When my mother was diagnosed with Lewy Body Dementia, it was the most difficult time of my life. Not only was I dealing with her care, but I was anticipating her slow, inevitable decline and death. I was living in a kind of betwixt and between, trying to balance caring for her, my young children, and my patients, while feeling palpable grief for what I was about to lose.
This is what’s known as “anticipatory grief”—a reaction to loss that hasn’t yet occurred. While it’s fairly common to experience it for a loved one facing a terminal illness, you can also experience it in other potential loss situations, like retiring from a fulfilling career, a child going away to college, or divorce. It often involves a liminal state of being, like what I experienced, that can wreak havoc with your well-being and interfere with your ability to be present.
While similar to after-loss grief, anticipatory grief has its own issues and trajectories that can make it hard to manage, says Alan Wolfelt, director of the Center for Loss and Life Transition and an expert on the topic. While you may lean toward ignoring or pushing away these complex emotions, denying your grief and suffering silently will probably not help you or your loved ones cope better.
“Too often, people are trying to be happy at times when they should be sad, and that inhibits their ability to fully integrate a life transition into their world,” says Wolfelt. “We can better cope with realities we face by acknowledging them.”
Anticipatory grief, like after-loss grief, can be painful. But by understanding what it’s like and giving yourself permission to explore its many facets, you might be able to mitigate some of the pain and move through it with more intention.
Similar and different from regular grief
Like grief after a loss, anticipated grief can involve strong and varied emotions. You may feel happy, sad, angry, confused, worried, relieved, guilty, and more, and the feelings may arise at seemingly random moments, sometimes overwhelming you. Your feelings can be hard to explain even to yourself, let alone others.
For example, imagine your teenage son is applying to colleges. Suddenly, you’re hit with the reality that he’ll be leaving home soon and your life will change dramatically. You may feel sad anticipating losing your son’s everyday presence, look forward to a new, freer chapter in your life, or both. You may feel pride and joy for his bright future, but fear losing your close relationship and your role as his parent.
These myriad emotions can be disorienting—but it’s important to honor them, however they show up, says Wolfelt.
“The more open acknowledgement you can have of what your genuine, authentic emotions are, the better,” he says.
While grieving a death may seem natural and expected, anticipatory grief may come with some resistance, like telling yourself (or other people telling you) there’s no reason to feel what you’re feeling. However, according to Wolfelt, denying your pain only adds to it, negatively affecting your everyday well-being. A better way to handle anticipatory grief is to own it and process it through mourning.
“Grief is the internal response, the thoughts and feelings inside,” he says. “In contrast, mourning is the shared social response or grief gone public; it’s taking your grief and putting it into action. That creates change or movement.”
The importance of mourning
There are known, socially-acceptable ways to mourn someone who’s died, like funerals, sitting Shiva, Dia de los Muertos, and other rituals. While there may be fewer structured ways to manage anticipatory grief, we can help ourselves through the experience by understanding the importance of mourning in processing grief.
“Mourning helps you integrate loss and be transformed by your grief,” says Wolfelt. “You get stuck if you grieve but don’t mourn.”
The very nature of anticipatory grief (or any grief) is that it can feel different from one moment to the next, and from one person to another. That means our mourning needs may change over time. No one needs to follow a specific pattern, says Wolfelt, but we all need to pay attention and take our grief seriously.
This may be easier or harder, depending on several factors. How close you were to a person, your cultural or spiritual beliefs, and differences in your personality and gender can all influence how you mourn and how effective you are at managing grief versus staying stuck in it.
“If you have low social support, a history of anxiety, a history of a [strongly] dependent relationship with the person (for example, you haven’t expanded your social support system beyond the person who’s dying); those are risk factors that research clearly shows can make it more challenging for you,” he says.
A healthier way to mourn
While no one needs to mourn in the same way, Wolfelt suggests in his guidebook on the topic that people try to meet six specific needs to get through the experience:
- Acknowledging that you are grieving and the reality of your loss. You may feel it’s too hard to acknowledge the impending loss, but denial doesn’t help. Instead, acknowledging all emotions is a better path toward well-being, even in the midst of grief. Facing your reality more squarely can help you figure out what you need.
“[T]hinking of yourself in this way will help you be both self-compassionate and honest about how challenging your current circumstances are,” he writes.
- Embracing all of your emotions, pleasant and unpleasant. Anticipatory grief is marked by changing, intense emotions. Naming them can help to tame them, making them less overwhelming. You can also try reframing the meaning of your feelings to make them less problematic, such as recognizing grief as a facet of loving someone deeply.
If you’re feeling emotionally overwhelmed by grief, Wolfelt recommends dosing it—meaning, letting yourself fully experience your emotions, but limiting how long you do that. When not focusing on your grief, it’s fine to distract yourself, evade thoughts, or do whatever you want to keep your grief from being so dominant, he adds.
“There’s a balance to be had between doing the work of anticipating loss and in balancing that with the ability to stay present in the here and now,” he says.
This may be especially important when taking care of someone you will be losing, as caregiving often requires a more outward than inward focus. Having a way to care for your emotional needs outside of that role can be helpful.
- Exploring memories of the love or attachment you’re losing. This may seem like a step to avoid, but Wolfelt says it’s important for managing anticipatory grief. Reviewing past memories allows you to create a narrative around what is happening, something humans need to help make sense of their lives and feel congruency. Research suggests that allowing ourselves to feel nostalgia for the past has many benefits, including putting us in touch with our authentic selves and what matters in life.
“The more time and attention you devote to exploring memories and sharing and discussing them with others, the more your sense of peace will grow,” writes Wolfelt.
- Developing a new self-identity. Often our relationships are part of our identity—we are a partner, a mother, a daughter, or a colleague. Our impending loss may make us question who we are in the world. It’s important to recognize that and address it.
For example, if you’re losing your wife of many years, through divorce or death, your friendships may be affected and your social circle may shrink; once-shared activities may no longer appeal or be possible. While you may grieve this transition and the changes it brings, it also opens up possibilities to embrace new roles in life.
“Change is often both a loss and an opportunity, even if it’s an opportunity you would never willingly have chosen,” writes Wolfelt.
- Searching for meaning in the experience. When facing loss, many of us begin to question the meaning of our lives. “It’s important to focus on meaning and purpose, both in the attachment that is ending and in your continued living,” writes Wolfelt. This might take you into spiritual territory, stimulating questions about why you exist, what it all means, and how you can go on.
Seeking meaning from your experience can help one cope in the present with difficult future losses as well as later on, after the loss has occurred. To help explore that, Wolfelt suggests reading inspiring texts, meditating or praying, talking with spiritual advisors, journaling, or spending more time in nature. Whatever puts you closer to your own sense of meaning will help you find peace, and more reasons to get up in the morning if you are feeling dragged down.
- Reaching out to others for support. As mourning is an outward experience of inner pain, finding other people who can listen as you grapple with your emotions, memories, and questions about life’s meaning can be soothing and helpful.
“You might feel undeserving of attention because the ultimate loss hasn’t really happened yet. But I’m here to tell you that your current grief is completely real, valid, and necessary. And there are others who will understand,” he writes.
Look for someone who can listen empathically without trying to guide you (or bully you) into feeling better, he says. No one experiencing anticipatory grief should ever be pushed into something that doesn’t feel right or given pat phrases that discount their pain.
“Cliches can be very painful to somebody who’s experiencing grief—trite comments like, ‘You’re holding up so well, time heals all wounds, think of what you still have to be thankful for,’” he says. “While well intended, they’re often misinformed and are a projection from the outside in.”
Choosing whom exactly to share with can be tricky. But you can look to family and close friends, support groups experiencing the same types of anticipated loss, spiritual advisors, or professional counselors, writes Wolfelt.
“Find people that can walk into the metaphorical wilderness of grief and honor that you’re in a liminal space, without feeling the need to pull you to the left or right or to pull you out,” he says. “Those are the genuine, compassionate people that we need in our lives.”
If approaching someone with your grief feels too daunting, you can still help yourself by just being around people more generally. We all need social connection for our health and happiness, and having a fun night out with friends, small interactions with neighbors, or a coffee at the local café can make you feel less alone, even if you don’t explicitly talk to anyone about your grief.
Dealing well with grief is a life skill
We will all face loss at some point in our lives—but we’ll only anticipate grief when the loss involves someone we love. Love and grief go hand in hand, says Wolfelt, making it central to a life well-lived.
“The capacity to give and receive love means we will likely mourn someday,” he says. But living in a “mourning-avoidant, emotion-phobic” culture, he adds, we don’t always have the right tools handy for guiding ourselves or others through it.
To be better prepared, it’s wise for us all to cultivate the skills that will serve us well in times of grief and loss. Having greater emotional intelligence, mindful attention, meaning and purpose, social connection, and hope can all help, says Wolfelt. Fortunately, these can all be deliberately practiced long before a loss comes along, helping us lead healthier, happier lives overall.
“These are central needs. The more you can befriend those needs, the more you integrate loss into your life,” he says.