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Dealing with anticipatory grief and understanding loss

November 23, 2021 - 13 min read


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What is anticipatory grief?

Causes of anticipatory grief

How is anticipatory grief different than grief after a loss?

Five tips for coping with anticipatory grief

We all face loss in life. Over the past two years, there was so much loss. Many people became more aware of different types of loss in a way they might not have thought about before. Each type of loss has its own challenges.

In this article, we'll explore some of the challenges that come from knowing that a loss is coming. Having time to prepare, brace, or say goodbye has some benefits, but it also often comes with grief that might be harder to navigate in our work and social lives. This pre-loss grief is called anticipatory grief.

What is anticipatory grief?

Anticipatory grief is grief that occurs before a loss. You have an awareness that a big change is coming and start to envision your life in the face of the change.

Many people experience anticipatory grief without realizing that it is a type of grief.  Indeed, it is a distinct kind of grief. It has its own characteristics, causes, and potential complications.

Anticipatory grief can catch people by surprise as they think that grief only comes after a significant loss.

As humans, we have the capacity to think ahead, strategize and plan. This capability to look ahead means that we can consider our new life or identity in the face of an upcoming, planned, or impending loss. 

This can serve us by allowing us to prepare and plan for the loss. In the case of a dying loved one, it affords the opportunity for loved ones to be purposeful about spending quality time together, say their goodbyes, potentially repair relationships or say things that were left unsaid. 

In the case of an impending job loss, it allows time to plan for financial impacts, update your resume, connect with colleagues, and enlist them as references for your job search.  

It does not make grief after the loss any easier though.  

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Causes of anticipatory grief

As with normal or uncomplicated grief, any significant loss, especially a loss that formed your identity, can cause grief. In the case of anticipatory grief, it shows up before the loss has occurred. 

Some causes of anticipatory grief include:

  • Caring for a loved one with chronic or long-term illness.  Caregiving is one of the hardest jobs any of us will ever do. We may be asked to do things we know nothing about, and things we never thought we would have to do all in service of our loved one.

    Anticipatory grief shows up as sadness as you consider the change in your relationship in the face of loss of function and disease progression in the patient. You mourn what you used to have and yearn for it back. In the case of dementia-related illness like Alzheimer’s, the grief may come as it sinks in that your loved one, as you knew them, no longer exists.

    Anticipatory grief may also show up as fear as you think about your own needs and if you will have the resources and fortitude to persevere in caregiving, especially over the long term. You may feel unworthy of support since “you are not the one with the illness.” You may try to push down your feelings or avoid seeking support.

    Anticipatory grief is real though and you deserve support for your own grief journey even as you care for your loved one.
  • The onset of a life-changing diagnosis.  Whether for yourself, a friend, or a loved one, a life-changing diagnosis can bring on anticipatory grief.

    It’s natural to think about what might change, what you may need to adjust in your life, what you may not be able to do anymore, and what the diagnosis means for others. You may feel fear as you think about the treatment options and how they may impact your life.  Feelings of sadness, fear, and anxiety are all normal as you experience anticipatory grief.
  • End-of-life care. Knowing that a loved one’s death is imminent can be one of the scariest times in one’s life.  It’s a time when you may be called on as a caregiver. It’s a time when many things are out of your control.

    It’s a time when you cannot help but think about what life will be like after your loved one dies. Not only are you thinking about the loss of the relationship, but there may also be other associated losses such as a home, holiday rituals, pressure on familial relationships, or financial considerations that are normal parts of anticipatory grief.
  • Hereditary cancer risk. Just knowing you have a family history of cancer can cause anticipatory grief.  You may have seen your loved one go through illness, surgeries, and treatments. You start to envision yourself going through those as well, perhaps you even envision your death. 

    It’s normal to play out these scenarios and to experience fear, sadness, or anxiety as you think about when or if a cancer diagnosis may come and how it will change your life. Thankfully, modern medicine offers some support through early screening and detection, genetic profiling, and targeted treatments. Yet, facing this can be scary. Any hope that modern medicine offers may not take away your anticipatory grief, nor should you feel unworthy or ashamed of your feelings as you move through this process.
  • Divorce. The decision to end the relationship can be traumatic, chaotic, filled with fear and contradictory emotions. You may feel a loss of control, fear for how it will affect children, fear for your financial future, and loss of identity.

    There may be associated losses such as common friendships or standing in the community. These are deep losses that helped form your identity and thus may lead to anticipatory grief as you look ahead to the divorce process and life after divorce.
  • Impending job loss. For many people, their identity is tied to their career. The potential loss of a job therefore can shake you to your core.

    It can be disorienting and hard to envision who you are without your job. It can be scary as you consider losing touch with colleagues, loss of identity, and potential financial impacts. For many, this loss impacts more than just the individual. It can impact the family and personal social connections.

    It’s normal to experience anticipatory grief over a known or upcoming job loss, even before it’s official. Indeed, many people find that the anticipation can be quite difficult as you work through your next steps, what you would like to do next, and put actions in place to embark on the job search. Many companies offer outplacement and/or career services support so try to take advantage of those offerings to support the transition.
  • Impending loss of a pet. Pets add so much to our lives. They can become like family, providing comfort, companionship, and enjoyment. When a beloved pet is sick, has been diagnosed with a life-threatening illness or is growing older, it’s natural to experience anticipatory grief.

    It’s hard when people in your life don’t recognize your grief and try to minimize your loss. Sometimes, others don’t understand your grief for the impending loss of a pet.  It’s important to seek out those who meet you where you are and support you in your grief journey as you mourn the impending loss of your companion.
  • Relocation to a new city. Even if relocation to a new locale is seen as a positive development, it can still be fraught with feelings of anxiety, uncertainty, and doubt. For many people, where you live, is where your social support system and family are. You may have spent years developing contacts in the community, participating in activities that bring you joy and that deepen your social supports.

    Even though technology today can soften the blow, providing opportunities to stay in touch and even see one another via video conferencing, it’s still a very big change to be across the country rather than right around the corner. 
  • “Empty nest” when children leave home. Parents plan for this transition almost from the day their children are born. Yet when it comes, it can be very disorienting. You have spent years, decades even, investing time and attention into your children. The home is noisy with the sounds of youngsters, then adolescents. Once children start to leave the home to begin their own lives, it’s normal for parents to have mixed emotions.

    Since most parents know that this day is coming, it’s ripe for anticipatory grief. Creating some new rituals or even going on a trip away can ease the transition to the empty nest and support parents in getting to know one another again, opening space for rediscovering old passions, or creating new ones.

How is anticipatory grief different than grief after a loss?

Anticipatory grief has many of the same emotional and physical symptoms as normal or uncomplicated grief. The biggest difference is that anticipatory grief occurs before the loss has happened. 

Anticipatory grief, like normal or uncomplicated grief, has no set timeline. You may experience anticipatory grief days, weeks, months, or years ahead of the actual loss. For instance, in the case of long-term illness, the time between diagnosis and death can be quite lengthy over years or decades.

Even after the loss has occurred, grievers may experience anticipatory grief in the days, weeks, or even months leading up to key milestones such as Mother’s Day, Father’s Day, birthdays, wedding anniversaries, or anniversary of your loved one’s death.

At times, grievers experiencing anticipatory grief may feel isolated as they don’t feel worthy to grieve prior to the loss. They may experience confusion over grief reactions that appear well after the loss yet in the time leading up to key milestones. That is, until they understand the true nature of anticipatory grief and can name their feelings for what they are.

In the most polarized reaction, grievers may catastrophize, envisioning the worst outcome. Catastrophizing can lead to even more anxiety, analysis paralysis, or inability to move forward. One way to circumvent catastrophizing is to reframe. Reframing involves the practice of identifying the thought, labelling it, and shifting the thought by choosing to replace it with one that is more helpful.

Five tips for coping with anticipatory grief

Knowledge of impending losses can bring on anticipatory grief. 

Here are five tips to support you through this time of transition:

  1. Stay in the moment. Even as you work through your anticipatory grief, don’t let your thinking about the future loss impede your joy for today. This is especially important if it involves caring for or spending time with a loved one who’s dying or has a terminal diagnosis. You don’t want to miss the important sharing and deep connection that this tender time in their lives can bring.
  2. Find the helpers. If you are a caregiver for someone with significant special needs or complex medical issues, it’s important to also take care of yourself.  Prioritizing what you need may feel difficult at this time. Yet it’s important to enlist others to support you, provide respite, pragmatic support such as cooking and cleaning, and companionship to bring distraction from the difficult task of caregiving.
  3. Avoid catastrophizing. It’s normal to feel overwhelmed and while there may be things that are scary as you look ahead, practice reframing to reduce anxiety, put the impending loss in perspective, and provide space for you to plan your next steps.
  4. Practice gratitude. Very often, impending changes that bring on anticipatory grief can also come with commensurate blessings. By focusing on what you have and shifting away from the focus on what you are losing, you may find a more positive outlook, stay in the moment much more easily and reduce catastrophizing thought patterns.
  5. Know when to ask for help. Depression is one of the potential emotional reactions to grief, including anticipatory grief. If you are experiencing difficulty sleeping, cannot get out of bed, are unable to work, or have severe anxiety or depression, it may be time to seek professional help.

Bottom line: Ask for help

The good news is that, just like normal or uncomplicated grief, anticipatory grief tends to lessen over time. Acknowledging anticipatory grief means that you understand how important the impending loss is to you. Allow yourself the time and space to work through your anticipatory grief just as you do through the grief after a loss.

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Published November 23, 2021

Nikki Moberly, PCC, CBC

Better Up Premier Fellow Coach

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