Dear Tanya,
I am 24 and my boyfriend committed suicide four years ago. I have been completely unable to move on since it happened. We had been together for nearly four years, during which time I had breast cancer and went through a mastectomy and gruelling months of radiotherapy and chemotherapy. My boyfriend would come and stay with me every day when I was in hospital and he'd go into college to pick up the work I had missed and the homework I needed.

He was the most supportive person in my life. I am now unable to remember any argument we ever had or any tiny part of him that I found annoying. If anyone asks me now if I have a boyfriend I get angry, because I should be saying yes. I recently went travelling and every amazing place I saw made me wish he was there.

If I go on dates, I feel like I am cheating, or making our relationship less special. I am unable to have an intimate relationship because he's the last person I was with. I don't want to break that - and no one else has ever seen my surgery scars.

I feel so guilty that he must have been in terrible pain for much of the time we were together and he was never able to tell me. He spent so long caring for me and convincing me I was still perfect and he never allowed me to do the same for him. I'm so angry with him, too, because nothing could have been that bad.

He didn't leave a note so I have no answers, but a few days before he did it he gave me flowers and a card that he had sprayed with his aftershave. I look at it every day when I get home from work.

Sometimes I feel like I can't breathe because the sadness is so overwhelming and my anger gets so strong that even my punchbag isn't enough. I know that I'll always love him and I never want to forget a single thing about him, but I do think I should be able to start to have a more normal life now. I just don't know how.
Alice

Where to start in this deeply tragic tale? Even the hardest of hearts will be unable to read this without feeling some sadness for all you have endured.

The process of writing this column usually begins with me reading and re-reading a letter and then leaving the thoughts and themes to emerge as I spend time thinking and reflecting. Walking around with your story aroused two strong feelings in me - profound sadness and also profound anger - feelings so very common after a suicide.

Suicide is a desperate and tragic act. It is also a selfish act. People who are genuinely intent on taking their own life will usually show no outward signs nor give any indication as they silently plan their exit route. Those I have met who have not succeeded in their genuine attempts have described to me how, in their black pit of helplessness and hopelessness, they finally landed on the one coping strategy available to them - to end their lives.

When working with the families of children and young people who have attempted suicide, it is important to help them to understand the despair but also the selfishness of the act. This seems harsh (and what I am about to write, even harsher) but the selfishness of your boyfriend's behaviour can be seen in the way you are still entangled in a complex and debilitating grief that includes guilt and unending despair.

I have no doubt that your boyfriend was wonderful when you had cancer. He sounds selfless and attentive in the extreme, and when you were ill he had you all to himself to a degree. Maybe as you moved into being well again he found the end of your dependency on him difficult. But there is no way of knowing what role, if any, your illness played in his depression; by leaving no note he has not allowed you to learn what was really going on. No wonder there is a part of you that feels so angry.

You have a chronic and unresolved grief that is complex and destroying your quality of life. By ending his life as he did - leaving you with only flowers and an aftershave-drenched card to hold and smell everyday - your boyfriend has ensured that you stay tied to him for ever while you have understandably created an idealised image of this perfect man.

The reasons for your boyfriend's suicide will never be known - he made sure of that. But I am very sure that you were not responsible. His actions have left you bound to him, both helpless and dependent, very like how it was when you were so ill with cancer.

He may have had experiences or mental health difficulties that he struggled with, but while he was able to manage your vulnerability with cancer, he clearly could not manage to show vulnerability to you or any others in his life. That is the most tragic thing of all - depression, a fully treatable illness, often precipitates suicide. People can be rescued from the deepest and darkest of black holes; they just need to stretch out their arms so that others can pull them out. It is very hard, though, to stretch out arms that hang so heavily.

Your boyfriend loved you, you know that. So whatever his reasons for taking his life and leaving you, would he really want you to spend a life alone? While your love for him will always remain, that doesn't mean that there isn't the possibility for you to love again.

Obviously this is a huge challenge given your time away from intimacy and also after your surgery. You need support as you tread gently through the many layers of complicated and painful feelings you hold. I suggest that you contact the following services that can offer you the time and space to grieve and also to say goodbye, finally, to your boyfriend: Cruse Bereavement Care (0844 4779400); Survivors of Bereavement by Suicide (0844 5616855) and WAY Foundation (0870 0113450). I also suggest that you contact Breast Cancer Care (0808 8006000), where you can find support for the cancer you suffered and the resulting mastectomy.

Also try Look Good Feel Better (01372 747500), an organisation set up by the cosmetics industry to support women after reconstructive surgery.

You deserve to love and be loved. I am sure your boyfriend would want that. It is possible to love another while keeping a place in your heart for the man who you once loved so deeply but tragically lost.

If you have a family problem, e-mail Dr Tanya Byron.

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