Ask a Psychologist: What is Anticipatory Grief and How Do We Manage It?

What is Grief?

Grief is a common and natural response that we experience in response to loss. The grief response can be social, cognitive, physical, and / or emotional. The loss may refer to the loss of a loved one, a job, a relationship etc. We all experience grief differently, and how we cope with grief depends on our usual emotional regulation patterns, our age, life experience, spiritual beliefs, etc. Some common feelings experienced during grief are:

• Sadness

• Anger towards self and others (or the environment)

• Guilt

• Shock and disbelief

• Numbness

• Anxiety and fear

• Fatigue

• Difficulty focusing

What is Anticipatory Grief?

Anticipatory grief occurs when one experiences grieving a loss before it has occurred, or when one is expecting a loss. It involves thinking, feeling, and imagining what life will look like or how one may feel when the loss eventuates, whether it is a loved one, a relationship, or a job, even though the circumstance and situation have not yet changed. It involves focusing on the future and steering us away from the present moment. Anticipatory grief is more common than we think, and can occur in situations where we watch a loved one battling a terminal illness, we become unwell ourselves and lose functioning in our daily life, experience a relationship inevitably coming to an end, or expect retirement in the near future etc.

How Does Anticipatory Grief Differ from Grief after a Loss?

When we grieve after a significant loss, we know what we are grieving for, and there are some certainties and practicalities in what we can do. It has a defined path, a clear before and after. The challenge with anticipatory grief is that it is usually unclear, and the situation or loss often lacks clarity. The lack of clarity makes it hard to understand and comprehend.

Anticipatory grief also means that we are holding different feelings and concepts in mind at the same time. Here are some examples:

· Hope and loss

With anticipatory grief, it is common that we do not know how long the anticipatory grief will last for, as the question of "how long" is often unknown and unanswered. The lack of certainty can be challenging to sit with. Holding hope while experiencing anticipatory grief is common. It is essential that we validate our response and allow both experiences to coexist.

· Connection and grief

Anticipatory grief is experienced while something or someone important is still present and around us. Very often, we are caring for the person in our daily life while feeling the sadness and grief. Similar to the above, experiencing ongoing connection and grief can coexist. This can be challenging for some, as being connected means being engaged meaningfully, which also puts us in a delicate position. For some people, the feeling of vulnerability may cause them to withdraw.

· Problem solving and letting go

When a loved one is battling an illness, our usual instinct is to problem-solve and find a way through treatment. At the same time, anticipatory grief means that we are also working on acceptance and letting go. These two seemingly opposite concepts tend to occur at the same time, and it is important to acknowledge the difficulty of being in this space.

How to Cope with Anticipatory Grief

The same as with grief, managing anticipatory grief is not about changing the pending loss. The management is grounded in accepting reality, accepting our own experience and making sense of our emotions. Here are some examples:

· Allowing ourselves to feel some opposing emotions.

as detailed above. For example, we may want to stay present and be connected with someone, while also allowing ourselves to feel the sadness and grief. We don't have to choose between one or the other, as both can be true at the same time.

· Identifying and naming the ambiguity we are experiencing right now is helpful in validating how we feel and what we think. There is no right or wrong way through this, and our experience is real. Naming and validating it helps reduce the intensity and isolation associated with grief.

· If you are the caregiver for someone, looking out for compassion fatigue is important. Seeking support and having respite when appropriate helps reduce burnout and allows time for ourselves to make sense of our experience and emotions.

· Consider professional support when your emotions start to feel unmanageable, or when they start to affect your everyday functioning. A psychologist can help navigate these complex emotional experiences and provide practical skills for managing different forms of grief.

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