What do we do in the waiting? Navigating anticipatory grief with grace

In my work as a therapist who specializes in grief and loss, I often encounter clients who have just learned of a horrible diagnosis - either of someone they love or of their own.  When I meet them I am brought back to my own experience with that heart breaking, unbelievably agonizing reality that I am not in control of what happens and that no matter what I try, I cannot change the unknown outcome. 

My own experience of anticipatory grief occurred when we found out that our unborn daughter would most likely not survive, and even if she did, she would have major physical, and perhaps, mental disabilities. We were told this at our 20 week ultrasound, and as first time parents, we were thrown into a world that involved specialists, science and fear. Suddenly, our joyful happy news turned into hushed conversations by those who knew us well. No one knew what to say. We were told all the platitudes, “God is in control”, “Look on the bright side, you can get pregnant”, “This too shall pass”.

I took it all in and tried to look at the bright side, pray and hope. But what I was feeling was anger, anxiety, sadness, fear, loneliness and guilt. I felt so alone and nothing anyone could say was going to change that.

I know now that I was experiencing anticipatory grief. Anticipatory grief is a reaction of grief that happens before the loss, such as a death, occurs. It can be experienced by a person who is dying, or by their loved ones. Much like conventional grief, there are phases that can occur which can include:

• Denial

• Anger

• Bargaining

• Depression

• Acceptance that death may happen which can lead to more sadness and/or depression

• Concern for the dying 

• Rehearsal of the death which may look like preparing to say goodbye

These phases are never linear and can occur multiple times a day or not happen at all. Everyone is unique in how they grieve and with anticipatory grief it may look similar or totally different from typical grief.

When we anticipate a loss, we imagine the world without our loved one in it. This can be a time when we start to prepare ourselves and those around us for what is to come. Unfortunately for many people, this can be a time of anxiety as no one truly knows the future. This can also be a time of guilt because others may be angered that you are grieving for what hasn’t happened yet. They may want you to act like it will be okay, even though you don’t think it will be.

If you find yourself stuck in the quicksand that is anticipatory grief, consider these coping tools:

1. Allow sadness in the moment. When you talk about your sadness, it will let you connect with the person you love and allow them to connect with you.

2. Instead of projecting yourself into the future and what may come, be in this moment and ask yourself what do I need right now?

3. Acknowledge that the future hasn’t arrived and be here, now.

When we allow all of our truthful emotions, it keeps us from wasting precious time with our loved one. 

Our daughter ended up being born healthy and happy (save one very stubborn clubfoot) and our fears were never fully realized. But in those dark days when we didn’t know the future, being able to use the tools to help the possible grief that was to come allowed me to be present in the moment.

Lori T. Howard is a Marriage and Family Therapist who specializes in grief and loss. You can find her at lorithoward.com.