Going to counselling is hugely helpful for people who are stuck, depressed and in pain. Exploring our thoughts and fears with an empathetic counsellor who really hears us.

But for people who feel consumed by intrusive thoughts about their partner’s past, counselling doesn’t work.

I’ve tried to make counselling work

About seven years ago, a guy came to see me with constant thoughts about how many people his wife had slept with before they met.

The thoughts and mental images of her with these other men were relentless. All day long and waking him up at night too.

I was familiar with OCD, but he wasn’t checking or cleaning or tapping or doing any rituals as far as we could see. But all these thoughts – we needed to figure out what was going on.

So we talked about the content of the thoughts. What it all meant, how his wife’s past made him feel. He was able to express the torment he’d bottled up for so long, bringing a sense of relief.

His marriage was suffering. He loved his wife, they had a daughter together, but he had a deep-seated belief about how many men a woman should sleep with before settling down. It wasn’t many, and his wife’s body count was higher.

He’d known this early in the relationship and never liked it. But it felt more and more wrong as time went on. Now it felt intolerable.

So we spent time unpacking this belief. Was it realistic? Could we reframe it? He’d slept with a bunch of women before, so wasn’t it a bit hypocritical? And it was all in the past, his wife was with him now. So let’s challenge that belief and see all the positives in his relationship and the family he loves.

And it worked – there in the room. He’d reflect and say “Do you know what? I think I get it now. I don’t know why I was so obsessed. She’s great, my wife, and that’s what matters.”

As a therapist, that felt great to hear too. Phew – I’ve helped him.

Except he’d come back the next week with exactly the same thoughts, images and obsessive torment. “I’ve been struggling again…”

So we do it again because it worked last week: “Oh what have you been thinking about this week?“

And it was pretty much the same thoughts: body count, feels wrong, can’t stop thinking about it, should we even be together?

Well I guess if we keep talking and understanding this, eventually we’ll get there. I’ll show him some relaxation techniques too, to help with the anxiety around all this. And I explain that these feelings can be quite natural, he’s certainly not the only guy to have them (which is true).

And he leaves the room feeling more positive again. Phew – we’re all right now. Until the next week…

The reassurance trap

It’s a trap that well-meaning therapy can easily fall into. We weren’t getting anywhere.

In fact, we were giving him more to chew on. Well how many people should women sleep with? Maybe these ideas came from my parents, we didn’t talk about these things at home. Maybe I’ve been feeling insecure since that girl dumped me at school. Thinking and ruminating.

In those sessions, we were ruminating on all this together. Chewing the fat. It felt therapeutic, but it wasn’t. Full disclosure.

Luckily, I did realise. I took some supervision on it, and realised that all this thinking and ruminating was his OCD compulsion. And we took a different approach from there on in.

This client taught me a lot about retroactive jealousy and I’m forever grateful. This form of counselling doesn’t work for retroactive jealousy.

Why counselling fails for retroactive jealousy

I have full respect for counselling and counsellors. I’m trained in counselling and the skills of active listening.

But there are clear differences in how conventional counselling helps and doesn’t help with RJ OCD.

Reassuring the client that they’re fine

You can do it, the thing you’re worrying about is really unlikely, you’re catastrophising. All this has its place. But with RJ, it just gives temporary relief.

Sooner or later, the thoughts push back: but she did it, what if these feelings ARE telling me something, my mate gave his girlfriend the benefit of the doubt and look what happened to him…

Reassurance only makes RJ dig in, so we need to get better at not needing it – and not needing to reassure ourselves.

A lot of counselling is open-ended

A journey of compassionate self-insight. It goes where it goes. But without a clear structure and protocol, retroactive jealousy just leads us down one rabbit-hole after another.

If we’re not seeing some tangible improvements – less time spent in the grip of rumination and doubt within 8-10 weeks – something’s not working IMO.

We need a more effective and tailored approach

So what kind of therapy – or therapist – would I recommend for anyone struggling with retroactive jealousy?

Exposure and Response Prevention (ERP). Which is a form of cognitive behavioural therapy (CBT) specifically for intrusive thoughts and OCD.

Not all forms of CBT are ideal for treating RJ. The non-OCD form involves exercises like weighing up the evidence for and against your feared outcome. Really useful for a lot of catastrophising and irrational fears, but retroactive jealousy will just eat that for breakfast. RJ absolutely loves weighing up evidence.

So Exposure and Response Prevention. Having the thoughts: the ‘what ifs’, the mental images about our partner’s past and the feelings too. Experiencing the discomfort, anger, disgust and jealousy.

And doing this willingly. Taking the RJ bull by the horns, so to speak.

And getting better at not reacting to any of it. Not avoiding or pushing away or doing anything to fix the feeling in the moment. That’s the response prevention part, and it includes mental rumination.

In order to practice and develop this attitude towards our thoughts – to hold them more lightly and help our nervous system realise that it’s not a panic situation – we do the exposure part. We find ways to deliberately lean in and have these thoughts on our own terms.

We turn the tables on retroactive jealousy. By not avoiding or fighting with the thoughts, we take back our agency.

The NHS webpage about OCD recommends exposure and response prevention. The BACP website advises people with obsessive compulsive struggles to ask their counsellor if they have any training in CBT and ERP. The International OCD Foundation advises the same.

ERP needs to be done correctly and consistently. See my article about some of the pitfalls when it comes to treating RJ.

But guided by an experienced therapist, exposure makes a truly positive difference.

Counselling for further healing and relationship repair

Of course, retroactive jealousy OCD and depression and trauma aren’t mutually exclusive. The relationships between intrusive thoughts, anxiety and negative life experiences are very much chicken and egg.

When we’ve made inroads with ERP and our sensitivity to thoughts about our partner’s past has reduced, and compulsions have abated, counselling may help with healing and facing a better future. For both partners in the relationship.

If a client is significantly depressed, therapists need to take this into account and address this first. Otherwise, leaning into discomfort and practising exposures could be too much of an ask. The same applies to trauma and PTSD.

But for the majority of people struggling with retroactive jealousy, I recommend giving priority to exposure and response prevention therapy.

Otherwise, we just feed the rumination and doubt. It feels cathartic and insightful, but discussion of all those thoughts and feelings doesn’t pull us out of the obsession.

That was my hard-learned lesson about counselling and RJ. I hope this helps provide some clarity and direction.