In the late nineties, a movie starring Meryl Streep called My One True Thing came out. It was about a dying mother and the daughter who was taking care of her. I recently saw it again, and it brought back memories of that painful time when I was in my early 20s and had to watch and try to help my mother with her death.

It was a time, not so long ago, when doctors — and the public alike — believed that we should not tell or discuss a terminal prognosis with a patient. It was also a time when housewife alcoholism, nervous breakdowns, ethnic prejudice, serious depressions, and suicidal behaviors were not spoken about out loud. In my childhood, I had to cope in fearful silence with an alcoholic mother who twice tried to commit suicide. The shame of these family secrets that I held inside for so long haunted and inhibited me.

The final family secret happened after my mother’s surgery for breast cancer in 1972 while I was still in college. That night after her surgery, which had included an immediate mastectomy, I went and told my still sleepy mom that she no longer had her left breast. All — family members and professionals alike — agreed that she was not to be told of her terminal cancer. Our doctor also counseled that my dad who had severe cardiac disease, not be told about my mother. Thus, the charade played out unencumbered. I came home from college to take care of her. I watched in horror as her hair came out and pain, weakness, and nightmares moved in. Still I stayed quiet.

One night, after one of my mother’s nightmares had awakened me, I got up and turned on a talk show. The guest was Rollo May, a noted psychoanalyst and author. Dr. May spoke about personal responsibility and truth. He told of his own battles with tuberculosis, an incurable disease when he had it in the early 1930s. He lay dying in a sanatorium while hushed staff whispered around him. Eventually, he discovered his diagnosis, and, though terrified, he felt there was tremendous meaning and importance in that sudden awareness. He had choice: to die quietly or to muster whatever he could to support and assist in his own care. He recovered. His life was his own, a ship he had the right to command.

What wonderful, courageous, and yet foreign thoughts those were. But what to do with them? I was 22, and silence still permeated my world. One day, though, about five months after her surgery and after the devastating effects of radiation treatments started to ease, my mother said the word “cancer”—and a few words about her own physical concerns. Though she had still not accepted the terminal nature of her cancer, it was the beginning of the end of her nightmares and the beginning of mine. I began to listen to my mother as she began to break through her own silence.

Suddenly we were on the same page. We both were coming out from a life of silence and talking more and more about our own truths. Yet over and over, I was cautioned by all involved not to say too much to my mother as it might precipitate her death. How wrong they were. My mother became more alive and aware. She tearfully struggled to look her own illness in the face.

As the months passed, the initial prognosis of six months began to change. I married in June and my husband and I went on a cross-country trip we had planned to take before my mom got sick.

But upon our return, we learned that the cancer had spread. The very doctor who had insisted that I should not be talking to her regarding her disease had inadvertently told her everything. He sent her home with packets describing the medication, including daily side effects and even told her how long the expected survival was thought to be.

In earlier times, my mother had been a capable and highly respected nurse. She read everything in the packets and understood clearly what they meant. She looked me dead in the eye and told me what I already knew was to come. The jig was up.

She told me she wished to fight as long as she could. Now she directed me. She said my part was to say nothing to my unsuspecting father, or to anyone else.

I, in turn, began to fall apart. Depression, alcoholism, money problems had prevented my mother from being a true mother. Much of the time our roles had been reversed as I had tried to act as the parent. When I was a child I had always kept waiting for the adults, for friends, family, anyone to see what was going on in my family and help. However, they couldn’t allow themselves to see the truth of what was happening or to say anything about it. This time, though, I had an ally, a truth-sayer: my mom. Help was now on the way.

In the Fall, just four months after my wedding, she and my dad visited me and my husband in New Haven. Our tiny apartment contained a rocker, and it was here that I became the daughter about to lose her now-peaceful mother. She had been a petite woman all her life, but at that moment, with her thinning hair, hoarse voice, and shrinking body, she stood tall and wise and whole as she rocked and comforted me. I sobbed on the floor with my head in her lap. During that afternoon, she held me, and tried to help me understand some of the “whys” of her life. The drinking, her depression, and how it felt to die. I kept crying and shaking as I shared all my terror and inability to handle what was coming. I remember, watching the light and shadows on her face as daylight started to fade and the day was ending, I saw that I finally had a mom, but now I couldn’t let her go. I needed her.

She then told me a story of a childhood friend of hers whose parents suddenly died in an accident. She remembered thinking, “how could this girl go on living?” But my mother said that the friend did, and she said I would too. I couldn’t fathom then that that would ever be possible for me. I left saying I love you, and I will be back next weekend.

I never saw her alive again. She entered the hospital the next day and died two days later alone in her hospital room.

Three weeks after her death, I was asked by the Yale School of Medicine to participate in a workshop where family members spoke with an audience of professionals who worked with the sick and dying. It was the dawning of the hospice movement in America, and people were trying to understand this important transitional time in a person’s life. I felt desperate that they hear me and the others who were struggling with matters of grief and dying. When asked if I had any regrets, I told the audience, yes. I deeply regretted that I was not there at the moment of my mother’s death. Sadly, I felt she had died alone.

After the meeting was over, a woman came over and took my hands.

“I am dying of cancer, and I want you to know that your mother did not die alone,” she said. “Thank you.” This I now know. The moment of death is not important, not really. It is our genuine presence with others during the process of their dying that is so deeply crucial.

And then too, I’ve learned that secrets can harm, hurt, and even kill. I’ve learned that it is safe to talk, to bear witness, to share, to cry, and yes, to be still and quiet. This, then, is My Own One True Thing about living and dying: our aliveness, our life journey, lies in our ability to know and sometimes to take the chance to speak our truths out loud.

We must allow pain and then find the courage to risk connecting and losing, and hurting, and caring. We must be present with those we love. And then, finally… we must love them enough to let them go.

This blog curates the voices of the Division of Psychoanalysis (39) of the American Psychological Association. This post was submitted by Patricia Tenerella-Brody, LCSW, Psychotherapist in New York City and Riverdale, NY (

About the Author

Kristi Pikiewicz

Kristi Pikiewicz, Ph.D., is managing editor of the American Psychological Association's Division of Psychotherapy DIVISION/Review.

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