What About Jealousy?

“Hi Jon, I wonder what thoughts you have on jealousy. I have had some patients whose close relationships was very impaired by suspicions towards partners. They have a hard time trusting, they envision disloyalty and unfaithfulness, which causes great pain and rage. But what kind of rage? It is rage towards some hypothetical person doing hypothetical things with their partner. It is also rage towards the partner, but again based on something hypothetical. So it seems wrong to ask “what´s your feeling towards her for kissing your boyfriend?” Is this anger best understood as a defensive pseudo-anger, and that the real problem is a pathological superego telling the patient that she is not good enough? If the last is true; how would you go about to establish such a focus? Thanks in advance for any thoughts on this. ”

What about jealousy? What a great question. And he got the key point: the patient is jealous and angry about something that never happened! How do we understand that?

The patient, based on her past relationships, has feelings that arise in a new relationship. Those feelings trigger anxiety in her body. Then here is the key problem: she projects. “He will betray me or is already betraying me with another woman.” When she projects, she now responds not to what her boyfriend did. She responds to what she thinks he did. Thus, her anger and jealousy are in response to an imaginary, not a real, stimulus.

That fact will determine how we work. We never explore feelings toward an imaginary stimulus. We explore feelings only toward real stimuli that actually happened to the patient.

Now, back to our patient and her projection. In response to this projection she becomes angry with her boyfriend for a crime he has not committed. And she becomes jealous of a woman who has not had an affair. In these ways, her projection manages to punish her for being enraged with her boyfriend (the transference feelings related to previous figures).

We do not explore feelings toward a projection (boyfriend who is accused of betraying her but did not do so). That would only reinforce her projection onto the boyfriend. Instead, we have to help her see her projection. In fact, we eventually have to help her see that she is unfaithful to her boyfriend. Rather than relate to him, she is in relationship to another man (her fantasy boyfriend who betrays her).

Two things can help here. Helping her see her projection onto the boyfriend, if possible, is one route. Another is to keep the focus in the room with you. Ask about her feelings toward you. Why? Often, exploring feelings in other relationships is not possible because the patient’s perception of other people is filtered through her projections. As a result, you don’t get an accurate picture of what happened. And let’s not forget, you weren’t there. You can explore projections in a current relationship, but then the patient can respond, “But that’s the way it was! You have to believe me because you weren’t there!” And that’s true. Since you weren’t there, you are in no position to help her see how her projections were not confirmed by reality.

It’s much easier if you focus on her feelings toward you in the room. Then when she projects onto you, you can much more easily address it in the room. You will know what the stimulus was in the room. You will know what her feeling was in the room. And you will know if her projection onto you is accurate. As a result, you will be able to restructure her projection much more easily.

So let’s go back to the triangle of conflict that drives this clinical situation. The patient has mixed feelings (including rage) toward the boyfriend based on past relationships. Those feelings trigger anxiety. To avoid her mixed feelings, she projects onto her boyfriend. The results of the projection (rage toward the imaginary betraying boyfriend and jealousy of the imaginary woman in his life) have the function of punishing the patient. Why? They punish her for her transference-based rage toward the boyfriend.

Now, just one caveat. If the patient’s boyfriend had been unfaithful to her in reality, then we would explore her rage toward him. Why? Because her rage would have been triggered by a real stimulus, not an imaginary one.






4 responses to “What About Jealousy?”

  1. Brozio, Raimund; Germany Avatar
    Brozio, Raimund; Germany

    Hello Jon,

    thanks for sharing your knowledge and skills on istdp.
    Your observation that the jealous person is not in contact with the real partner but with a imaginary one is very interesting.
    What about patients who are contantly in kontact with an imaginary illness which they don’t have but might aquire like everybody else? Mostly cancer, heart attack or stroke.
    The constantly live in panic about this imaginary illness.
    How do you get a hook an this with istdp?

    Thank you very much.

    best wishes

    Raimund Brozio

  2. Jon Frederickson Avatar

    Dear Raimund,
    What a great question! Yes, what you describe is a well-known phenomenon which the psychoanalyst Edmund Bergler referred to as “misusing one’s fantasy life for the purpose of self-torture.” If we look at the triangle of conflict, there can be no doubt that tormenting oneself about imaginary illnesses is maladaptive, thus, a defense. So the question is: what is the feeling which the patient wards off through his defense? Usually, it involves anger toward someone, but the patient turns the anger onto herself through the cruel rumination. At the same time it is a lovely example of displacement: “Let me ruminate about physical illnesses. Then I can avoid facing the psychological illness I am demonstrating right now.” The therapist can sometimes bring the patient’s attention to the defense by asking questions such as, “Could this be a form of self-torture?” “Do you notice how you misuse your capacity for fantasy for the purpose of self-torture?” “Do you notice how you torture yourself now just after expressing anger at your father?” Help the patient see the defense and its function, then explore the feeling underneath, which the defense is designed to cover up. Thanks again for your question!

  3. John Carlson Avatar
    John Carlson

    Dear Jon,

    Thank you for the extremely thought-provoking blog. I have a question about your comments on not putting pressure to feelings attached to patient projection. My current sense is that part of ISTDP involves helping the patient to experience rising complex transference feelings toward the therapist, whether these be due to the therapist’s efforts to remove defenses or from a transference distortion. By your remarks, are you of the mind that transference distortions are only to be clarified without pressuring the client to experience fully his angry feelings, since they stem only from projection? My sense is that much of what takes place in the ISTDP relationship involves helping the patient to fully experience avoided anger that so often exists alongside projection and transference. Any thoughts you have on this issue would be most appreciated. Again, thank you for this highly useful blog.
    John Carlson

    1. Jon Frederickson Avatar

      Dear John, What a great question! When the therapist explores the patient’s inner life and problems, the patient’s feelings and anxiety will rise. If the patient reports feeling angry with us while we explore his feelings, we will explore his anger. If the patient begins to distance from us, using a transference resistance, we will identify his resistance, and then ask about the feelings toward us that lead him to put up that wall. Here, the feelings arise toward the therapist due to a stimulus in reality: the therapist tries to form a more intimate relationship with the patient.
      Sometimes, a patient has a feeling, becomes anxious, then uses a defense of projecting to avoid conflict. The patient may project his feeling and believe the therapist is angry. Or the patient may project his superego and believe the therapist judges him. If the patient equates the therapist with the projection, loses his reality testing, uses other regressive defenses, and his anxiety is in cognitive/perceptual disruption, we will restructure the projection to improve reality testing, and deactivate projective anxiety (anxiety resulting from the projection).
      If anxiety is in the striated muscles, explore feelings toward the therapist as fully as possible. When anxiety goes into the smooth muscles and cognitive-perceptual disruption, other defenses are regressive, and the patient is losing reality testing, restructure the projection. Also, keep in mind whether anger is in reaction to a real stimulus (the therapist addresses defenses and explores the patient’s inner life) or in reality to an imaginary stimulus (“I’m angry at you because I can see from your eyes and your comments that you are judging and criticizing me.”).

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