Anticipatory Grief: Are You Mourning Before a Loss?

“At its most basic, anticipatory grief is feeling grief from the knowledge that a loved one is dying,” says Dr. Mary-Frances O’Connor, a neuroscientist and psychologist in Tucson, Arizona. “Imagining it so vividly that you feel that grief now.”

You may also experience anticipatory grief for other reasons. For example, when you feel your marriage is leading to divorce or when you’ve received a degenerative disease diagnosis.

“This is a uniquely human capacity, to imagine the future, to create the virtual reality of bereavement in our own minds, as though it were true,” says O’Connor, who has an upcoming book called “The Grieving Brain: The Surprising Science of How We Learn from Love and Loss.”

With anticipatory grief, you may start experiencing signs of grieving even if you haven’t quite faced the loss yet.

Does anticipatory grief help or hurt?

For some people, experiencing anticipatory grief may help to process the loss gradually. It doesn’t mean that you won’t find it as painful when the loss occurs, but you may have developed some coping skills that help you manage your mourning.

On the other hand, anticipatory grief may lead some people to behave in a way that protects them from pain. For example, they may inadvertently create friction or distance in a relationship so the loss “doesn’t hurt as much.” Or they may experience intense negative emotions that might get in the way of fully enjoying the last moments with a loved one.

Working on self-awareness may help you handle anticipatory grief in a way that doesn’t create more hurtful situations for you or your loved one.

Anticipatory grief was first noted in the 1940s by psychiatrist Erich Lindemann, who witnessed relatives of WWII soldiers in immense distress when their loved ones left for the war.

Since then, research has shown that anticipatory grief can impact many people, including:

• family members and friends of people with terminal illnesses or hazardous occupations
• hospice and palliative care staff
• caregivers of those with a progressive illness, like dementia
• those facing a potential terminal condition, like cancer

The current body of research most commonly associates anticipatory grief with caregivers, says O’Connor.

“There are the many losses that caregivers face other than death itself, including the loss of the loved one’s health and capacity, loss of their shared memories and even personality, and loss of a potential future together,” she says.

For some, anticipatory grief may feel different than conventional grief, says Dr. Joseph Stern, a grief expert and neurosurgeon in Greensboro, North Carolina.

“It can be more of an unpredictable, uncontrollable roller coaster of complex emotions,” explains Stern, the author of the book “Grief Connects Us: A Neurosurgeon’s Lessons on Love, Loss, and Compassion.”

You may feel sad or anxious about the potential loss while you feel guilty about feeling this way because your loved one is still with you.

Stern adds that the process can include both highs and lows, like:

• anger
• anxiety
• denial
• fear
• frustration
• guilt
• hopelessness
• sadness
• relief
• hope
• gratitude

You may experience any or all of these emotions. Sometimes you might go from one to the other in a matter of minutes. All of this is natural.

Anticipatory grieving can also take the form of “what if” thinking. You may wonder what it’s going to be like without them, how much worse their condition is going to get, or if they are going to make it through to the holidays. This also is natural and expected.

Anticipatory grief impacts everyone differently, but you can get through this. These coping tips can help:

Name it

People can cope by first understanding that it’s OK for grief to be happening before a loss takes place, says Jackie Tassiello, a therapist in Montclair, New Jersey.

“When we know what we’re going through, we can normalize how we feel and name it,” she says. “Once we do that, we can begin to work with processing the emotions as they come up.”

Focus on making memories

There are many ways to honor those you love, which may help your grieving process. Now may be the time to:

• celebrate holidays and birthdays early
• record photos and videos together
• read, play games, or take scenic drives
• look at family photos or home movies
• smooth over difficulties and ask for forgiveness
• help a loved one get their affairs in order
• talk about common memories and past times
• build something together, from an art project to a business to a song

Lean into your existing network

Consider cluing in people about what’s going on with you, be it a partner, friends, family, or your boss.

Research shows that those who rely on their support system are better able to cope and get to post-traumatic growth, which is the ability to find peace of mind after a difficult event.

Honor your self-care

Self-care doesn’t have to be a long and involved process. It can be as simple as pulling over on the side of the road to have a good cry after visiting your loved one.

You may also find it helpful to take up a practice that allows for reflection, like:

• mindfulness and meditation
• painting
• playing music
• calling a friend who “gets it”

Give yourself permission to just ‘be’ for a while

Grief can take a tremendous amount of emotional energy; it’s natural to feel drained, overwhelmed, and burned out, says Lear, who has an upcoming book called “A Parent’s Guide to Managing Childhood Grief.”

“Some days, you may be ready to express your feelings. Other days, you might be desperate for a distraction that can help you feel like yourself again,” she says. “Remind yourself that there’s no timeline in which you have to be done with your grief and no right or wrong way to feel.”

Find professional support

Working with a therapist can help with any grief, says Tassiello, and it doesn’t have to be talk therapy, either. There are other modalities you and your loved ones can explore together.

“For example, a child who has a terminally ill relative could begin to process their own anticipatory grief through a modality that is suited to their developmental level, such as art therapy,” she explains.

Find a support group

Even if your immediate social circle doesn’t understand anticipatory grief, some people do, says Katie Lear, a licensed therapist based in Charlotte, North Carolina.

“Group therapy can connect you with other people who may get it in a way that non-bereaved friends or family don’t,” she says. “You can have a place to say things out loud that might feel too heavy to share with other people in your life.”

You may find it helpful to join an online support group or ask your local hospice chapter for resources in your community.

Anticipatory grief is a natural reaction to impending loss. This loss can be about someone passing away or a significant life change.

While nothing can take away the sting of losing someone or something you love, there are ways to navigate anticipatory grief. For example, you can find ways to create cherished memories, work with a therapist, and keep up on some self-care.

No matter how you feel, it’s all OK. It’s all allowed. Go through what you need to go through.

“Grief doesn’t end, but it does change — and you will grow and change, too,” says Lear.

With time, peace will trickle in. If you feel it doesn’t, you may be living with prolonged grief disorder. This can be managed, too.