Let's Talk About Anticipatory Grief, What It Is, Its Effects, And How To Handle It

Read below my new article published in Brainz Magazine. 

 

Let’s talk about grief, and most specifically about a type of grief called ‘anticipatory grief’, what anticipatory grief is, the common signs of anticipatory grief, the difference between anticipatory grief and grief after death, and the different support systems available when going through anticipatory grief. 

 

“anticipatory” is a misnomer: we are grieving not just the anticipated future death, but also losses that have already occurred in the past and are occurring in the present.” 

Donna S. Davenport 

 

When a loved one dies, we want to keep them forever, we do not want to let them go, we do not want to forget them, and we do often bury them in our heart. We call this the grieving process. 

 

Let’s start by defining what grief is. 

 

In simplest terms, it is a reaction to loss. The loss of a loved one through death, but also the end of a marriage or relationship, the end of a career that meant the world to you… 

 

Grief is a natural human response to the loss of a loved one. It can show itself in many ways. Grief moves in and out of different stages from disbelief and denial to anger and guilt, to finding a source of comfort, to eventually adjusting to the loss as well as possible. 

 

For survivors, the grieving process can take a long time, often many years. The challenge of accepting death and dying as the end stage of life is what the grieving process is all about. 

 

If you love, you will grieve, and nothing is more mysteriously central to becoming fully human. 

 

We do not talk enough about the effect that grief will have on us. Our culture often makes the bereaved feel alone, isolated, broken, and like they should just ‘get over it’. In my own personal and professional lives, I have heard these words far too often. “Life goes on and you will just have to get over it”. If only it was that easy… 

Grief can manifest itself in many different ways. 

 

It can be so powerful that all your usual coping mechanisms are useless. 

 

You find yourself physically and emotionally unable to function with any semblance of normality. 

 

Grief is easily one of the most complex human emotions. Experiencing grief can mean intense sadness, rushes of anger, periods of numbness, difficulty focusing, and more—and it all comes and goes in waves that can last for years after a loss. While we traditionally associate the feeling with the death of a loved one, we experience grief for all kinds of things— periods of time that are coming to a close (like a baby's newborn phase or graduating from college), relationships that have ended, or places that no longer exist as they once did. No matter what causes grief, it is a hard feeling to sit with. And the loss does not have to have happened yet to cause these grief-fuelled emotions—you can feel something called anticipatory grief as well. 

 

“Understand there’s no right or wrong way to grieve, including anticipatory grief. It’s like the ocean. It ebbs and it flows. There can be moments of calm. But out of nowhere, it can feel like you’re drowning.” 

Dana Arcuri 

 

This quote is a reminder that grief is very personal and that there is no timeline. Everyone will grieve in their own way. There should never be any expectations with grief. 

 

What is anticipatory grief? 

 

Grief is generally thought of as something that happens after the death of a loved one, but what many people do not realize is grief takes on many forms and can happen at any time. Grief can occur when witnessing a loved one lose his or her independence, when a loved one is diagnosed with a terminal illness, begins hospice care or after a loved one has died. 

 

Anticipatory grief is the grief that comes before a death happens. When facing an impending loss, you might experience what is known as ‘anticipatory grief’. Anticipatory grief is the grieving that happens before a death or other type of significant loss. It typically happens when a loved one is diagnosed with a terminal or life-limiting illness. It can also occur when faced with a personal diagnosis of a terminal or life-changing illness or when faced with the loss of abilities or independence. 

 

Anticipatory grief is more than just normal grieving that starts early. It is often regarded as a means to process and resolve issues related to a dying person or a life-changing event. It may provide you with a means to proactively address your feelings and the likely consequences of the loss, dealing with them now rather than after the fact. 

 

This means experiencing the emotions associated with grief before the expected loss actually happens. Rather than grieving the loss of a person, anticipatory grief might be better understood as grieving the loss of experiences, possibilities, or an imagined future together. 

 

When facing a significant loss, like the death of a loved one, it is natural to feel many strong emotions. It is also normal to think about what your life will look like after they have died and how you will cope. This does not mean you have given up on the person or that you do not care for them. 

 

So, yes, you can grieve someone who is still alive. I also want to say that it is probably one of the most heartbreaking things to go through. And it is difficult for people around you to understand. In turn making it difficult for you because you do not always get the sympathy, concern, and understanding you would if your loved one were dead. So, I would say that it can sometimes be harder to grieve a living person than loved one who passed away. 

 

Some examples of anticipatory grief. 

 

Anticipatory grief can be triggered by many different things, including: 

 

- Getting a terminal diagnosis, such as stage 4 cancer 

- Being diagnosed with a progressive disease like Alzheimer's disease, cystic fibrosis, muscular dystrophy, or macular degeneration… 

- Having to address end-of-life care, such as hospice 

- Seeing a loved one being physically present but emotionally absent (having a loved one affected by dementia for example) 

- Caring for a child with a chronic disease or a developmental disorder like autism 

- Having to undergo amputation or potentially disfiguring medical procedures like mastectomy or colostomy 

- Life-changing situations like an impending divorce, a child leaving home for college, or having to move out of one's house 

- The impending death of a pet 

 

Who can experience anticipatory grief? 

 

Firstly, not everyone will experience anticipatory grief. For some, it may be that not acknowledging what is happening is a very good coping strategy and grieving may be perceived as giving up hope. Those who are living with the knowledge of their loved one's impending death can find themselves conflicted. 

 

Anticipatory grief is quite common among caregivers and family members of people suffering from Alzheimer’s disease, cancer, and other terminal illnesses. 

 

If you have been diagnosed with a terminal illness, you may experience many emotions including shock, fear, and sadness. You may feel grief for events and celebrations you will not be around for, such as weddings, graduations, births, christenings, family celebrations... You may be grieving lost opportunities or experiences you will miss — even small ones, like the pleasure of the sunshine or a lovely hot cup of tea. 

 

If someone you love is facing a terminal illness, it is common to experience anticipatory grief in the months, weeks, and days before death. You may feel grief over the same things they do, or your anticipatory grief might take a completely different form, as your experience of loss will be different. 

 

If your loved one experiences confusion or a reduced state of consciousness for a long time, for example if they develop dementia, you may also experience anticipatory grief. This could be because you feel that the person you knew is already gone, even if they are still physically there. 

 

If your loved one has a decline in physical health or mobility, you may experience anticipatory grief as your opportunities to share experiences, like hobbies, holidays or events will be diminished. 

 

Anticipatory grief vs grief after death. 

 

Anticipatory grief is quite similar to ‘conventional’ grief after death insofar as they involve many of the same emotions. 

 

But with conventional grief, the emotions you experience are the direct consequence of a loss. Anticipatory grief is the grief that you expect to experience, much of which is conceptual and can change over time. 

 

Anticipatory grief is sometimes described as a ‘rollercoaster’ of emotions because you can shift back and forth between feelings of distress for several days and feelings of normalcy for several days. 

 

There may also be a part of you clinging to the hope that the diagnosis is wrong, and that your loved one can recover, buoying you at one moment and triggering intense anxiety at another. 

 

With conventional grief, your emotions and actions are reactive. With anticipatory grief, your emotions and actions are largely proactive. 

 

How does anticipatory grief affect grief after death? 

 

In some cases, carers of people who are terminally ill become closer to their loved one, making their feelings of grief after death even more intense. Other people found that anticipatory grief helped them to process their grief before death and that they feel a sense of relief or closure after the person dies. 

 

Most common Signs of Anticipatory Grief 

 

All the signs and feelings below are to be expected and are natural and normal. 

- Sadness / tearfulness 

- Anger / resentment / irritability 

- Loss of control over one’s emotions 

- Emotional numbness 

- Anxiety and depression 

- The desire to withdraw from social situations 

- Poor concentration/forgetfulness 

- Lethargy or lack of motivation 

- Anxiety 

- Extreme and chronic fatigue 

- Denial 

- Desperation 

- Dread 

- Guilt 

- Shame 

- Feeling of extreme loneliness 

- Desire to talk 

- An intense preoccupation with the dying person 

 

What can you do to support yourself? 

 

Acknowledge to yourself and others (if you can) what you are feeling. Try not to hide those emotions and remember that others may well be feeling the same, but no-one is talking about it. 

 

Ask for help. 

I write this because so many of you might convince yourselves that you can handle it all on your own and might struggle to ask for help. I suspect people would love to help support you if you would only ask them? Remember that people cannot read your mind… 

 

If you are experiencing anticipatory grief, it is important to talk about it with someone. Grief is a universal human experience, as each and every one of us will experience some sort of grief at some stage in our life, and talking about it with others is how we begin to work through it. 

 

Find ways to spend what time you have with your loved one (if, for example, anticipatory grief is related to a loved one diagnosed with a terminal illness) that are meaningful to you both. 

 

Now is the time to start having those conversations you might have been avoiding. What is it you would like to say to your loved one? Perhaps think about what you might regret not having said while you had the chance. 

 

Please take care of yourself. 

 

Self-care is key in any type of grief. Find time for a bit of relaxation, make time to connect with your family, to have a bath, to cook a nice meal, to call your friends, to breathe deeply, to read a book and ultimately to reassure yourself that you will be okay. These are just examples of things you can do to soothe yourself while going through anticipatory grief. 

 

Seek professional help and look for therapy. 

 

Common counselling interventions include narrative therapy, which can help the grieving person reframe loss, and active listening, which allows the grieving person ample time and space to talk out their feelings, prompted by insightful questions from the counsellor. This type of approach can help a person process their grief. 

 

Another form of evidence-based intervention is cognitive behavioural therapy. In this type of therapy, grief-related thoughts are identified and processed, and the grieving person is taught to reframe their evaluations about themselves, the world and their future. It focuses on managing distressing emotions and encouraging actions to help a person experience pleasure, joy, and a sense of community. 

 

And of course, last but not least, try hypnotherapy. As a hypnotherapist I believe I work in a profession which is fantastically placed to be of service to people on their grief journey. 

 

Hypnosis is a very powerful modality which helps us manage our grief. 

 

One of the best ways to deal with the emotional aspect is by using hypnosis for grief. That is because grief is a form of trauma, an event that overwhelms our ability to cope. 

 

And because grief can be such a traumatic experience, it makes sense that hypnosis can be an ideal modality to help manage it. 

 

Hypnosis for grief offers so many options. Hypnotherapy is a useful and effective intervention for prolonged grief. Its effectiveness lies in the fact that it is so good at helping people deal with underlying conflicts or issues. 

 

Hypnosis is an extremely powerful modality to help people going through anticipatory grief as it will help with deep relaxation and by creating a state of increased inner peace. 

 

For an end-of-life patient, anticipatory grief therapy may improve quality of life before death and may alleviate depression. 

 

If you do not have the financial resources to hire a therapist, it is still very beneficial to talk to family and friends, who can engage in active listening and offer other support that is important for processing grief, such as empathy and validation. 

 

Hope this gives you a better understanding of anticipatory grief, what it is, the common signs of anticipatory grief, the difference between anticipatory grief and grief after the death occurred and the different support systems available when going through anticipatory grief.