OP, it sounds to me like you pity and feel sorry for your wife's condition, yet accept less than what you deserve in a marriage and a relationship because you feel so obligated to her due to a vow that states "in sickness and in health". Does that vow also mean enduring longstanding emotional and verbal abuse? Your therapist has said it's abuse. I said earlier that you're a saint for putting up with this kind of treatment. At the same time, I think you make excuses for her because of her illness. Not to be harsh, I'm just being honest in order to help you. The constant threat of a breakup is also a part of emotional abuse. Perhaps it would help you to read up on emotional abuse tactics and signs of abuse. Perhaps you will recognize many of your wife's behaviors as being exactly that.