November 2025: The Grief of Unspoken Words

After nearly 40 years of marriage, Carl knew he had not told Nancy nearly often enough or in specific detail how she had impacted his life. She had been an amazing wife and mom and, over the last two years with widely metastatic triple negative breast cancer, she had demonstrated unyielding courage in the face of all the odds. But for some reason, he had not quite found the words to tell her all that she meant to him.

Besides, Carl had reasoned, the hospice nurse told him she thought Nancy had a couple of weeks left. She so wanted to get to Thanksgiving and the hospice nurse had told the two of them it was likely she would not want to eat anything but she would probably make it the next couple of weeks. He had even begun working on the letter he would read to her on Thanksgiving morning before the family gathered. So, when Nancy lapsed into a coma during the night on the Saturday before Thanksgiving, Carl was devastated. She died just six hours later while he was napping in the next room. 

Carl was “a mess,” according to their two daughters and the hospice nurse when she arrived. He blurted out that he wasn’t ready for Nancy to be gone; he had much more to tell her and he had not had the chance to say goodbye. They had only talked about their plans for the holiday and not what would happen if she did not live long enough to see it.

Readers of GriefPerspectives are all-too-familiar with cases like Carl’s. Even seasoned hospice professionals sometimes get caught off guard by a patient’s quick decline and death, surprised that a patient’s condition can change from stable so quickly. But what is often left in the wake for family members and friends are the unspoken words, the expressions of gratitude we never got around to sharing, and the last “I love you” while a patient could still respond. So how do we as caregiving professionals and volunteers best support individuals who are struggling with the grief of unspoken words?

Bear witness through supportive presence . One of the hardest tasks before a bereavement support professional or volunteer is to silently bear witness to the pain of loss, often by providing presence and not words. We feel we need to say something to make the pain better when in fact, no words really can. Rather, we stand by (or sit close) and without fully understanding the depth of loss, attempt to enter into the devastation of another’s heart all the while not making that pain our own pain.

The importance of bereavement professionals and volunteers at this point cannot be overstated. Often, well meaning friends and family members tell bereaved people who express guilt, “Oh, you don’t have anything to feel guilty about,” or “Well you did the best you could.” Unfortunately, these “rational explanations” do not adequately bear witness to the pain of the guilt, and as such, may leave the bereaved individual feeling even more isolated than if friends said nothing at all.

Don’t minimize the experience of guilt . Maybe the most inevitable emotion for those who grieve unspoken words is one of regret and its close cousin, guilt. Some guilt grows out of a person’s faulty expectation of response to an impossible scenario such as not having been present at the precise moment a loved one died or wishing that a “crystal ball” would have told us when to say what. But in most cases, the positive power of guilt is that it helps us recalibrate priorities to respond differently the next time. In other words, reflecting on guilt—even of the false variety—might help us to adjust our future behavior to a more desirable outcome. 

An illustration from personal finance helps us see the nature of this grief. People who have gotten into mountains of debt and then worked tirelessly over years to climb out might know the power of this response to guilt. Student loan debt accompanied by a car note after graduation, along with two or three credit cards scream, “You’ve worked hard and you deserve this vacation/jewelry/sofa.” Perhaps the results were, at least in part, the fault of a system that makes such things possible and the social pressure that suggests they are desirable. But after working through the emotional shame and the accompanying guilt, most people who eventually pay off that debt never approach debt that way again. Behavior changes, often for life. By the way, this is my story and explains why I do not use a credit card to this day! Guilt can be a powerful motivator for change.

Nevertheless, “benefit-finding” and other discoveries of new meaning in loss (Gillies & Neimeyer, 2006) are for the bereaved individual to discern, not for the counselor to superimpose. While it is appropriate to ask, “What are you making of this?” or “What are you learning through this?,” it is not appropriate to editorialize with the well-meaning friends who suggest, “Well, at least…” 

Inquire about alternative ways to express final words . Since Carl did not find the opportunity to say what he had longed to say, a thoughtful counselor might ask, “So what do you wish you would have told her?” and “What else would you tell her?” After hearing those ideas expressed, I find myself often following up with, “I bet there is a story behind that; would you tell me?” Sometimes, these can be written in a journal or drafted in a letter. One son asked the funeral director if he could come to the funeral home earlier during the visitation day and he quietly and privately read his letter to his mom. A widow did the same thing many months later at the seashore where she and her husband had frequently walked.

I once worked with a mom whose only daughter had died in a car crash. This mom, a relatively recent widow herself, struggled with what to do with the college fund she had accumulated for her daughter to attend college. She decided to utilize the funds for an annual scholarship at her daughter’s high school and this provided a positive outlet for the guilt she experienced at not having told her daughter often enough, at least in the mom’s grief-stricken memory, how proud she was of all her daughter had accomplished both academically and in her character.

Support throughout the process . Like other aspects of the bereavement process, the guilt around unspoken words often come and go, so watch for changes. Check in with the bereaved individual often throughout the first year or two of loss since emotions tend to change and shift throughout the grief process. Listen intently and ask follow-up questions when bereaved individuals indicate they are struggling with some aspect of their grief. Be especially mindful when death came with little or no warning because it is more likely that there will be words unspoken in those scenarios. But like with Carl whose story began this article, expect there might be guilt about unspoken words even when a death was long-expected, in part because there seems to be a human tendency to think we have more time.