The narrator’s husband and her brother, who are both doctors, believe women who are suffering from what was then referred to as hysteria should not work. In the case of the narrator, that work is her writing. She doesn’t agree with the opinions of her husband and brother, but the idea that women should obey men in all things is so strong in the nineteenth century that she feels it wouldn’t be of any use to object.
The narrator feels guilty about not appreciating what her husband is doing, despite how controlling it appears to modern readers, because in her society it is seen as a sign of love:
He is very careful and loving, and hardly lets me stir without special direction. ...
I have a schedule prescription for each hour in the day; he takes all care from me, and so I feel basely ungrateful not to value it more.
She even feels guilty about being sick, because she feels she isn't meeting her obligations as a wife:
John does not know how much I really suffer. He knows there is no reason to suffer, and that satisfies him. ...
Of course it is only nervousness. It does weigh on me so not to do my duty in any way! ...
I meant to be such a help to John, such a real rest and comfort, and here I am a comparative burden already!
The only place where the narrator feels free to express her true, forbidden feelings is through writing:
John is a physician, and perhaps (I would not say it to a living soul, of course, but this is dead paper and a great relief to my mind)—perhaps that is one reason I do not get well faster. ... You see, he does not believe I am sick!
However, her husband hates it when she writes, and her sister-in-law, who meets the ideal of what a wife should be like according to the cult of domesticity, also objects:
There comes John's sister. Such a dear girl as she is, and so careful of me! I must not let her find me writing. ...
She is a perfect, and enthusiastic housekeeper, and hopes for no better profession. I verily believe she thinks it is the writing which made me sick!
Although the narrator continues to write, the one thing that gives her relief also wearies her and stresses her out because she has to hide it. All this pressure only makes the narrator's condition worse, and she slowly loses her grip on reality as the story progresses.