Anticipatory Grief: A Journey Through Loss Before the End
In my work as a grief therapist, I often encounter a type of grief that begins long before
a loved one is gone. This is what we call anticipatory grief—a quiet, creeping sorrow
that fills the spaces of everyday life. Unlike the intense grief that comes after a loss, this
kind is slow-burning, always lingering in the background, waiting. It manifests as we
watch a loved one decline, as treatments stop working, or as energy drains from
someone who once seemed so full of life.
Anticipatory grief is uniquely challenging because it forces us to confront loss in stages.
It’s a deep, layered grief that arises when we see the gradual disappearance of the
person we know, whether through illness, cognitive decline, or the inevitability of aging.
The future we imagined begins to shift, and we start grieving not just the eventual death
but the smaller losses along the way—their ability to speak, to remember, to simply be
who they once were.
One of the most poignant aspects of anticipatory grief is that it’s accompanied by a mix
of emotions. There’s sadness, of course, but often there’s also frustration, anger, guilt,
and even relief. Relief that their suffering may soon end, coupled with guilt for feeling
that way. Families, in particular, struggle with these conflicting emotions. They love the
person they’re caring for, but they also long for the suffering to be over. It’s a painful and
complex emotional landscape to navigate, and as a grief therapist, I hold space for all of
it.
One client I worked with, Maria (Client’s name changed for privacy), was caring for her mother who had been diagnosed
with Alzheimer’s. Every week, Maria would come in and talk about how she felt she was
losing her mother in pieces. “She’s still here, but she’s not the same,” Maria would say.
“I miss the version of her that knew who I was.” This is the heart of anticipatory grief. We
grieve not just the future death, but the loss of identity, the loss of connection, and the
loss of the relationship as we once knew it.
In therapy, I often encourage my clients to allow themselves to grieve during this time.
Anticipatory grief isn’t about giving up hope or accepting defeat; it’s about honoring the
reality of what’s happening while still finding moments of love and connection. Grieving
in pieces, as I sometimes call it, allows us to adjust emotionally over time, rather than
being hit all at once after a loved one’s passing.
It’s important to remember that anticipatory grief is entirely normal. There’s no right or
wrong way to feel during this process. Some days, my clients tell me they feel more like
caregivers than family members, and that shift in role comes with its own grief. Others
express that they don’t know how to be fully present because their mind is already preparing for the final goodbye. These feelings are valid. Grief is not linear, and anticipatory grief, in particular, can be a rollercoaster of emotions.
One thing I try to help my clients understand is that anticipatory grief can be an
opportunity. It’s a chance to have meaningful conversations, to express love, to create
memories in the time that’s left. While the pain is real, so is the potential for deep
connection during this period. It’s about embracing the complexity of loving someone
who is still here but also slowly slipping away.
For those who are going through this type of grief, know that it’s okay to feel everything
at once. It’s okay to feel both sadness and relief, love and exhaustion, hope and dread.
Anticipatory grief is not about trying to control the emotions but allowing them to coexist.
There’s no rush to figure it all out or to “move on.” Grief, even the kind that starts before
the loss, takes its own course.
As a therapist, I strive to provide a safe space for my clients to process all of these
emotions, to explore their grief without judgment, and to help them find a way to
navigate this difficult journey. Anticipatory grief is a unique challenge, but it is also an
opportunity for growth, for connection, and for healing, even before the final goodbye.
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