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Five women with excessive and irrational jealousy of their spouses have long defied my therapeutic efforts and have prompted me to explore the sources and the ramifications of conjugal jealousy. This paper presents my experiences and the formulations that have emerged from them.
A 36-year-old man suffered from pathological jealousy during three marriages. The episodes involving delusions of infidelity were usually preceded by premonitory symptoms. At first, the patient responded by discontinuing his medication (a phenothiazine) so that he might remain vigilant. Later he came to recognize the premonitory symptoms as signals indicating a need for help, and he would request hospitalization. In the periods between his marriages he was never troubled by feelings of jealousy. The chief determinant of delusions of infidelity in this instance, as in three reported by Docherty and Ellis, seemed to be exposure to the mother's extramarital sexual relations. This case, in which three different wives were subjected to the same pattern of behavior, would seem to be an exception to the rule that if marital problems occur both partners are responsible for creating them.
Literature on the treatment of marital jealousy has focused on individual and interpersonal awareness/insight and the use of communication-negotiation skills. This paper proposes an alternative viewpoint applying the problem-solving approaches of Erikson, Haley, Watzlawick, Weakland, and Fisch to the alteration of jealous systems. Through a detailed case study, the author describes the concept of the therapeutic triangle and the use of paradox and symptom transfer as potential contributions in the treatment of jealousy. Finally, the author discusses briefly a possible factor leading to the success of the systematic, problem-solving modality: serious playfulness.
The authors describe an unexpected coincidental finding in three couples who sought therapy because the husband was pathologically jealous. In the course of treatment they found that during early adolescence each of these men had witnessed his mother engaged in extramarital sexual activity. The authors discuss the implications of this finding for further understanding of the etiology of the syndrome of pathological jealousy, its transactional dimensions, and possible psychotherapeutic approaches. They also present a typology of morbid jealousy that consists of excessive obsessional-delusional, and ego dysfunctional forms.
Morbid jealousy can occasionally be indistinguishable from obsessive-compulsive neurosis and then be partially amenable to broad-spectrum behavioural treatment. This can involve the partner and includes (a) methods to reduce jealousy and (b) other methods where appropriate, such as social skills training, and sex and marital therapy. This pilot study describes such treatment of four jealous out-patients. Rituals improved in three patients but ruminations in only one. Of three patients who were depressed at the start of treatment, two improved in rituals and in mood. The patient who failed was poorly motivated and did not comply with treatment.
The data on sex pathology in alcoholic delusions of jealousy with sado-masochist behaviour are reported. Such behaviour was seen when the patients tried to force their wives to "acknowledge" infidelity. A total amount of 196 patients were studied. Abnormal behaviour was characterized by moral and physical torture of their wives and selftorture. They were mostly expressed at late night hours and were connected with a peculiar satisfaction of the "tormenting voluptuosness" (Lemke-Rennert). There was also a sexual excitation with a dissociation between high necessities and a dropped possibilities in the sexual sphere against the background of lowered potency and other sexual disorders. Moreover, there was a high level of general excitation with a narrowing of consciousness, vegeto-vascular changes, which are described during ciotus and a satisfaction of sexual necessities by perversions. A visualization of images related to jealousy was observed, which lead to an increase of the affective shading in delusions.
A 62-year-old female presented peduncular hallucinosis accompanied with outstanding manifestation of delusion of jealousy and erotic delusion in the acute phase of cerebellar infarction. The delusion seemed to appear as the swollen cerebellum was compressing the tegmentum of brainstem. CT scanning revealed the sequential images of the compression by the swollen cerebellum and deformity of the brainstem and their final recovery. The reason why the patient showed the outstanding delusion that is unusual in the ordinary peduncular hallucinosis is unclear. It might be brought about by the acute hydrocephalus induced by the occlusion of aqueduct.
Two cases of pathological jealousy are presented and their successful treatment with thiothixene is discussed. Evaluation of the projection mechanism is also presented.
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