What You Need to Know About Anticipatory Grief
May 3, 2022
When we think of grief, we often think of death. But the truth is that grief is our natural, emotional and physical response to any loss, at any time in our life – such as the loss of a job, a relationship, or with a change in your health status. Grief is not only experienced after a loss but is often felt in advance of a loss. This is called Anticipatory Grief.
What is Anticipatory Grief?
Anticipatory grief is the distress people feel in the days, weeks, months, years before an impending loss. It is a completely normal and human response. For example, it is the sadness we feel knowing that someone we love is going to die, perhaps from cancer or ALS. It is the despair we may feel knowing that there will come a day when a loved one living with dementia will no longer recognize you.
Anticipatory grief manifests itself through a wide range of symptoms including anxiety, sadness, anger, guilt, relief, denial, withdrawal, isolation, dread, tearfulness and preoccupation with the loss to come. These are similar to the symptoms of traditional grief and can come in waves.
It is important to be aware of anticipatory grief, because when we are able to name and understand the process, we are able to embrace our emotions instead of denying them. Many people feel guilty thinking about the impending death of their spouse or parent or child, when their loved one is still alive, right in front of them. Friends and family will tell them to "Stop thinking about the future – enjoy your time with them now”.
While this comment often comes from a caring place, it can be harmful, as it doesn’t allow space for that individual to think about and grieve the impending loss. Instead, the grieving individual is left isolated and alone with these feelings. By recognizing this grief as anticipatory grief, something that is common, natural, and human, we can normalize this experience and allow space to hold the range of emotions that come up, without casting judgement or blame.
Does Anticipatory Grief Serve a Purpose?
Anticipatory grief can in fact be helpful. This acknowledgement of an impending loss, such as death, can be the impetus to initiate important conversations about what is most important to now, end-of-life planning, and how they want to live the rest of their life. Anticipatory grief can also help individuals proactively find meaning, to mend relationships, and find closure. It gives them the opportunity to say the four things that matter most - “Please forgive me", "I forgive you", "Thank you", and "I love you”.
Coping with Anticipatory Grief
It is important to share your experience with a trusted friend, partner, or family member since this will help you process the grief and make sense of it. Local illness-specific or caregiver support groups can be a great source of strength. Other helpful resources include:
Talking about your grief with a professional such as a palliative care clinician, a therapist, or a counsellor can help. If the grief interferes with your daily responsibilities, it is critical to seek professional help.
Anticipatory grief is a normal human reaction to an impending loss. It can serve as an opportunity to have conversations about advance care planning, end of life care, as well as to find closure. Anticipatory grief, like traditional grief, can come in waves, and most people won’t be “cured” of it, but instead will find a way to live with the grief, folding it into the stories of their life.
Ashwini Bapat M.D. is a palliative care doctor and co-Founder and CEO of EpioneMD, which provides virtual advance care planning and serious illness coaching to individuals and telepalliative care consultation to healthcare organizations.