How to Overcome Anticipatory Grief

No one makes it through life without being touched by grief, and if you have a loved one whom you expect to lose soon, you may experience something called anticipatory grief.

Anticipatory grief is a distinctly human experience in which we grieve something we still have. For many people, this means grieving a loved one whom we know we will soon lose. This kind of grief is very common, and nearly half of family caregivers meet criteria for psychological distress at the very beginning of a palliative care journey.

When we have a loved one in palliative care, the anticipation of loss can feel overwhelming. However, it’s an unfortunate reality that life goes on, both during and after loss. Work and family obligations continue. If you’re finding the anticipation of your loss overwhelming, an experienced psychologist in Sydney can help. Grief and loss counselling can help manage overwhelm as it occurs and may give you a good foundation with which to cope with your impending loss.

Understanding what you’re going through can also help. The following article will explain what anticipatory grief is, how to manage symptoms, and when to seek professional help.

What is anticipatory grief and loss?

Anticipatory grief is much like traditional grief, albeit more conceptual. One anticipatory grief definition could be the grief that you expect to experience, much of which you don’t yet fully understand. This kind of grief is also coloured by the anxiety of the unknown, the pressure of caregiving, and the concern of trying to make the most of now. In this way, some people find that life before loss is actually more stressful than life after loss.

It’s normal (and human) to flinch when you know that pain is coming. In some ways, anticipatory grief is like emotional flinching, and it can be painful and exhausting in equal measure.

Anticipatory grief examples, meaning situations where you are likely to experience anticipatory grief, can include:  

•         Facing the approaching death of a loved one following a terminal illness diagnosis.

•         Caring for someone with a progressive condition like advanced dementia.

•         Hearing your own life-limiting diagnosis and grieving the loss of your future as you expected it.

•         Watching loss of function or independence in yourself or a loved one.

•         Preparing for death that is likely but not immediate.

For many people, anticipatory grief is a normal part of the grieving process, and something they work through as they approach a significant loss. For others, anticipatory grief can be overwhelming, and can take away from the enjoyment of precious time with their loved one.

Anticipatory grief meaning and symptoms:

There is no right way to feel, and both anticipatory grief and grief manifest in all sorts of ways. In general, however, the following anticipatory grief symptoms are common:

·       Intense sadness or tearfulness

·       Anger, irritability or frustration

·       Dread about the future

·       Regret about past moments or decisions

·       Feeling emotionally isolated

·       Difficulty regulating emotions

·       A sense of hopelessness

·       Preoccupation with thoughts about the impending loss

·       Difficulty concentrating or making decisions

·       Replaying scenarios in your mind

·       Feelings of disbelief or denial

·       Withdrawing from friends, family or usual activities

·       Avoiding conversations or situations that trigger grief

·       Changes in routines or loss of interest in normal hobbies

·       Sleep disturbances

·       Appetite changes

·       Fatigue or low energy

·       Mourning not just the loss of the person, but the life you imagined with them

·       Struggling with moments of relief alongside guilt for feeling relief

The 5 stages of anticipatory grief

When people talk about the five anticipatory grief stages, they’re usually referring to the well-known five stages of grief first described by Elisabeth Kübler-Ross. These stages are experiences many people might recognise when they start coming to terms with a major impending loss.

1.     Denial: At first, it can feel too big or too painful to face what’s happening. You might find yourself thinking “This can’t be real” or convincing yourself that the diagnosis will change. Denial is the mind’s way of easing us into the reality of a serious loss.

2.     Anger: You might feel angry at the illness, at the situation, at others, or even at the person who’s unwell. It’s a natural reaction to helplessness.

3.     Bargaining: Many people find themselves thinking “If only…” — wishing for more time, for different outcomes, or making deals in their mind to delay the inevitable.

4.     Depression: You may feel overwhelmed or withdrawn. This stage reflects the heartache of realising what’s being lost and the life changes ahead.

5.     Acceptance: Acceptance doesn’t mean being okay with the loss. Acceptance means you have come to recognise the truth of the situation and can begin to find a way forward emotionally. Many people carry major losses with them for the rest of their lives, but eventually you will start to make new, meaningful memories, plan for what’s ahead, and find moments of calm.  

Contrary to what many believe, these steps aren’t like steps on a ladder— you can move back and forth between them, or feel more than one at the same time. For most people, grief, loss, and healing are not linear experiences. You might experience a long period of depression (stage four) and then find yourself back at anger (stage two). Or you might feel that you’ve concluded your journey through the five stages, only to find yourself back on the bottom rung.

There is no such thing as a normal grieving experience.

Managing anticipatory grief

Unfortunately, if you’re experiencing anticipatory grief because you know that you will lose someone you love in the near future, then, much like regular grief, the only way out is through.

As you work through this challenging time, some common things that help include:

•         Openly sharing how you’re feeling with trusted friends, family or a support group.

•         Letting yourself experience your feelings, rather than suppressing them. This can lessen their intensity over time.

•         Learn about what’s coming. Understanding the illness or situation can make you feel more prepared and reduce uncertainty.

•         Say what needs to be said with your loved one.

•         Stay connected to your support network.

•         Take care of your body. Grief affects the whole person. Prioritise sleep, nutrition, movement and hydration.

•         Mindfulness and grounding. Simple practices like deep breathing, meditation or mindfulness can ease overwhelm.

Most importantly, seek professional support when needed. A trained, compassionate Sydney counsellor can help you manage the extent of your grief so that you can enjoy the time you have left with your loved one. Both anticipatory grief and grief are a marathon, not a sprint. If you’re struggling, a counsellor can help you pace yourself.

The impact of grief anticipatory on relationships

When we are caring for (and grieving) a loved one, it’s normal for our other relationships to fall by the wayside. This can be challenging to navigate, especially if you are anticipating a loss that may not happen for many years. In the meantime, life must go on.

Anticipatory grief can absorb a lot of emotional energy, making it hard to be fully present with friends, siblings, children or partners. The emotional burden and stress of watching a loved one decline can reduce the time and emotional capacity we have for others, and can also heighten sensitivity to conflict.

This can create misunderstandings, withdrawal or a sense of loneliness in relationships that once felt strong. Acknowledging these pressures openly, and seeking relationship and family counselling when needed, can help couples and family members navigate a long period of caregiving and grief.

When to seek professional help

It is normal to feel sad, overwhelmed, frustrated, or anxious about the impending loss of a loved one. But when these feelings are persistent, stop you from functioning day-to-day, or feel heavier than you expected, it may be time to reach out for professional support. If you find yourself struggling to eat or sleep, withdrawing from activities you used to enjoy, or feeling unable to cope with everyday responsibilities, a mental health professional can help you sort through what you’re experiencing.

Remember that it’s not necessary to reach a crisis point before you reach out. Even if you feel that you are coping well, anticipatory grief treatment with an experienced counsellor or psychologist can help. Learn more about how we approach anticipatory grief anxiety counselling here.

Help is available 24 hours with Lifeline Australia. Call 13 11 14.