Grief and guilt.

Grief is miserable. You probably don’t need convincing of that. It is, however, made much worse if you blame yourself for some aspect of the death. You did not get there soon enough. You did not respond to her call for help. You encouraged her to double up on her pills. You missed that bed sore,,,,and so on. (We deal with regrets about events that jeopardized the relationship more generally in the next section.) Perhaps the most common source of guilt of all is the self-accusation of not being sufficiently attentive or present.

Close family seem most exposed to this guilt and perhaps especially daughters, even when they have not been closely involved in the care of the deceased.

Although, goodness knows, it is far easier said than done, we owe it to you to insist that you do not allow grief to compound the guilt. That is to say, try to be as forensic, objective and (odd word, perhaps) dispassionate about the facts of the case. The effect of a general state of grief is to simplify, crudify and exaggerate our negative feelings, so a wonderful breeding ground for guilt. Actually, you were late because of an overturned lorry on the A12. You encouraged her to take more pills because the doctor said it would not do her any harm. You missed the bed sore because she was asleep when you visited and you did not want to disturb her.

The difficulties come when that wretched little voice at the back of our head replies: “Well, you should have left earlier. You know how busy that road gets”. “Yes, but that could be code for “it will quicken her end which is now inevitable”. Why didn’t you think of that?” “But it must have been there the last time you looked at her bum.”….That voice will not let us get away with anything. It is hell-bent on making us feel even more miserable than we do already. Debating with it is seldom helpful: it always has one more trick up its sleeve. All that happens if we try is that the sense of guilt deepens. My faults are revealed to be even deeper and wider than even I had realised. …Clinical depression may not be far away. Most people find the best protection from this destructive inner dialogue is to share it with someone you love and you know loves you. Yes, maybe you did get something wrong. You are human, after all. You were not being malicious or cruel - and your loved one can say that with total conviction and honesty. Very few of us can manage a difficult death without wondering if we could not have done it better in one way or another. That is part of life; part of being part of a death.

Now for some people in some situations that wretched little voice will not shut up, no matter what they do. A danger sign is when it keeps them awake at night so that they become sleep starved. At times of heightened stress, that can become serious. Time to get medical help in the shape of a gentle tranquilliser and/or a sleeping pill. Usually, the acute phase of the guilt does not last very long, and it will often regress as the generalised stress moderates. But if it is keeping you awake for prolonged patches of the night, don’t delay. You need a little help; get it.

And things do pass … it takes time but the pain does go.