Anticipatory Grief

Anticipatory grief is the collection of thoughts, feelings, and physical sensations that we experience when someone close to us is dying or we fear is going to die. It is similar to "normal" grieving, in that anticipatory grief often includes all the classic stages of grief: denial, anger, bargaining, depression, and acceptance. Depending on the nature of the illness or injury, the process can last for months, even years.

Anticipatory grief reactions vary widely; some people have a strong grief reaction, while others have none at all. Many factors contribute to how we experience anticipatory grief. The type of illness or injury, its duration, the periods of uncertainty before and after the diagnosis, the strength of our support system, and the relationship we have with the person who is sick all play a part. Often, the result is a rollercoaster of emotions. The grieving process changes how we experience life and how we cope with its everyday stresses.

As I write this, I too am working through the process of anticipatory grief. My father died when I was thirteen years old. His sudden death and the upheaval in my family in its wake took me years to work through. Now, twenty-nine years later, my stepfather is in treatment for cancer. While his prognosis is good, I have struggled with feelings that are common in anticipatory grief. For example, I am unable to trust that he will be "okay". I sometimes worry about his pain and fear. Also, I remember my fatherís death with renewed clarity. These and other feelings arrive unexpectedly and depart suddenly.

Although my personal experience with anticipatory grief is consistent with my expectations from my training as a therapist, the intensity of my reaction has surprised me. My relationship with my stepfather is complex. He came into my life just a few months after my dad died and we have always had a difficult time communicating. His way of interacting is abusive and I have chosen not to be in contact with him.

However, as I work through the anticipatory grief process, I have discovered many feelings for my stepfather that I never knew I had before. I realize that I am thankful for all he has given me and for all he has tried to teach me. I realize that he has love for me, and that I have love for him as well. When I think about the possible imminence of his death, I grieve not only all that will be lost, but for all that is still left unsaid between us.

I know that healthy anticipatory grief can be a healing experience - a way to take care of any "unfinished business". For me, it also feels like an unexpected gift - an opportunity to explore past hurts and to rethink my relationship with my stepfather.

© Jill Lehman, MFT

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