The pain of loss, the agony of bereavement, is legitimate. But I believe that there are other complications that you need to understand if you are to work out your distress.
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Q: I don't really know what my question is, but I do know that I am really hurting. I am almost sure that you will say this is very legitimate pain and that I will soon get over it, and then learn to live with it. In the meantime, though, I'm in pain and need to talk about it.

I am taking care of my father who is dying. My siblings and their families don't live near us, so I am the primary caregiver. My father has nursing care, so basically I just go over to his place to keep him company and to make sure everything runs smoothly. The situation isn't too demanding, but I am scared of the moment of the death. I will be alone, there will be no other family member present, and it will be my responsibility to call everyone. I keep replaying that scene in my head so that at least I will not feel that it is so shocking or overly painful. I know I will be able to handle it and I have my list of whom to call, but I still feel that moment of dread every time I enter his home.

At the same time, I am helping Beatrice, a very old friend of my parents, to pack up and to move to an assisted living home near her daughter in another state. My mother died two years ago and Beatrice's husband died about five years ago. They were inseparable as couples. I always felt closer to Beatrice than I did to my own mother. Beatrice always made time for me and seemed to understand the depth of my feelings, much more than my mother did. In fact, I always thought that after my mother died, Beatrice and my father would get together and I would then have better parents -the ones I always wanted. Not only didn't that happen, but after their spouses died, they hardly saw each other at all. Only Beatrice and I maintained a relationship.

It is probably important for you to know that my husband, Franco, died over ten years ago. We had no children and our love affair was the core of my life. Even though everyone objected to our marriage, his family and mine, Franco and I were one unit, completely intertwined with one another. After his death, I tried to stay in contact with his family but much to my dismay they ended up ignoring me -- as they did before we were married. My own family was little better. They knew I had suffered a loss, but had little appreciation of the depth of my loss. My soul mate was gone -- not just my husband, but the love and lover of my life.

I'd like to say that the last ten years have been a period of rediscovering myself, reinterpreting life, or even remarrying, but that has not been the case. Franco is still with me. I talk to him whenever I need to work through an issue or whenever I feel extremely alone. This was especially the case after my mother died. Even now, I dream often about Franco and I know that he is near. I enjoy the company of men, but I really don't think one can ever find substitutes for one's main love in life. I am not unhappy. Instead, I finally feel calm and content, although it did take over five years for the intense loneliness to abate.

Now it has returned and I again feel the intense pain of Franco's loss. Will this ever stop?

A: You know the answer. Of course you will deal with your father's death and of course you will triumph over yet another loss, but as long as Franco remains the only way to resolve a problem and as long as there is pain in your life, you will feel the repetitive, intense pain of losing Franco. When your mother died you felt the pain of Franco's absence. Whenever you have a painful issue, you turn again to Franco for resolution. You have integrated him into your thinking so that in effect you are still talking to him and he is still around. That incorporation of the cherished characteristics of our deceased loved ones is an effective way of getting past the intense pain of grief. You have done that instinctually by talking to Franco when you are feeling confused or lonely.

But, you have also chosen not to move on to another potentially satisfying new life or new lover. That is your choice. However, that choice will always bring up anew the process of mourning as each time you hurt you revert back to the original dynamic between you and Franco in order to feel better. Once again, that is your choice. But the result is that the intense pain of losing Franco will reemerge. And this will occur especially when you experience loss or death, as you are at this moment. So, you talk to Franco and you search out others that you can interact with.

I will tell you what you thought I would say. The pain of loss, the agony of bereavement, is legitimate. The pain is appropriate. And you seem to be handling it as well as you can. As you have done before, you wait for a scab to form and for you to feel content and calm again.

Aside from the very real loss that you are experiencing, I believe that there are other complications that you need to understand if you are to work out your distress. The situation you are now in mimics other feelings you have that may be unrelated to actually grieving a death -- previous feelings not only of loneliness but of betrayal as well. You do not express any anger, but there are clues that for you, loss and betrayal are closely intertwined.

What am I talking about? First of all, your family doesn't seem to be a tight-knit group capable of offering your either support or pleasure. You state that they are not around to take care of your father, and you leave it at that. You don't say if you talked this over with your siblings. Did you ask them for help? Did they turn you down? Did they just expect you to do what they would not? Did you expect to do what they would not? Does any of this make you angry? Do you feel used? Do you feel betrayed?

You say your mother didn't understand you as well as Beatrice did. How about your father? Did he understand you? You don't say. I would assume that your enjoyment of Beatrice is part of a search for a family that you could construct for yourself. In fact, you had hoped that Beatrice would become your step-mother. It doesn't sound like you took great pleasure from your own family.

As for you and Franco, the two of you kept it to the bare minimum -you, Franco and no children. You constructed your life the way you wanted. You may have wanted Beatrice to begin a new family for you, but that's was only after Franco had died. Before his death, you both had only each other for family. You both only trusted each other.

Your present circumstance leaves you alone again. You could always talk to Franco and you also talked to Beatrice. But now she is leaving and so, in a profound way, is your father. You are losing any family you may have enjoyed. Your loneliness now is becoming more acute. You seem to have no one to turn to.

The word that comes to mind -the feeling I think you are experiencing -is betrayal. You had hoped to hold onto Franco's family after he died, but they retreated. Your own family gave you no support when you married Franco -or, for that matter, when he died. And now, your father's death and Beatrice's moving away is another betrayal. They are leaving you alone yet again. All of your past painful feelings -not merely grief -- are rising to the surface.

You are not only grieving. You are dreading the impending recurrence of intense loneliness, anger, and betrayal. There is no instant remedy for what ails you. You need to find a therapist and work out mourning which, for you, includes intense echoes of the original loss and the reemergence of other unresolved feelings. You hopefully can work through all of this without Franco.

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