Dear Amy: I have been married for nearly 41 years. From Day One, my husband decided it was OK to criticize my looks and every move I made. According to him, I have never done anything right in my entire life. I am so sick and tired of the constant abuse. Nothing I do even makes him slow down -- he just goes on and on.

He doesn't physically beat me, but emotionally he has beaten me down to nothing. At one point, he agreed to go to counseling. I made the appointments, but he conveniently stayed late at work.

I don't know how much more of this I can stand. He attacks me, and now I respond by screaming about all the mean things he's done. There's nothing but anger in me now. I'm ready to blow, and I feel as if I'm losing my mind. He attacks what I do at home and even what I do at work, although he knows nothing about my job. I've been told I'm inept, incompetent, worthless and a burden.

Our children are grown and gone, but we do have grandchildren who would be affected if we got a divorce. And I really don't want a divorce; I just want him to stop belittling me. Any advice for me?

WORTHLESS

Amy says: I realize that getting a divorce seems like a painful process, but given what you're going through and what you say you have been through for the entirety of your marriage, leaving your husband will be the only thing to bring you peace.

You must realize by now that you simply cannot make someone change. You cannot make your husband stop belittling you, and the process of trying to get him to stop has transformed you into a screaming, nasty, unhappy person.

If you can't afford a place of your own, stay with a friend or family member for now. Get counseling and legal advice. Do not use your grandchildren as an excuse to stay in this abusive marriage. Scores of letters to this column have shown me that when lengthy abusive marriages finally end, other family members (including the kids and grandkids) are extremely relieved.

Thank thank-you-gift sender? Dear Amy: I am a nurse practitioner, and recently a favorite patient gave me a thank-you gift. The gift was thoughtful and very generous, and she included a card with touching thoughts. Should I send a thank-you note for the thank-you gift?

SARAH

Amy says: A note or a phone call to say you received and appreciate the gift would be nice.

Send questions via e-mail to Amy Dickinson at askamy@tribune.com or by mail to Ask Amy, Chicago Tribune, TT500, 435 N. Michigan Av., Chicago, IL 60611.