Question 1

How do you work with patients when they present with intense jealousy that is "rational", that is; as a reaction to an actual betrayal in their relationship?

Robert Leahy · Accepted Answer

This is not uncommon since many people may find themselves in a relationship that has led to betrayal. As I mention in my book, The Jealousy Cure, it is important to validate and normalize these feelings, since we, as humans, are going to find ourselves having unpleasant feelings we wish we never had. Telling someone not to feel jealous about a betrayal seldom works and I have found that the best approach is to validate the pain and to link the pain to the values that the person holds dear. For example, you can validate someone by saying, “It hurts so much for you since you value commitment, honesty, and trust, and this has let you down in a profound way”. 
The goal is not to eliminate the jealousy, but to avoid getting overwhelmed and hijacked by it. There are a range of techniques that we can use. First, we can examine what the betrayal means to the person. This can include viewing it as a personal failure, “I wasn’t attractive enough” or over-generalizing, “No man (woman) can be trusted” or catastrophizing, “My life is over”. We can examine how these thoughts may be understandable at the moment but may not be reasonable. Second, we can challenge these negative thoughts. For example, rather than personalize the betrayal we can view it as a problematic behavior of the person who violated our trust. We can examine evidence that people often can be trustworthy, rather than condemn an entire gender. Third, we can reduce the sense of catastrophe about losing the relationship. We can try to understand that our lives can return to what we had before the relationship, by giving ourselves credit for the capacity we have for other meanings in our lives, such as work, interests, friends, and future relationships. Fourth, we can increase the social support that the person has so that everything is not based on retaining this relationship.

Question 2

Where do you draw the line between jealousy and relationship OCD? e.g., how would you help someone who is obsessed that their partner is cheating on them, even though it is very unlikely and is checking their partner's phone and building fake social media profiles to keep tabs on them?

Robert Leahy · Accepted Answer

This is a good question because jealousy may often simply be an emotional statement that someone matters enough to them to feel jealous about. In fact, some people early on in a relationship may try to make their partner jealous to test out how much they are interested in them. Relationship OCD is another way of viewing the jealousy as hijacking the person. They keep checking, trying to control, interrogating, and other “mate-guarding” behaviors. A certain amount of jealous thoughts and feelings are normal and often will decrease as the relationship becomes more secure and there is more commitment on the part of both parties. But relationship OCD involves eliminating any possibility of jealousy, and this is an impossible task. There is no certainty in an uncertain world, and recognizing that the safety behaviors only drive you apart from each other is an important first step. I work with patients to experiment with giving up the surveillance to see if this makes them more or less anxious. Usually, they feel more anxious at first, but over time their anxiety declines. This is a kind of exposure with response prevention—that is, allowing yourself to accept your jealous thoughts without “neutralizing” them through checking behavior.

Question 3

How do you help someone who has been cheated on multiple times in the past and is traumatized by relationships?

Robert Leahy · Accepted Answer

This is often a source of jealousy because the person has built up a strong belief that they will be betrayed. I find it helpful to normalize some distrust and to validate the jealousy as a legitimate feeling. The question is whether it has become over-generalized to all partners. You can look at the kinds of choices that you made with previous partners. Were they rebellious, untrustworthy, lacking character? Perhaps the evidence was there but you ignored it. Some people are drawn toward excitement, charisma and challenge, but that is seldom a good basis for a lasting committed relationship. I think it is important for partners to have honest discussions about what they are committed to. If one partner wants an open relationship while the other wants monogamy you will have serious problems.

Question 4

What is jealousy and what makes it pathological?

Robert Leahy · Accepted Answer

Jealousy is a powerful emotion that occurs when we believe that a relationship that feels special to us is threatened by a third party. Jealousy always involves at least three people. For example, “Is my wife interested in someone else?” We can feel jealous about our romantic partners, friends, siblings, and coworkers. The question that arises for us is whether our partner (friend, sibling, etc.) is interested in or is getting attention from another person. We feel that our “primary” relationship is threatened. I have suggested that jealousy is a universal emotion found in all cultures, although the triggers for jealousy may differ for individuals and for cultures. We can see jealousy in infants as young as 12 months and in our pets.  The research shows that dogs are more jealous than horses, who are more jealous than cats. 
	I wrote The Jealousy Cure: Learn to Trust, Overcome Possessiveness, and Save Your Relationship (https://www.amazon.com/Jealousy-Cure-Overcome-Possessiveness-Relationship-ebook/dp/B075SSC9HV) because I could see a lot of people were suffering from their jealousy or from the jealousy of their partners. Conventional wisdom often is naïve about jealousy, equating it with low self-esteem or telling the person to just stop feeling this way. None of this helps. Indeed, jealousy can be related to higher self-esteem for some people because they insist that they will not be treated disrespectfully. 
What makes it pathological is when it leads to excessive anxiety, rumination, worry, anger, hostility, clinging, and feelings of hopelessness. For example, is your jealousy occupying a lot of your time and energy, keeping you from getting sleep, making you angry, anxious, depressed, and hopeless, and interfering with your relationship? Are there people and places that you avoid because of your jealousy? Are you having more conflicts with your partner, or are you avoiding your partner? Jealousy is the leading cause of domestic homicide.
 I distinguish between jealous thoughts/feelings and jealous behaviors. For example, the jealous thoughts—“My partner is interested in someone else”—can often lead to jealous behaviors, such as interrogating, accusing, threatening, withdrawing, and surveilling. The jealous person believes that these behaviors will help them get the information that they need to determine if their partner is interested in another person. But these behaviors can also lead to further alienation from the partner and even the termination of the relationship. We can think of these behaviors as “safety behaviors” because the jealous person believes that this will assure safety and reduce uncertainty. However, they seldom make you safe but rather add to the conflicts in your relationship.

Question 5

What's the difference between jealousy and envy from a CBT point of view?

Robert Leahy · Accepted Answer

Jealousy is about a threat to a significant relationship—often an attachment –for example, romantic partner or sibling rivalry. We fear that we may lose that relationship. Envy is about a threat to our status or our position in a dominance hierarchy, where we believe that someone else’s achievements or personal qualities threaten our own status. We can be envious of someone we feel jealousy toward. For example, you might envy the attractive qualities of the person flirting with your partner. In this case, the envy is that the other person has qualities that you believe you lack and the jealousy is that their attractiveness is viewed as a threat to your primary relationship. However, it is typical for people to use these terms as if they refer to the same thing, but they do not. 
Think about the idea of the evil eye, which we find in a wide range of cultures. The evil eye is that you are reluctant to say positive things about yourself since this will trigger the envy of other people. It is instructive to know that the word “envy” comes from the Latin word videre, to see. We fear being seen and envied and so the evil eye that others direct toward our accomplishment is to be avoided. People wear amulets to redirect the evil eye elsewhere. Since envy is about status we can examine whether you need to view yourself primarily in terms of status. I ask my patients to consider viewing their lives as a large pie with different pieces of various sizes representing meaningful parts of their lives. For example, someone who is envious because someone has gotten a promotion can consider the different sources of meaning in their lives. This might include roles within the family (parent, child, sibling), friendships, interests, hobbies, being a member of the community, and other meaningful roles that we engage in. We can also ask ourselves, “What can I still do even if this person has gotten “ahead” on something? For example, list all the activities that you can do in the next year that you can still do and all of the activities that you cannot do as a result of this person getting “ahead”.”  When we are envious we have tunnel vision focusing on a limited part of our lives to the exclusion of the many meanings in our lives. Finally, we can ask how someone who is not doing as well as you are doing can function and how they should feel. Ironically, many people who are envious don’t realize that there are people who envy them.

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