Dear Therapist: I’m Ashamed of How I Treated My Dying Husband

Dear Therapist,

My husband of 19 years passed away in April. He had Stage 4 cancer, but was not bedridden. He was a positive, happy guy and just a very, very good husband. He spoiled me throughout our married life. I am so consumed with guilt, as I feel l neglected my husband, even though I was with him the whole time he was going for treatment. I did things like make him dinner and help him bathe, but I feel like I didn't take good-enough care of him.

Two days before he died, I yelled at him and said hurtful things to him. I feel guilty that I didn’t give him rice when he asked for it. It was late and I didn’t want to go out to buy it. I just have so much guilt; it seems like everything I did to him was hurtful, even though I didn't hurt him intentionally.

I miss him so much and keep asking for some sign that he has forgiven me and still loves me in spite of everything. Please help me. I am really, really suffering.

Anonymous

Dear Anonymous,

I’m sorry that you’re suffering so greatly, and I can only imagine how much you must miss your husband. I know you’re tormented with guilt, but I want to help you see that what you’re experiencing is grief, and not an indication of your worth as a partner.

Grief often takes people by surprise, not because they didn’t expect to feel it, but because it doesn’t present in the way they’d imagined. Sometimes grief presents so unlike their conception that they don’t even realize that a behavior is tied to their grief. For instance, one way to deal with intense grief is to focus the pain elsewhere. In your case, it might be easier for you to distract yourself from the pain of missing your husband by turning the pain inward and beating yourself up over what you did or didn’t do for him.

After the death of a loved one, people tend to spend a lot of time thinking about the relationship—remembering conversations or experiences you had together, revisiting joyful and meaningful moments and also those you regret or wish had gone differently. These memories can serve as a way to feel a continued connection to the person who’s gone. But when these thoughts veer into obsession—you can’t stop thinking about them; you’re “consumed” by them—they start to take on similar qualities to obsessive-compulsive disorder or even an addiction.

Addictions, no matter what they’re to, have one thing in common: They temporarily numb you. But instead of helping you deal with your pain and move forward, they start to take over your life. Similarly, with OCD, people may temporarily quell their anxiety by repeatedly performing a ritual (such as flicking the lights on and off or compulsively washing their hands). But what they’re actually doing is soothing themselves with something that on the face of it seems miserable. For you, whenever you think about the loss of your husband, you soothe yourself by doing something miserable—going over and over the time you yelled at him or said something hurtful or didn’t buy him rice.

One reason you may need to escape your feelings is that you’ve been feeling them for a while—since long before your husband died—but have had no healthy outlet for them. Often when one person in a marriage is seriously ill, the couple directs all of their energy toward this person, even though the illness is also excruciatingly hard on the partner. I once treated a woman who was dying of cancer, and although her husband had been loving and attentive throughout their ordeal, he had also been suffering in silence. One night, as he was relaxing in front of the TV, his wife came in to show him another study about a possible experimental cancer treatment that she’d found online, and he snapped.

“Can’t we just have one night off from cancer?” he yelled. To which she replied, “I don’t get a night off from cancer!”

His reaction didn’t make him a bad partner. Instead, it brought to the surface something many couples dealing with a terminal illness don’t talk about: Grief doesn’t begin the day a person dies. We experience the loss while the person is alive, and because our energy is focused on doctor appointments and tests and treatments—and because the person is still here—we might not be aware that we’ve already begun grieving the loss of someone we love.

Partners aren’t superhumans or saints. So what happens to their feelings of helplessness, sadness, fear, or rage? It’s not uncommon for people with a terminally ill partner to push their partner away in order to protect themselves from the pain of the loss they’re already experiencing and the bigger one they’re about to endure. They might pick fights with their partner. They might yell at their partner. They might avoid their partner, and busy themselves with other interests or people. They might not be as helpful as they had imagined they would be, not only because of the exhaustion that sets in during these situations, but also because of the resentment: How dare you show me so much love, even in your suffering, and then leave me. In short, they might not buy the rice.

But that doesn’t capture the entirety of the relationship, and reflecting on your 19 years together and not just the ending will help you so much more. It’s human nature to place undue emphasis on the last things we do or say with a person, allowing those events to supersede whatever came before. I had a patient whose wife collapsed and died mid-conversation, as he was being defensive about not doing his share of the laundry. “She died mad at me, thinking I was a schmuck,” he said. In fact, they’d had a strong marriage and loved each other deeply. But because this one argument became enshrined as their final words, it took on a significance it wouldn’t otherwise have had. So, too, have your last interactions with your husband.

You don’t need a sign indicating that your husband died loving you—after all, people don’t tend to treat their partner the way he treated you all those years if they aren’t deeply in love. Besides, no sign could take away the pain of missing him. But having some self-compassion for the ways you, too, were overwhelmed by his illness when he was alive will help you move through your grief in a much gentler way, which will in turn help you process your loss in a way that heals rather than wounds you.

Dear Therapist is for informational purposes only, does not constitute medical advice, and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, mental-health professional, or other qualified health provider with any questions you may have regarding a medical condition. By submitting a letter, you are agreeing to let The Atlantic use it—in part or in full—and we may edit it for length and/or clarity.