearance provokes familiarity.

This type of delusion is hidden and much more difficult to treat than acute delusions of red jealousy. Both types can alternate and replace each other. As a rule, delirium is accompanied by detective activity. Man eavesdropping telephone conversations wife, conducts investigative experiments, using a stopwatch to repeat the wife’s route to the market, to the store...

A sign by which one can recognize the delirium of jealousy at the everyday level is interrogation with bias. This same hero with whom we started our conversation conducted such interrogations methodically almost every night for many months. At about 12, he dragged his wife into the kitchen, sat her on a chair, shined a light in her face and pestered her with questions to which sometimes it was impossible to give an intelligible answer. "How could you allow yourself to have sexual intercourse? Where was your conscience?"

Delirium of jealousy, although a difficult test for the patient, contains a peculiar element of pleasure, a masochistic syndrome. It is often associated with sexual dysfunction. He definitely needs to be treated, and with the involvement of a sex therapist. “Cuckolds” (real or imaginary) are dangerous, because they are capable of murder, suicide, and any antisocial act.

You can recognize a jealous person right away. If not at the first meeting, then within a couple of days of communication - definitely. Delusions of jealousy do not arise out of nowhere. The flaw lies within the personality itself. It is not difficult to see a character initially prone to painful jealousy. The main features are being “stuck” in troubles, vulnerability, and fear of change. He is a bore, a selfish person, a pedant, with a low tolerance for disorder: if something is wrong, if the food is not prepared according to the recipe, he loses his temper.

If your husband is delirious and it comes to interrogation and torture, do not be an obedient sheep. Experts have discovered that when wives behave “submissively” and endure beatings and insults without complaint, the husband’s sadomasochistic behavior progresses. And the wife’s resistance, oddly enough, calms the patient.

Never admit to cheating, even if something happened! Learn to give win-win answers to the tormentor’s questions, even the wildest ones: “How could I cheat on you?! You’re my one and only...”

Keep in mind: jealousy is a family disease. In a sense, the delirium of jealousy is contagious - stress fluids spread to healthy people, especially traumatizing the child’s psyche if the children are aware of parental squabbles. So at some point you have to choose: either the jealous person or the children...

If your husband is not yet pathologically jealous, counter his mistrust with your wisdom. Behave in a way that reduces jealousy. For all occasions, have an iron-clad alibi. Don't linger over trifles. If you're behind schedule, call! Do not disappear without leaving your husband your coordinates. Spare the jealous person, have pity on him. Just as it is unethical to shame a husband for sexual weakness, which does not depend on him, one cannot reproach him for jealousy. Jealousy must be handled carefully.

Pathological jealousy is a rather serious and dangerous phenomenon that can lead to irreparable consequences. You can and should fight it.

There are few people in the world who have not had to deal with or experience jealousy. This is a rather unpleasant feeling, and pathological jealousy is also destructive. Most often, such relationships lead to divorce and psychological trauma for the victim of jealousy.

Often, a pathological jealous person also turns out to be a domestic tyrant who tries in every possible way to subjugate his partner and limit his communication with the outside world. However, even if this goal is achieved, scenes of jealousy do not stop; more and more new reasons are found for them.

What it is

In the case of pathological jealousy, this feeling arises for no reason and is not caused by any real external factors, but rather by personal internal problems and complexes.

Many experts are convinced that pathological jealousy is a disease bordering on mania, which, unfortunately, cannot be cured, but can only be temporarily suppressed.

Such a mental disorder either develops on the basis of constant suspicion and jealousy, or it was originally present in a person and, under certain conditions, worsened.

Signs

The clinical picture of the disease is expressed in a constant search for evidence of a partner’s betrayal, while the arguments of the other side are not heard or considered; rather, on the contrary, they are perceived as evidence of infidelity and an attempt to lull one’s vigilance.

In men

A woman can notice that a man is jealous based on a number of signs:

causeless aggression;
the husband’s refusal to kiss and tender hugs when his partner tries to show feelings;
constant reproaches with or without reason;
discontent and frowning and so on.

Even the most harmless things cause negative emotions:

meeting with a friend;
call from a colleague;
early departure or late arrival and much more.

Among women

The manifestation of pathological jealousy in a wife, despite the natural emotionality of the fairer sex, is not much different from that of a man.

One can only add to them:

refusal of sex with your spouse;
manic surveillance of the spouse: checking the phone, email, pages in social networks etc.

Causes

The most common causes of pathological jealousy are:

low self-esteem;
fear of loneliness;
doubts about the sincerity of the partner’s feelings;
decreased sexual function;
inability to love, etc.

Why is pathological jealousy dangerous?

This form of psychosis develops progressively and as a result can lead to tragic consequences:

Over time, a jealous person may begin to come up with options for revenge, carry a weapon with you and wait for the moment when you can catch the traitor in the act and use it.
It is difficult for a jealous person to control their emotions and resulting aggression. Often, an outburst of emotions can result in violence, both psychological and physical.
In addition, against the backdrop of an emotional outburst, delusions of jealousy may occur. When a partner is accused of all mortal sins. Most often, completely ridiculous statements and accusations are heard that have nothing to do with reality.
A jealous person may develop obsessive or overvalued ideas. In an attempt to catch a traitor, he can monitor his partner and check him in every possible way.
When delusional ideas arise the development of a more serious mental disorder - schizophrenia - begins.
Pathological jealous people are not only socially dangerous, but can also cause harm to themselves. According to statistics, 20% of jealous people attempt suicide, and some more than once. In addition, having inflicted serious injuries on his partner or even killed him, “Othello” most often kills himself. A reasonable question arises - what to do?

Treatment

A pathological jealous person usually does not recognize the existence of a problem as such, writing off his behavior and shifting responsibility to the object of jealousy, sincerely believing that his reaction is quite normal. Treatment of this condition is extremely difficult.

In addition, it is impossible to completely get rid of the manifestation of emotions. However, you can only try to learn to control yourself.

Some jealous people themselves get tired of such emotional outbursts, as a result of which they try to drown out jealousy with the help of:

alcohol;
cigarettes;
narcotic drugs;
eating problems;
work;
breakdown with loved ones;
sleep and other things.

Such “treatment” has a short-term effect and most often, on the contrary, aggravates the problem. The state of pathological jealousy is much more effectively alleviated by:

playing sports;
heart-to-heart conversations with colleagues and friends;
relaxation music and other relaxing procedures.

To alleviate the state of pathological jealousy, it is best to contact a qualified psychotherapist or psychologist. Manifestations of jealousy must be fought.

Most often, for this kind of painful manifestations, doctors resort to prescribing antipsychotic drugs. At the same time, psychosocial treatment methods are prescribed.

At the same time, the psychologist can give a number of recommendations to the object of jealousy:

Under no circumstances should you push your partner away.. A jealous person is in dire need of praise, care and affection, and it is necessary to appreciate not only some serious achievements, but also little things. In addition, you need to thank your partner for the pleasure brought in sex. You can praise both in private and in front of other people, excluding, of course, praise for sex.
Try to create a warm atmosphere in a relationship to make the spouse feel comfortable.
Keep your promises, do not deceive and try to always be open.
Demand respect for yourself, at the same time, not forgetting to respect yourself.
Stop any manifestations of violence both psychological and especially physical.
Frankness is important in relationships and trusting relationships. It is necessary to talk with your partner, discuss both problems and some everyday issues.

Among other things, you can create some family rituals and traditions. You don’t have to come up with something global, it could be a regular kiss before work, an SMS, going somewhere together, etc.

If you want to save the relationship, but for this you need to make every possible and impossible effort and fight to the end. At the same time, you need to be aware that if jealousy leads to violence, it is better to end the relationship, no matter how difficult and painful it may be. Having used force once, Othello will do it again and again.

Video: How to deal with jealousy

The defining, integral feature of pathological, or morbid, jealousy is the abnormal belief that the marital partner is unfaithful. The condition is called pathological because this belief, which may be associated with delusion or with an overvalued idea, does not have sufficient grounds and is not amenable to reasonable arguments. Pathological jealousy was examined in the works of Shepherd (1961) and Mullen and Maack (1985). Such a belief is often accompanied by strong emotions and characteristic behavior, but these in themselves do not constitute the essence of pathological jealousy. A husband who finds his wife in bed with her lover may feel extreme jealousy and, losing control of himself, do something bad, but in this case we should not talk about pathological jealousy. This term should only be used when jealousy is based on painful ideas, unfounded “evidence” and reasoning.

Pathological jealousy has been frequently described in the literature, mostly in the form of one or two case reports. It has been given various names, including sexual jealousy, erotic jealousy, morbid jealousy, psychotic jealousy, and Othello syndrome. The main sources of information are the results of their studies of morbid jealousy published by Shepherd (1961), Langfeldt (1961), Vauhkonen (1968), Mullen and Maack (1985). Shepherd studied the medical records of 81 hospital patients in England (London), Langfeldt did similar work with 66 medical records in Norway, Vauhkonen conducted a study based on a survey of 55 patients in Finland; Mullen and Maack analyzed the medical records of 138 patients.

The incidence of morbid jealousy in the general population is unknown. But this condition is not so rare in psychiatric practice, and most practicing clinicians see one or two such patients a year. These patients deserve special attention not only because they cause suffering to their spouses and families, but also because they can be extremely dangerous.

All evidence suggests that morbid jealousy is more common in men than women*. In three of the above studies, the ratio between men and women was: 3.76:1 (Shepherd), 1.46:1 (Langfeldt), 2.05:1 (Vauhkonen).

Clinical signs

As stated above, the main characteristic Pathological jealousy is an abnormal belief in a partner’s infidelity. This may be accompanied by other pathological

beliefs, for example, a patient may believe that his wife is plotting something against him, trying to poison him, deprive him of sexual abilities, or infect him with a venereal disease. The mood of the morbidly jealous patient can vary depending on the underlying disorder, but most often it is a mixture of distress, anxiety, irritability and anger. As a rule, the patient's behavior is characteristic. Usually he conducts a persistent and intense search for evidence of his partner’s infidelity, for example, through a scrupulous study of diaries and correspondence, and a thorough examination of bed and underwear in search of traces of genital discharge. The patient can spy on his wife or hire a private detective to spy on him. It is typical that such a jealous person constantly subjects his partner to “cross-examination,” which can lead to wild quarrels and cause fits of rage in the patient. Sometimes a partner, having reached complete despair and exhaustion, is eventually forced to make a false confession. If this happens, jealousy flares up even more rather than subsides. Interestingly, the jealous person often has no idea who the intended lover might be or what kind of person he is. Moreover, the patient often avoids taking measures that would provide irrefutable evidence of the guilt or innocence of the object of jealousy.

The behavior of a patient with morbid jealousy can be strikingly abnormal. A successful businessman, a representative of London's commercial circles, carried a machete in his briefcase along with financial documents, preparing to use it against any lover of his wife whom he could track down. A carpenter built a complex system of mirrors into his house so he could watch his wife from another room. The third patient, while driving, avoided stopping next to another car at a traffic light, fearing that while waiting for the green signal, his wife, who was sitting in the passenger seat, would secretly make an appointment with the driver of the neighboring car.

Causes

In the studies described earlier, morbid jealousy was found to occur in a variety of primary disorders, the incidence of which varied depending on the population studied and the diagnostic criteria used. Thus, paranoid (or paraphrenia) was observed in 17-44% of patients with pathological jealousy, depressive disorder - in 3-16%, neurosis and personality disorder - in 38-57%), alcoholism - in 5-7%, organic disorders - in 6-20%. Primary organic causes include exogenous ones - associated with the use of substances such as amphetamine or cocaine, but more often - a wide range of brain disorders, including infections, neoplasms, metabolic and endocrine disorders and degenerative conditions.

The role of personality traits in the genesis of pathological jealousy should be emphasized. It often turns out that the patient experiences an all-consuming feeling of inferiority; there is a discrepancy between his ambitions and real achievements. Such a person is especially vulnerable to anything that can cause and aggravate this feeling of inferiority, for example, to a decrease in social status or to impending old age. Giving up in the face of such threatening events, a person often projects guilt onto others, which can be expressed in the form of jealous accusations of infidelity. As already mentioned, Freud argued that subconscious homosexual impulses play a role in all types of jealousy, and especially in its delusional form. He believed that such jealousy could arise if these impulses were subjected to repression, denial, and the subsequent formation of a reaction. However, none of the studies reviewed above documented a link between homosexuality and morbid jealousy.

Many authors believe that morbid jealousy may be caused by erectile difficulties in men and sexual dysfunction in women. In studies conducted by Langfeldt and Shepherd, such a relationship was either not detected at all, or only minor evidence of its existence was obtained. Vauhkonen, however, reports sexual difficulties in more than half of the men and women he sees, but his data were partly obtained from a marriage and family counseling clinic. The prognosis depends on a number of factors, including the nature of the underlying mental disorder and the premorbid personality of the patient. There are few statistical data on forecasts. Langfeldt examined 27 of his patients after 17 years and found that more than half of them

still suffer from constant or recurring jealousy. This confirms the general clinical observation that the prognosis is generally poor.

Risk of violence

Although there are no direct statistics regarding the risk of violence in morbid jealousy, there is no doubt that the risk can be extremely high. Mowat (1966) examined patients with homicidomania in Broadmoor Hospital for several years and found morbid jealousy in 12% of men and 15% of women. In Shepherd's group of 81 patients with morbid jealousy, three showed homicidal tendencies. In addition to this, there is undoubtedly a significant risk of bodily harm caused by such patients. In Mullen and Maask's (1985) group, few of the 138 patients had been criminally charged, but approximately one in four threatened to kill or injure their partner, and 56% of men and 43% of women were aggressive or threatening toward perceived rivals.

Assessment of the patient's condition

Assessment of the condition of a patient with pathological jealousy must be thorough and comprehensive. It is extremely important to obtain as complete an idea as possible of his mental state; Therefore, you should first meet alone with the patient's spouse and then with him. Information about the patient's painful ideas and actions, reported by his wife, is often much more detailed than information that can be obtained directly from him.

The doctor should try to tactfully find out how firmly the patient is convinced of his partner’s infidelity, how great his indignation is, and whether he is planning to commit an act of retaliation. What factors provoke him to bursts of indignation, accusations and attempts to arrange a “cross-examination”? How does your partner react to such outbursts? How does the patient, in turn, react to the partner’s behavior? Were any violent acts committed? If yes, in what form? Was there any serious damage? In addition to this, the doctor should collect a detailed history of the marital and sexual life of both partners. It is also important to diagnose the underlying mental disorder as this will have implications for treatment.