What is Anticipatory Grief?

Anticipatory grief – or preparatory grief – refers to the thoughts, feelings and emotional state often seen in those who know they, a loved one or someone close to them is going to die. Anticipatory grief can also apply to pets and animals who play a big part in our lives.

Anticipatory grief is often experienced following a diagnosis of a disease, such as cancer, dementia and other serious illnesses and is a coping mechanism that can bring feelings such as:

*Anger
*Shock
*Disbelief
*Numbness or disbelief
*Overwhelming sadness
*Anxiety
*Fear
*Relief
*Hopelessness
*Mood swings
*Loneliness
*Exhaustion

As you might notice, many of these are similar to depression, and people living with anticipatory grief often feel ashamed or embarrassed to be experiencing this particular sense of mourning while they or their loved one is still alive. They might also find it difficult to talk about – sometimes this is because even they can’t make sense of their feelings, or they might feel bad about experiencing these emotions, especially if they feel they have to be strong for those around them.

Many clients tell me they are feeling the loss of the person they used to know. This is common in people caring for loved ones who are living with dementia. They might also be mourning the future they feel robbed of – the milestones, life plans, holidays, grandchildren, shopping trips, watching films together… a shared future.

As well as finding it difficult to talk about this kind of grief, those experiencing it can often be told to ‘keep up appearances’ for the sake of others, or for the person who is ill. I often hear that people are told to ‘make the most’ of the time left and ‘make memories, while you can’ – these things are hard to hear for people living with anticipatory grief. They might well be judging themselves harshly already if they are experiencing complex feelings they’re ashamed of feeling or can’t make sense of.

What helps with this kind of grief?

People living with anticipatory grief often feel physical side effects such as loss of appetite or nausea and digestive issues or an inability to sleep – or they find that they’re sleeping a lot, including during the day. It’s common to feel drained and exhausted and to rely on comfort food. Concentration can be affected: brain fog and forgetfulness can be an issue. So, what helps? While everyone is different and every circumstance is unique, but there are some things you can try that might help if you feel you’re in mourning while a loved one is still alive:

*Talking: share how you’re feeling with a close friend or family member. If you don’t feel you have anyone you can open up to, ask a member of your loved one’s medical team if they can signpost you to a talk therapy. And of course, talking things through with a specialist bereavement counsellor will help

*Lifestyle: are you eating well and enjoying a balanced diet? Is your sleep impacted – if so, what might help improve your night-time routine? Are you moving much? Exercise can help with sleep, anger issues and improve overall wellbeing. Going for a walk in nature will help you cope

*Relaxation: are there any calming activities you can do? Yoga, meditation and breathing exercises are helpful as is visualisation

*Cut out unhelpful coping mechanisms: alcohol, caffeine, junk food and takeaways, smoking, substance misused… while these might feel comforting, they won’t help in the long run

*Get it out; keep a journal and write down your feelings. If you can’t do that, speak about how you’re feeling and record it in a voice note

*Find a community; depending on what kind of illness or condition you’re dealing with, there might be in-person or online support groups where you can chat with others who can understand. Most areas also have bereavement meet-ups on a weekly or monthly basis (these are run by churches, hospices, charities and voluntary groups) where you can talk to others who have gone through the same or similar circumstances and who understand.

 Know that it’s normal

All grief is a natural response to loss and while anticipatory grief might feel overwhelming at times, it’s normal too. Know that there is no right or wrong way to grieve and there is no normal way to think, feel and behave when faced with death. Be kind to yourself and practise self care: don’t pay attention to the negative internal and external voices that you feel are judging. Put them in a box in your mind and put them away and take each day as it comes.

Seek help

Remember, your GP can help if you feel your anticipatory grief is too much to bear and organisations like Samaritans and Cruse have trained listeners if you feel better able to talk to a stranger on the phone.

Here are some helpful numbers for seeking support:

Samaritans – call 116 123

Cruse – call 0808 808 1677

Dementia UK – call 0800 888 6678

Maggies Cancer Care – 0300 123 1801

Papyrus Hopeline – call 0800 068 41 41

If you're living with anticipatory grief and think you might find talking to a specialist bereavement counsellor to be helpful, please don't hesitate to get in touch. And lastly, please take care of yourself.