Tag Archives: Morbid Jealousy / Othello Syndrome

How is Morbid Jealousy diagnosed?

Clinical Case Studies

Her son wants her to see me, thinking that the mother couldn’t let go of the past, and has always been picking fights so much that the home is never felt peace. So she came.

When I asked about her relationship with the husband, she said they are always fighting. “Which couple wouldn’t? We face each other 24/7. We live together, work together, go out and in together. It’s normal right (that they fight all the time)?” I tried to imagine, being married for about 40 years, facing each other 24/7, yea, perhaps she’s kind of right (deep inside I still don’t feel right, especially if there is only “fight” between them). So we continued to talk about her children, grandchildren, work, neighbour, leisure etc. And I figured that her life is all about this family for the past few decades, she’s never seen the world outside, and she feels miserable in the family, that she’s sacrificed so much for the family but is not treated fairly and nicely by the members in it. So I helped her to find out what she used to love when she was young, and wanted her to look into engaging in these activities again.

What concerns me took place during our second session. She said she has nobody to talk to about “these things” for the past so many years. “Even if I said it, nobody believed me, they all think that he’s a perfect dad.” She told me the husband is always flirting other women, including her own sister, their maid, neighbour, and now daughter-in-law. I was slightly shocked, because I’ve heard a lot about the family from the son, in my mind, her husband is a traditional but good dad, except that he’s bad tempered and uses swear words when he’s angry. But I listened on.

She gave examples. She told me a few incidents that she observed. She even questioned the husband when things happened. But that only led to arguments, as the husband always denied it, and the children always sided their father. She felt alone, unfairly treated, and disappointed. (What do you think at the point?)

Some of the incidents she observed are: the husband peeping the maid while the latter is taking shower; the husband’s hand gesture was very close to the daughter in law’s face which she deems very inappropriate as a (asian, traditional) father-in-law; the husband used very gentle voice to speak to the daughter in law; the husband was chatting up with her sister. It’s mainly surrounding in themes of this sort.

She has told me not to tell her son or anyone about these. She doesn’t want to spoil their father’s image, and she knows nobody would believe what she says anyway, because they are never really there, she’s the one who spends so much time with him. She also thinks the husband will “lose face” if these things are broken out in the family.

When I was listening, I had “morbid jealousy” (read more here) in my mind. But at the same time, I know it’s also possible that the husband is really “that kind of person” (sorry for being judgmental, I’m a woman, haha). It’s not quite possible to confirm either way, unless I have a third party in the family who can tell me more, but I’m not allowed to share these with the members in the family since that would break confidentiality and trust.

So I’m going to continue digging without causing suspicions in the family. I’ve seen quite some cases of morbid jealousy in the past few years, the diagnosis is always confirmed with the statements of the spouse and/or family. Is this diagnosis possible without presence of another party?

Do email/whatsapp me if you suspect that you or your partner might have the condition, or you would like to know more about the treatment. There is also a quiz you can do here!

N.B. I’ve noted this else where in my blog, but I think it’s important to again emphasise that all cases under my “Clinical case studies” category are written either agreed by the patient and family OR modified/combined so that it’s not possible to trace back to the person. 

Substance-Induced Psychosis & Addiction-Linked Divorce

Clinical Case Studies, Issues & Debates, Schizophrenia & Psychotic Disorder, ,

When I was doing my master back in the uni, I remember one of the presentations I did was about substance induced schizophrenia. That was just about 4-5 years ago, but I can’t quite remember the details, though I’ve always remembered that one of the triggers of schizophrenia was illicit drugs, I had a diagram in my powerpoint showing how much it contributed to the population with schizophrenia and related illness.

After starting to work in the clinic in KL, I’ve encountered quite some patients who have had a history of taking ecstasy pills or other drugs and have led to psychotic episodes. For the majority of them, their family members took charge and managed to stop them from continuing taking illicit drugs (by stopping them from mixing with so-called “bad friends”, moving to different or new environment, cutting off their finances, threatening to cut off their relationship with the subject etc).

Recently I’ve had this big man, who has had a long history of taking aramine and ecstasy pills, and is seeing the psychiatrist for his anxiety (no, he didn’t show signs of psychosis). He once told me that everyone has their way to release stress, some people go exercise (like me), some go shopping, some watch movies, some do gardening, some just need a good sleep, and for him, he hangs out with his friends, singing karaoke, and… taking pills, spending their nights high. During Chinese New Year, he could be drugged for over a week continuously. Though on normal days, he works, he goes gym (hence he’s called big man, as he’s not just fit, but muscular – like a staff always says, he doesn’t look like a typical drug abuser), he looks after his wife and children. Oh yes, I didn’t mention that he has a family. The wife is lovely, supportive, and all good qualities you can expect from a traditional Chinese woman.

Each time he tries to quit the pills, he would experience a moody state which lasts for two to three weeks, with fears, insomnia. Normally the psychiatric medicine that he’s taking will bring him back to normal and functional. The last time I heard from him after Chinese New Year, he said this round he would definitely quit it, he would stop seeing those friends (I later learnt that it’s much harder because one is actually his business partner), he wouldn’t want to have relapse again and again, and he doesn’t know when those drugs are going to destroy him (his brain/mind), and his family… because the wife said if he takes it again, she’s leaving him (I still remember he said “妻离子散”, such powerful words). I believed what he said, for I know how much he loves his wife.

On last Monday I encountered a motor vehicle accident and had to take the day off. On this very day, big man’s sister called up to the clinic saying that he was really unstable, as the wife brought the kids back to her parents’ house, big man was threatening to cut his wrist (which he did later on). The family members were advised to admit him to psychiatric wards in general hospital. On Thursday when I was at work, big man came with his father (who is also our patient but is in good remission and maintaining with a minimal dosage). The wife called to tell me what had happened this week. She said big man has become really paranoid and delusional recently, always suspecting that she is unloyal to him. On the Sunday before, he went outstation with his business partner (aka one of the bad friends), and spent the night being high, and had called her on 5am, questioning her about the man she kept, threatening that he would do her harm when he came back later. On the next day, he beat her up after being really angry for “what she has done behind him”. That’s the day she had to run away from him with the children, even after he sliced his wrist twice, she didn’t go back, she knows the children’s safety is the utmost important and her husband is not her husband anymore.

What the man presents, is what we call Morbid Jealousy, or Othello Syndrome (an old case study here). He was never delusional or paranoid during the years he was seeing us. He was just having anxiety and fear over some life issues, and is a perfectionist. I believe morbid jealousy is related to paranoid schizophrenia or other psychotic illnesses, and so I can’t help thinking the links between his history of substance use, and the development of his morbid jealousy. From a lot of cases that I have observed, suffering from schizophrenia or other mental illness don’t usually make your partner leave you, quite often the partner can even tolerate morbid jealousy despite how frustrating it can cause and how destructive it is to the relationship; but being mentally ill, having addiction yet refused to go into rehabilitation, and beating wife, that’s the bottom line for any woman, I believe.

N.B. this post was written in March 2016. According to the sister, big man passed away jumping off from a building at the end of March, after calling the wife and speaking to her. 

Is this Morbid Jealousy? – Social Media

Clinical Case Studies, Issues & Debates

We talk a lot about trust in relationships. It’s like the fundamental of any relationships, it’s probably quite easy to lose it with one small action in a few seconds, but to rebuild it can take ages, or forever.

This is a young girl born in 1990s. She knew her current boyfriend of 4-months through an online game then moved on to social media. After meeting each other, they also exchanged phone numbers and start to connect through Whatsapp.

She doesn’t want to be a control freak. But she recently realized that the boyfriend seems to be less caring. Sometimes they don’t talk to each other for whole day. She thought they should still be in the honeymoon phase, how did it end so fast? Sometimes she’d see that her boyfriend was last seen early in the morning on Whatsapp, but he didn’t talk to her, so who did he talk to at such early hours?

So one day when they were out dating, she found a chance to check on his phone, and found this girl’s phone numbers who the boyfriend appeared to be chatting with quite often on Whatsapp.

She wrote down the girl’s numbers, and added it to her phone book. So now the girl’s whatsapp account also appears on her phone. She started to monitor when the boyfriend and this girl are online, whether they are online on the same time, and whether they’re last seen on the same time (one of Whatsapp’s features, it tells you when the contact last online/seen). She’s getting almost obsessed with this checking, especially when she found that they appeared to be online at the same time so often.

At the end she confronted the boyfriend, and ended the relationship, without even finding out that the guy was really cheating. She couldn’t stand it, couldn’t stand the fact that the guy MAY be chatting to somebody else so often, and what’s most, she couldn’t stand her own checking behaviour. She knew when there is no trust in a relationship, the relationship will never work.

Sometimes I’m really not so sure if social medias bring us more benefits or hazards. When people sit in front of each other but do not look at each other, do not talk to each other, but look at the phone and chat with the persons over the phone. Is this still considered as social interaction? Perhaps it isn’t a bad thing when people use it to know more friends and to look for companions, but now people even use it to check on partners, is this still a healthy act?

Is what she does considered morbid jealousy? Can social media now function as a tool to check on partners?

(See more about morbid jealousy and a clinical case study here.)

Morbid Jealousy

Clinical Case Studies

There was this young beautiful girl, who from the age of 16, got into her first relationship with a working guy. She then became so obsessed, and had the delusions that the boyfriend was flirting with other girls, having an affair with others etc. She skipped classes, and went to her boyfriend’s working place to “watch over” him, see what he was doing, who he talked with…

Over the years the girl got into various relationships, because of how beautiful she is, guys get attracted, and when she becomes attached, she also gets really obsessed and possessive, especially when the guy having any contact with other girls, despite how faithful the guys were. The girl slowly realized this a problem, and consulted a psychiatrist. Over the years she also gained insight with her problem — a condition now called “morbid jealousy”.

Morbid jealousy is a psychiatric condition where the person holds strong belief that his/her partner is being unfaithful without any convincing or “solid” evidence that this belief is true. It tends to happen over and over again no matter how many partner this person changes and how “innocent” the partner is.

It is getting to quite a common condition nowadays. As we would probably all expect that conditions like anxiety disorders and depression would be a lot more common, now probably every 1 in 10 people with a psychiatric condition comes to the clinic due to this problem, although most of them may not understand this as their problem (but only think that they can’t sleep, get anxious easily, feel unhappy, got no appetite, is bad-tempered, gets agitated easily… which can simply appear as anxiety depression).

Here it’s important to clarify that morbid jealousy doesn’t apply when actually you find some convincing evidence, or when you are just feeling a bit insecure whether your partner gets a bit too close to someone (yes, just a bit insecure, which does not affect your life that much, and problem may simply be solved after you speak calmly with your partner), or when it’s just part of a more sensitive type of personality.

For the patient’s partner to come to understand that their partner has this problem would be helpful to the patient, and being understanding, considerate, supportive and patient to the patient will be significant to the process of recovery.

N.B.: This was first posted at huibee.blogspot.com by the same author