How to Cope With ‘Anticipatory Grief’ When a Loved One Is Dying
There’s no roadmap for navigating grief when you lose someone you care about. It’s a deeply painful and complicated process that we all handle in our own ways. It’s also an unavoidable part of life for most of us: We grieve late parents, grandparents, friends, coworkers, and pets. We can even mourn the loss of celebrities we didn’t personally know.
Grieving doesn’t always start after someone dies, though. Sometimes the process begins beforehand, when, say, you find out your loved one has been diagnosed with late-stage cancer, or as you watch your parents get older. Feeling a mix of overwhelming emotions when you know death is coming (and there’s nothing you can do to stop it) is totally natural—so much so that the experience has a name: anticipatory grief.
This type of grief is marked by feelings of sadness, helplessness, anxiety, anger, frustration, or guilt when you’re expecting a loss, and it can be an emotional roller coaster, Mekel Harris, PhD, licensed psychologist and author of Relaxing Into the Pain: My Journey Into Grief, tells SELF. “Even if the person is alive, there can be so many different losses,” Dr. Harris says. “There might be the loss of time spent together or the loss associated with not being able to do the same things that you used to.”
Watching one of your favorite people grapple with their mortality as you realize that your time with them is limited can be extremely difficult. Trying to stay positive under such devastating circumstances might even feel straight-up impossible. If you’re dealing with anticipatory grief, consider this expert advice that may make this seemingly hopeless situation feel a little less dire.
Don’t be afraid to call it grief.
You might have ideas about what grief is supposed to look like, but it can take many forms. You can grieve lost time, for example, or the end of a relationship. You can also mourn the loss of objects, like your favorite childhood stuffed animal or a family heirloom, and you can certainly grieve people who are still alive. Just because what you’re feeling doesn’t align with what society typically considers “normal,” it doesn’t make it any less real, Megan Devine, LPC, a Los Angeles–based therapist and the author of It’s OK That You’re Not OK: Meeting Grief and Loss in a Culture That Doesn’t Understand, tells SELF. “When nobody has died yet, people feel like they can’t call it grief,” Devine says. “But loss is a spectrum, whether it’s before or after someone dies, and it’s not helpful to qualify whether this is legitimate or not.”
You might be angry, sad, or anxious. Or maybe you’re in denial and not feeling much of anything. No matter your emotional state, the point is that your experience is valid: “You’re feeling what you’re feeling, and adding expectations can create a lot more suffering for ourselves when we’re also judging if we should be having such intense feelings or not,” Devine says. Accepting that your grief, however it shows up, is legitimate won’t necessarily make these feelings go away. But being honest with yourself—and having the words to name those very real emotions—is the first step in moving forward, she adds.
Recognize when you’re fixating on worst-case scenarios.
We, as humans, are generally not so good at dealing with things we can’t control. That’s one reason why so many of us (me!) will catastrophize an upsetting situation or imagine the worst-case scenario. You might visualize what your loved one’s death will look like, say, or spend each day worrying that it’ll be their last. It’s the brain’s subconscious effort to numb the emotional pain during high-stress situations, research shows, but the experts SELF spoke with say it’s also a form of self-sabotage. One study that surveyed people grieving the loss of a pet, for example, found that catastrophizing was associated with more grief, guilt, and anger compared to positive coping strategies, like practicing acceptance or shifting perspective.
Challenging these anxious and intrusive thoughts is easier said than done, though, especially if you don’t have access to a therapist. That’s why Dr. Harris suggests finding ways to practice mindfulness on your own. Since anxious thinking is typically future-based (you’re worrying about things that haven’t happened), focusing on what’s right in front of you can get you out of your head, she says, and allow you to see your thoughts for what they are: fears, not reality.
For example, maybe you’re thinking, I’ll never be able to live without this person. By getting some space from that thought—say, via practices like deep breathing or mental body scans—you may be able to reframe it more objectively: I recognize I’m having fearful thoughts, which is totally normal, but right now my loved one is still here, and there will be a future where I’ll learn to be okay. It takes time, but the goal, she says, is to recognize that catastrophic all-or-nothing thinking isn’t based in the present.
If it feels appropriate, discuss the elephant in the room.
Many of us avoid the “D-word,” much less talk openly about it over the dinner table. Death is an incredibly uncomfortable and sensitive topic, so it’s understandable if you don’t know how to broach the subject “correctly.”
However, Devine believes it would be more helpful (and less awkward) to be open about death—especially when you’re dealing with it directly. “We miss out on connection when we don’t tell the truth about how we’re feeling, and trying to hold back those emotions can make grief even harder,” she says. You and your loved one know what’s to come, so ignoring that reality can make you both feel more isolated. On the flip side, being emotionally vulnerable with one another can help you both feel a little less alone.
If you don’t know where to start, Devine suggests just being honest: Admit that you don’t know what to say or how to navigate such a bleak conversation, and, depending on how close you are with the other person, you can also express that you’re afraid of what’s to come. “We create a lot of suffering when we hold back something that’s hurting us, so even just acknowledging that neither of you knows what to do in this situation can be comforting,” Devine says. For your loved one, sharing their feelings can be an opportunity to be seen and heard while dealing with an uncertain and scary road; for you, it can be a way to have authentic, meaningful dialogue with them before it’s too late.
Surround yourself with people who validate your experience.
If you tell someone you’re anticipating a loved one’s death, chances are you’ll be met with a not-so-helpful response like, “You can worry about that later,” or “Hey, at least you still have time!” They’re probably coming from a good place, but these comments can be really invalidating, and being heard is crucial to feeling less isolated and more understood—which are important for healing, Dr. Harris says. “Confide in someone you know will listen to you and not just try to ‘fix’ things,” she suggests, whether it be a close friend, family member, or an online support group.
If you don’t feel ready to get so vulnerable with others, that’s okay too. Instead, you might try writing down your thoughts in a journal. It may sound silly, but “the page offers no judgment, and that can be really comforting, especially for a person who feels guilt,” Dr. Harris says. “Think of it as a space to name, acknowledge, and be honest about how you’re really feeling.” If writing isn’t your thing, you can also try a journaling alternative, like talking things out in a voice memo.
Don’t ignore your own needs just because you’re grieving.
Are you the family member who “has it all together” amidst all the chaos? Maybe you’re the friend who cancels all their plans, just in case the unthinkable happens. It can, of course, feel extremely important to be there for someone you love in their final days (it’s the least you can do, right?) but putting your life on hold to support them can be emotionally exhausting.
“We’ve got this binary that in order to take care of ourselves, we must abandon our dying loved one. Or that you can fully take care of this person, but you have to abandon yourself,” Devine says. But both can be true: You can show up for them and also tend to your own emotional and physical needs, whether that means taking some time off to go on that much-needed run or spending a few hours of your night watching your go-to self-care Netflix show. As difficult and selfish as it may feel, taking the time to care for yourself as best as you can is “necessary” for processing your grief in a healthy way, Dr. Harris says, and it can allow you to be more present for the other person too.
Try to reframe the loss as a reminder to appreciate life.
We know, we know—it’s easy to dismiss somebody who consoles you with cliché phrases like “Find the light at the end of the tunnel” or “Look on the bright side.” But the truth is, there is some merit to these platitudes. Even research has supported that “positive reframing” of death can lead to more emotional growth and fewer depressive symptoms compared to avoiding these feelings altogether.
As an example, instead of harping on how unfair the last few weeks or months have been, you can try to focus on happy moments you had with your loved one or lessons you’ve learned from this experience. Or instead of ruminating in the pain, maybe you spend your hospital visits bonding over and sharing your mutual-favorite meals. Anticipatory grief can be a powerful reminder to make the most of the limited time you have together. “It’s normal to anticipate a loss, it’s normal to grieve in advance, and it’s normal for our mind to dwell on the what ifs,” Dr. Harris says. But focusing on the present and celebrating what you do have (versus fixating on what you don’t or won’t in the future), can make the situation more bearable—and maybe even joyful at times, she says.
The death of a loved one is never easy, but know that you can heal.
If you’ve read this article in hopes of finding an easy hack to “get over” the pain of knowing you’re going to lose a loved one, you sadly won’t find that here. Remember, anticipatory grief is a legitimate, powerful experience of loss, and you’re probably going to feel a whirlwind of emotions like denial, anger, sadness, and anxiety.
But there is some comforting news. First, it’s worth repeating that you’re not alone in your grief (anticipatory or otherwise) and that it will hurt less over time, Devine says. For now, if you take things day by day, and perhaps follow some of the advice above, you might find the experience a little less hopeless than you anticipated.
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Originally Appeared on SELF