Gina Moffa, LCSW, a licensed grief and trauma therapist and author of the upcoming book Moving On Doesn't Mean Letting Go: A Modern Guide to Navigating Loss, explains that anticipatory grief is a grief that is experienced when expecting a loss—before the actual loss occurs. "We know that in time, we will lose them, and so we preemptively feel the loss and the grief," she says. This is particularly common for people whose loved ones get a terminal health diagnosis (like end-stage cancer).
Moffa adds that people can also experience anticipatory grief with non-death health loss, such as dementia, Alzheimer's, or a diagnosis that leads to decreased mobility or participation in everyday activities. Anticipatory grief can also accompany other losses, such as losing future identities, routines, experiences, possibilities, or an imagined future. For example, a person might feel anticipatory grief over their imagined future as a parent if they receive an infertility diagnosis. "Any changes that can lead to an interruption or a complete stop to a way of life is something that can be grieved and also can be grieved in advance," she says.
Holly Strelzik, a death doula, grief specialist, and founder of Center for the Heart, adds that people can also experience anticipatory grief with a dying pet, when dealing with birth problems (in-utero complications, in-vitro fertilization, or adoption), as well as when going through big life changes like moving, leaving a job, or changes in relationships.
"Every individual experiences grief in their own timeframe." —Holly Strelzik, death doula and founder, Center for the Heart
While the circumstances surrounding anticipatory grief might differ from grief after death, the emotional experience of both is fairly similar. Moffa says that for some people, anticipatory grief may help them prepare in advance for the void that grief can create, but the emotional and physical symptoms can be just as overwhelming and painful to endure. "[Symptoms of anticipatory grief] can range from emotions such as sadness, confusion, anger, denial, depression, anxiety, fear, or even numbness," she says. "This can also be accompanied by full-body experiences, such as headaches, stomachaches, increase or decrease in appetite, sleep, disturbances, sexual disturbances, and many more."
Moffa says experiencing anticipatory grief doesn't necessarily mean you will grieve the loved one any less after they are gone. In some cases of anticipatory grief, she says carers of people who are terminally ill become closer to their loved one, making the grief they feel after that person's death feel even more intense.
It's also important to remember that with any form of grief, don't expect it to follow a particular timeline. "Every individual experiences grief in their own timeframe," Strelzik says. "Even if their loved one has been declining for a long period of time, there is no true preparation for the grief after the actual death." Don't get too caught up on the popular concept of the five "phases" of grief, either. It's often cyclical, ebbing and flowing depending on other things going on in your life.
What's unique about anticipatory grief is that it happens while you're still in the process of losing someone or something—whether that's watching your grandmother with Alzheimer's deteriorate before your eyes while you're taking care of her, or scheduling appointments to have a D&C for your pregnancy loss. This might make it hard to make space for feeling these feelings, particularly if you're in a caregiving role for the person whose loss you're anticipating. But it's important to honor your anticipatory grief rather than bottle it up permanently inside. Moffa and Strelzik share their tips for coping with this unique form of loss below.
3 ways to help you start to deal with anticipatory grief
1. Take care of yourself
Although grief can be overwhelming and all-consuming, both experts emphasize the importance of taking care of your mind, body, and spirit during this time. In other words, put self care at the forefront as much as possible. Moffa says that includes nourishing your body with good food, drinking lots of water, resting, and incorporating gentle movement into your days. Strelzik also points to being in nature, connecting with your pets or other animals, taking warm baths, and carving out some quiet moments alone to listen to soothing music as great forms of self care when experiencing anticipatory grief.
Getting enough sleep is also vital. "Without [sleep], you run a high risk of damaging other important relationships, developing burnout, and running your own health into the ground, which will not serve anyone," Strelzik says.
2. Feel your feelings
Whatever you're feeling, Strelzik says it's normal and natural, and it's important to allow yourself to feel all the emotions that may be coming up. Moffa recommends finding a safe place and way to express those emotions like keeping a journal, which she says can be a powerful therapeutic tool to help you process your feelings and experiences. You can also "schedule" time to feel your grief by setting aside 15 minutes in a day to let loose your emotions in a safe space. The most important thing, she adds, is not to numb your feelings with things like alcohol or drugs.
3. Lean on your support system
Lastly, remember that you don't have to cope with anticipatory grief (or any grief, for that matter) alone. This is the time to lean on your support system, whether that includes trusted friends, family members, or a professional therapist. "There's no shame in seeking help, even if someone doesn't feel like it's an acceptable time to feel grief or feel they will be judged," Moffa says. "Your experience of grief is valid, whether before a loss, during, or after experiencing a loss."
In addition to reaching out to loved ones for support, Strelzik suggests finding a support group with whom you feel safe expressing your true feelings. Talking with others who are going through or have gone through what you're experiencing can bring great comfort during this time. You might find such groups offered through a therapist's office, through local faith groups, or organizations like GriefHaven or Center for the Heart.
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