After Mrs. Doyle leaves, Miss Lonelyhearts gets sick. He imagines himself in a pawnshop full of "paraphernalia of suffering." He muses that man has a tendency toward order while the physical world tends toward disorder. He assembles the objects in the imaginary pawnshop into various shapes, culminating in a giant cross that he moves to the ocean, where it collects the refuse of the tides.
Miss Lonelyhearts falls asleep, then wakes up as Betty enters his room with nourishment. He apologizes for his actions the other day, and she blames his job and tells him to quit. He says quitting would make no difference, as he would still remember the letters. He explains in detail what his advice-column job comprises: that it was initially only a joke, a circulation stunt, but that it soon made him aware of the unstoppable pain in the world and forced him to examine his own values. He sees that Betty does not understand him, and he asks her to talk. She speaks of the benefits of country living until Shrike comes in, at which time she leaves.
Shrike describes various lifestyles Miss Lonelyhearts might pursue, but dismisses each of them in turn. Shrike first talks about a life in the country, then refutes it as a reasonable recourse. He goes on to describe an indulgent life in the South Seas, and lives of hedonism, art, suicide, and drugs, but rejects them all. He maintains that only a life of God and worship can provide hope. He dictates a letter to Miss Lonelyhearts from a twenty-six-year-old in the "newspaper game" who says that he has lost his joy for life and wonders how he can keep his faith.
Betty continues to visit Miss Lonelyhearts. She feels he is not trying to get well, and she attempts to nourish him back to health with food and talk of the country. When spring comes she takes him to the zoo, then later gets Shrike to extend Miss Lonelyhearts's sick leave at work and takes him to her aunt's farm in Connecticut. On the drive up, Miss Lonelyhearts concedes that the nature around them is indeed beautiful.
Miss Lonelyhearts and Betty install themselves in the musty farmhouse, cleaning house, cooking dinner, and going down to the lake, where they watch some deer. They huddle together in the kitchen to sleep as loud noises of animals and crickets echo around them at night. They make a fire to warm up and then each eat an apple. Miss Lonelyhearts tries to seduce Betty, but stops when she says she is a virgin.
The next morning, Miss Lonelyhearts goes to a gas station where he tells the attendant about the deer. The attendant says there are still deer near the lake because no "yids" (a slur for Jews) ever go there. Later, while Miss Lonelyhearts and Betty walk through the woods, he finds the rotting mass of dead leaves and fungi under the shade depressing. He later watches Betty hang up wet clothes in the nude. He runs to her and kisses her as they tumble into the grass.