1. The programme at a glance
Indication. The programme is for the adult whose jealousy, excessive but without delusional conviction, takes over life and the relationship: suspicions come back several times a day or take up hours, the person checks — phone, messages, social media, location, bank statements —, interrogates and constantly asks to be reassured, and suffers a great deal from it; they recognise at least at times that their jealousy is excessive, and they are asking for help with it. The programme is meant neither for ordinary jealousy, which does not call for treatment, nor for situations that belong to another manual or another service (section 4).
What comes before the indication. Safety comes before the indication. Before deciding whether to treat the jealousy, you look for whether it comes with violence, threats, coercive control — forbidding, monitoring, isolating, punishing — and whether the partner is afraid (section 3). The answer may suspend or replace the programme.
Reference model. There is no reference treatment for excessive jealousy, and the published studies are few and small (section 12). The programme therefore assembles components whose effectiveness is established in other indications, and says so: response prevention for checking and reassurance, taken from the treatment of obsessive-compulsive disorder; work on rumination, taken from the treatment of worry; cognitive restructuring of interpretations, the core of the rare studies on jealousy (Bishay et al., 1989; Dolan and Bishay, 1996); emotion regulation; and a few couple communication tools (section 7).
Format. The programme comprises twelve individual sessions, weekly, of 50 to 60 minutes. Session 2 is a meeting with the partner alone, offered systematically, which serves first of all their safety. Session 10 is an optional joint session, which only takes place if written conditions are met (section 31); otherwise, it is held individually. Three booster sessions follow, at one, three and six months. Section 15 justifies this total.
Mechanism targeted. The programme does not seek certainty that the partner is faithful, which exists in no relationship; it aims at four changes: that controlling behaviours stop, immediately; that checking and requests for reassurance decrease until they disappear; that suspicions and rumination stop taking up hours; and that the person can feel jealousy, fear and anger without acting at their dictation.
| Session |
Focus |
Session deliverable |
| 1 |
Assess, sort, secure |
Violence screened for, situation decided, written safety commitment, baseline measures |
| 2 |
The partner, alone |
Fear and violence screened for, resources handed over, worksheet 8 given |
| 3 |
Understanding the circle |
Circle drawn, goals written |
| 4 |
Checking and reassurance |
Inventory and hierarchy written |
| 5 |
Letting the urge pass |
First step of response prevention held |
| 6 |
Jealous thoughts |
Two interpretations examined |
| 7 |
Rumination and doubt |
Fixed time set up, distancing phrase written |
| 8 |
Progress review, and rising emotion |
Measures repeated, pause plan written |
| 9 |
What lies underneath |
Feared scenario worked on, core belief named |
| 10 |
Together, under conditions |
Written agreements, or individual session on communication |
| 11 |
A life of one's own |
Activities and ties outside the couple scheduled |
| 12 |
Review, plan, relapse |
Measures repeated, written plan |
What the person takes away. The person takes away nine printable worksheets, listed in section 38: my jealousy record, my circle and my commitment, my checking and my questions, letting the urge pass, examining a thought, when emotion rises, my own life, for the partner, my plan for what comes next.
What sets this programme apart from the other manuals on this site. It starts with safety, even before the sorting. It refuses to treat control as a symptom: the checking the person imposes on themselves is reduced step by step, but the surveillance, prohibitions and threats they impose on the other person stop straight away. And it gives the partner a precise place: seen for their safety and to be informed, never made responsible for reassuring, proving or monitoring the treatment.
2. Before you begin
The five preliminary decisions
Is anyone in danger? This is the first question, and it is asked before the others, at session 1 and again at session 2 with the partner alone (section 3). Violence, entrenched fear or coercive control change everything else.
Is the jealousy delusional? An absolute, unshakeable conviction, based on strange "evidence", calls for a psychiatric opinion and for Delusional disorder: a therapist's manual, not for this programme (sections 4 and 9).
Is there a cause to treat first? Alcohol, stimulants, a neurological illness, a medication, depression, a psychotic disorder: new jealousy in a person who had never been jealous, especially after the age of fifty, requires a medical assessment before any psychotherapy (section 9).
Should it be treated? An ordinary jealousy, proportionate to an event, which calms down when the situation becomes clear, is not an indication (section 4).
And do the suspicions have a basis? A discovered infidelity, repeated lies, an ambiguous relationship with a third person do exist. Assessing plausibility is part of the work, and the approach changes when the suspicions rest on facts (section 33).
What this programme does not treat
It does not treat coercive control. A person who monitors, isolates, humiliates, threatens or hits their partner belongs in a programme for perpetrators of intimate partner violence, where one exists, with the protection of the victim coming first (section 3). Work on jealousy can come as a complement, never as a substitute. Anger and intermittent explosive disorder: a therapist's manual describes, in its section 3, an identical line of reasoning for anger.
It does not treat what belongs to another manual: delusional jealousy (Delusional disorder: a therapist's manual), a broader obsessive-compulsive disorder (Treating obsessive-compulsive disorder in adults: a therapist's manual), a jealousy embedded in a borderline or paranoid personality (Borderline personality: a therapist's manual, Paranoid personality: a therapist's manual), nor overall relationship distress without violence, for which Couple therapy: a therapist's manual is often more suitable.
It is not intended for minors. In adolescents, jealousy intersects with the question of violence in first romantic relationships, which requires its own framework, with the parents and sometimes the child protection services.
How to use it
Read the whole manual before the first session, in particular sections 3, 4, 7 and 15 — safety, sorting, the model and the framework —, then sections 29 to 32 before the sessions that draw on them. Each session is described with the same structure: the objective, the steps, what you say, what you do not say, common errors, and the criterion for moving on.
Two warnings specific to this presenting problem.
The drift that most threatens is the investigation. The session can be spent examining the week's clues — this message, this lateness, this photo. The person asks for your opinion, you give it, they are relieved for an hour, and you have become one more source of reassurance. The agenda is your protection, and the partner's fidelity is never ruled on in session (section 15).
And the person in front of you is sometimes dangerous to someone who is not there. Their suffering, often sincere, draws compassion; it does not exempt you from asking the questions about violence and control, nor from seeing the partner alone. Most jealous patients are violent towards no one; you will only know by asking.
3. First of all: violence, control and danger
Why this section is placed here
This section is placed here because it is the only one that can suspend the programme, and because jealousy is at the heart of much intimate partner violence. In a case-control study carried out in eleven American cities, which compared 220 women killed by their partner with 343 women who were victims of intimate partner violence but alive, the risk of murder was multiplied by about nine when a highly controlling partner was separated from the victim after living together (adjusted odds ratio 8.98), and by a little under three when he was highly controlling without separation; it was multiplied by nearly five when the most serious episode had been triggered by the perpetrator's jealousy or by the victim leaving for another partner (adjusted odds ratio 4.91) (Campbell et al., 2003). A meta-analysis of seventeen studies of women murdered by their partner ranks among the most strongly associated factors the perpetrator's access to a firearm, prior non-fatal strangulation, prior rape of the victim, threats with a weapon, controlling behaviours and threats to harm (Spencer and Stith, 2020). And one of the twenty questions of Campbell's Danger Assessment asks whether the partner is "violently and constantly jealous" (Campbell et al., 2009).
These figures concern women who were already victims of violence, and almost all concern male perpetrators. They do not say that jealousy makes people violent; most jealous people are not. They say that, when it coexists with control, threats or violence, it is a danger signal.
What this manual is not
It is not a programme for perpetrators of intimate partner violence. Those programmes work on responsibility, control and respect; they are often part of a judicial response, and even they achieve modest effects on reoffending (Babcock et al., 2004, 2024).
And work on jealousy can worsen a situation of control, by wrongly reassuring the victim ("he's getting treatment") or by giving the perpetrator a vocabulary for shifting responsibility ("it's my morbid jealousy, it's not me"). Sociology describes under the name of coercive control a set of means — surveillance, isolation, humiliation, threats, control of money, sexual coercion — which deprive a person of their freedom in everyday life, with or without blows (Stark, 2007). Jealousy is often its stated justification. Johnson (2008) distinguishes this controlling violence, which tends to worsen over time, from situational violence, made up of conflicts that escalate without one partner seeking to dominate the other. What separates the two is not the intensity of the jealousy: it is control, with the fear and loss of freedom it imposes on the other person.
How to screen, on the patient's side
The questions are asked directly, at session 1, to everyone. Not "are you violent?", which always gets "no", but questions about behaviours: "When the jealousy rises, have you ever blocked the door, taken their phone by force, pushed them, shaken them, gripped their neck, even briefly? Broken an object? Threatened to hurt yourself, to hurt them, or to hurt someone they see?"
Control is looked for, since it does not show in the account of the crises. "Do you look at their phone without their agreement? Do you know their passwords? Have you installed location tracking without their knowledge? Can they see their friends, go out, spend money, without accounting to you? Have they given something up because of your jealousy?"
The question of fear is asked. "Has your partner ever been afraid of you?" It is the most useful question, and it often settles things.
Signs of high danger are looked for: strangulation, even once; an accessible weapon or threats with a weapon; death threats; violence that is getting worse or more frequent; a recent, announced or feared separation; harassment, following, surveillance after a separation; violence during a pregnancy; forced sex; threats of suicide if the other person leaves; alcohol or stimulant use associated with the crises.
Children are asked about: their age, their presence during the crises, their fear. A meta-analysis finds in children exposed to violence between their parents more marked difficulties than in unexposed children, which do not differ significantly from those of physically abused children (Kitzmann et al., 2003).
The history is asked about: police call-outs, complaints, protection orders, ongoing proceedings, violence in previous relationships.
How to screen, on the partner's side
The partner is seen alone, always, and asked, from the other side, what the patient is asked. The person who lives with the patient knows whether they are afraid, and will never say so in front of them. The couple is never seen together before each has been seen alone. This is the purpose of session 2 (section 17).
If the patient refuses this meeting, you note it, you do not make it an absolute condition, and you come back to the question of fear with more precision: a repeated refusal, accompanied by concern about what the partner might say, is clinical information. If the partner does not wish to come, you get worksheet 8 and the contact details of a helpline to them, through a safe channel and without going through the patient if possible.
What is decided next
No violence, no fear, no control imposed on the other person. The programme proceeds as described.
Surveillance behaviours, without violence or entrenched fear. The patient reads messages or looks at a location, but the partner is not afraid, moves about freely and confirms this alone. This is the most frequent indication for this programme, on one condition: whatever encroaches on the other person's freedom stops from session 1, through a written commitment (section 15). Only behaviours directed at oneself are reduced step by step.
Isolated violent acts, in a context of conflict, without control or entrenched fear. The programme is possible under four conditions: the act is named as violence, and not as a manifestation of jealousy; an explicit commitment is made — no physical violence, no threats, no destruction, no surveillance during the programme; the joint session does not take place; and the situation is rechecked with the partner alone at session 8 and before session 12.
Coercive control, entrenched fear, repeated violence. This is not this programme. You refer to a perpetrator programme, you make sure the partner has received the contact details of support services, and you tell the patient why: "what you are describing to me is no longer just jealousy; it is violence, and it is treated differently".
Signs of high danger. The approach becomes an emergency approach: protection of the partner and the children, specialist services, and, depending on the situation and the law of your country, emergency services or judicial authorities. Section 32 details the obligations and possibilities for reporting found in most countries.
All configurations
Controlling violence is most often exercised by men against women, and the most serious forms mainly affect women (Johnson, 2008). It also exists in same-sex couples, and women can exercise it. Excessive jealousy, for its part, is found in men as well as in women. The screening questions and the approach are the same for everyone.
4. Four situations not to confuse, and those that belong elsewhere
The same words — "I'm pathologically jealous", "my jealousy is destroying my relationship" — cover situations that do not call for the same approach. The literature speaks of morbid, pathological, excessive, obsessional or delusional jealousy, without a settled vocabulary (Kingham and Gordon, 2004). This manual sorts them into four situations, then lists those that belong to another manual.
1. An ordinary jealousy
What you observe. The jealousy arises in a specific situation — heavy flirting at a party, a former partner who reappears, a very present colleague —; it hurts, it sometimes leads the person to ask a question or talk about it, and it calms down when the situation becomes clear. The person sleeps, works and lets the other live.
What points the way. The jealousy stays proportionate to a real event, remains flexible, and subsides when the situation is clarified. Pfeiffer and Wong (1989) distinguish three dimensions of jealousy: suspicious thoughts, the emotional reaction to a real threat, and checking behaviours. The emotional reaction to a real threat — being hurt on learning that one's partner desires someone else — is an expected response. It is the other two dimensions that are a problem when they become invasive.
What it implies. There is no protocol to apply. One session, sometimes two, is enough to listen, to say that the emotion is understandable, to look with the person at what they do with it, and to leave the door open.
2. An excessive, non-delusional jealousy that takes over life and the relationship
What you observe. Suspicions come back several times a day, triggered by minimal clues — lateness, a smile, a "like", a changed password —, and develop into complete scenarios. The person checks, asks the same questions again and again, demands oaths, conducts interrogations, often at night. They feel relieved for a few minutes, then the doubt comes back: "maybe he deleted it". They feel ashamed after the crises, and the next crisis comes anyway.
What points the way. The person recognises, at least at times, that their jealousy is excessive, and their conviction fluctuates with circumstances. And the suspicion-checking-relief-doubt circle takes up time, in hours, with distress and impairment. Tarrier and colleagues (1990) describe this picture as a systematically biased interpretation of ambiguous events; Ecker (2012) links it to the obsessive-compulsive spectrum, because checking and reassurance play the role of rituals in it.
What it implies. This is the indication for this programme, after section 3.
3. A jealousy that controls
What you observe. The jealousy does not remain an inner suffering and questions: it is imposed on the other through rules, surveillance and sanctions. The person forbids friends, family, work, clothes. They demand passwords and install location tracking. They punish through scenes, silences, withholding money. They threaten. The other lives in fear, or organises their life to avoid the crises.
What points the way. You look for control and fear as in section 3, and have them confirmed by the partner seen alone.
What it implies. This is no longer the indication for this programme, but for a perpetrator programme, with the protection of the victim coming first (section 3). The boundary between the second and third situations is not always clear: this is why the immediate stopping of everything that encroaches on the other person's freedom is a condition of the programme.
4. A delusional conviction
What you observe. The person is absolutely certain of being cheated on, and nothing can shake this certainty; they rely on strange "evidence" — a stain on a sheet, a moved object, a car parked in front of the house, a code in a conversation —; they sometimes describe an imagined lover who comes in at night, marks on the partner's body, neighbours who are accomplices. The person is not asking for help with their jealousy: they are asking for help in proving it.
What points the way. The person has no doubt, even at times; the evidence is of a strange nature; and other psychotic or neurological signs may be present. Othello syndrome, named after Shakespeare's character, refers to this delusional jealousy.
What research says about it. Among 14,309 patients admitted to psychiatric hospital in Munich between 2000 and 2008, 72 had delusional jealousy (0.5%), with a higher frequency in schizophrenia and the other psychoses (1.3%); one in five was aggressive on admission, compared with 6.2% of all patients (Soyka and Schmidt, 2011).
What it implies. Ask for a rapid psychiatric opinion, assess the danger to the partner, and refer to Delusional disorder: a therapist's manual, whose sections 9, 33 and 34 deal specifically with jealousy.
The other situations that belong elsewhere
Five other situations are identified at the same time, and section 9 gives the criteria: a relationship-centred obsessive-compulsive disorder, where the doubt concerns one's own feelings rather than the other's fidelity, or where jealousy is only one theme among others; a jealousy embedded in a personality disorder, borderline or paranoid; a jealousy linked to alcohol or stimulants; a jealousy that appeared with a neurological illness, dementia or a medication, often late in life; and real infidelity (section 33). Each belongs to its own manual or to a medical assessment, and the partner's safety is assessed in the same way.
The three sorting questions
"When you are calm, away from a crisis, how sure are you that he is cheating on you, from 0 to 100?" It isolates delusional conviction: a stable "hundred", whatever the moment, changes the manual.
"Do you ever stop them from doing something, monitor their exchanges or movements, or are they ever afraid of you?" It isolates control.
"How much time a day does the jealousy take from you, between the thoughts, the checking and the discussions?" It measures its grip, in minutes rather than impressions.
5. The dimensions of excessive jealousy
Jealousy is not a simple emotion. It mixes fear of loss, anger at the partner or the rival, humiliation, sadness, and often a doubt about one's own worth. In practice, it breaks down into five dimensions, which need to be explored separately because they are not worked on in the same way.
Thoughts: suspicions, scenarios, rumination
What you observe. Suspicions triggered by ambiguous clues, developed into complete scenarios; questions with no possible answer — "what if he's thinking about her right now?" —; rumination about the past: former partners, a scene at a party three years ago, an inconsistency in an account. Pfeiffer and Wong (1989) call this thought side cognitive jealousy.
What needs to be clarified. The difference between a suspicion about a fact that can be checked once and a rumination that goes round for hours without producing anything. Only the latter is worked on as rumination (session 7).
Emotions
The person feels fear of losing, of being abandoned, of being replaced. They feel anger, at the partner or the rival, sometimes at themselves, and humiliation and shame, at being cheated on or at being so jealous. They also feel sadness, and self-doubt: "what has he got that I haven't?". Their intensity rises fast, within seconds, and it is during this rise that the most costly behaviours occur (session 8).
Behaviours directed at oneself
The person rereads past exchanges, looks at the public profile of a former partner or a colleague, searches for information online, mentally reconstructs the other's schedule, compares. They bring relief for a few minutes and keep the doubt going. They are reduced step by step (sessions 4 and 5).
Behaviours directed at the other
Those that make demands on the other. The person asks the same question ten times, demands an oath, insists on details, calls until they answer. These are requests for reassurance; they are reduced step by step, with the partner's agreement on how to respond to them (sessions 4, 5 and 10).
Those that encroach on their freedom. The person reads the partner's messages without agreement, demands their passwords, tracks their location, searches their belongings, follows them, sets traps for them, forbids them people or activities, controls what they wear. They are not reduced step by step: they stop (section 15).
The boundary is not always obvious. A question asked once, calmly, about a specific fact, is a couple's conversation. The same question asked for the tenth time at two in the morning is a request for reassurance, and it becomes coercion when the other cannot go to sleep until they have answered.
Digital surveillance
Phones and social media have multiplied both the triggers and the means of checking. Tokunaga (2011) proposed the notion of interpersonal electronic surveillance to refer to the use of profiles, messaging and other tools to keep track of someone close. Among 308 Canadian students, time spent on a social network predicted jealousy linked to that network over and above personal and relationship factors; the authors see in it a circle, ambiguous information discovered online prompting a return to it (Muise et al., 2009). Among 250 adults in a relationship, anxious attachment predicted both this jealousy and surveillance of the partner's profile (Marshall et al., 2013). These studies are cross-sectional. In practice, digital surveillance is asked about with precision: the person does not think of it as checking, they are "just looking".