Grieving Before Goodbye: Understanding Anticipatory Grief 

By Nathan Galvan, LPC-Associate
Supervised by Jennifer Buffalo, LPC-S, LMFT-S

I remember growing up and losing my Abuela when I was young. Everyone had gathered around the house, tears were being shed, and I was playing with toys with some of my cousins. I hadn't understood, at the time, what was going on and why everyone was so sad. It wasn't until my mom explained it to me that I realized what losing someone meant—that one of my favorite people would no longer be around. I began to get sad, and I cried. I was feeling grief.

Since then, loss and grief have not been strangers to me, but the newest feeling of grief is anticipatory grief. Being a caregiver for someone I love and cherish, and knowing they too will no longer be a phone call away or a dinner conversation to be had with them. I had heard once that grief is an expression of love when love doesn't have its place to go anymore.

If you are a caregiver or know that a loss is coming, then you may be experiencing anticipatory grief.

So what is anticipatory grief, and how is it different from grief?

Anticipatory Grief

Anticipatory grief is when we begin to mourn something or someone when a loss is expected. Most often, caregivers or loved ones will experience this emotion when someone has a terminal diagnosis or long-term illness. This kind of grieving can be for the thought of the loss or even the experiences and opportunities that will be missed because of the loss.

Knowing something in advance doesn't always change the outcome, nor does it always change how we feel about the situation. Many have heard of the five stages of grief by Elizabeth Kubler-Ross: denial, anger, bargaining, depression, and acceptance. In anticipatory grief, there are four stages: acceptance, reflection, rehearsal, and imagining.

In acceptance, one has come to terms with the expected outcome.

With reflection, closure may be attempted, coming to terms with feelings and the past.

During rehearsal, one may imagine how they would feel when the loss occurs, how they'll act, and things they may need to do.

And with imagining, you begin to imagine what life is going to be like after the loss has occurred.

But everyone grieves differently, and loss means different things to different people and cultures. It's not always stages, and it can cycle.

Some ways to know you may be experiencing anticipatory grief are:

• Loss of appetite
• Intense emotions of sadness, anger, and loneliness
• Playing scenarios in one's head or rehearsing
• Anxiety and fear
• Sleep disturbances
• Numbness
• Difficulty concentrating
• Withdrawal from others

What can you do when experiencing anticipatory grief?

• Be open and talk to others
  • Share the experience you are going through, tell stories, discuss hardships, laugh and cry, and have someone to help you feel less alone.
• Embrace the time you have left with them
  • Ask them things you may not have asked before, share memories, and help provide comfort.
• Grieve in small doses and feel your emotions
  • Grieving can build up unexpectedly. Experiencing your emotions allows you to hold space for yourself. Bottling up emotions can lead to other means of coping that aren't so healthy.
• Take care of yourself
  • Whether you're a caregiver or someone preparing for a loss, taking time to care for yourself is important and paramount. Do a comforting activity or something that brings you peace.

Conventional grief and anticipatory grief are parts of life that may be unavoidable. But we can do our best to take care of ourselves and the loved ones we're caring for.

If you or someone you know needs support, contact us at Luminary Counseling. We offer both individual therapy and support groups, including a Chronic Illness Support Group! Reach out to us at [email protected] or [email protected] if you’re interested.