Coping with Anticipatory Grief

First you hear the awful news: your loved one has a terminal illness. Then anger, denial, bargaining, sadness, or all of these feelings set in as your mind tries to grasp what seems impossible to grasp. Terminal is not a word that should be applied to an illness from which a loved one is suffering. Terminal has no place in this world, our world, we've so carefully, lovingly built together; nevertheless, unfortunately, loved ones do become terminally ill and there is no escaping that terrible fact.

And in the days, weeks, months, or even years to follow, the word and its meaning sink in and anticipatory grief often becomes a new, unwelcome, part of our life.

Anticipatory grief is very common for anyone watching a loved one succumb to a terminal illness. It is especially common for those who are the primary caretakers of the terminally ill loved one. It is the caretakers who witness death's progression most vividly and who have little time to reflect on and process their emotions.

Anticipatory grief, like other forms of grief, can invoke a variety of painful thoughts and feelings that are difficult to cope with. Drawing from my own experience, I've compiled a list of thoughts and feelings to expect if you are facing the loss of a terminally ill loved one.

Every grief situation is unique, but these are some thoughts and feelings you should know are common during anticipatory grief:

You may experience haunting, bizarre thoughts that are exactly the opposite of how you truly feel or believe. All parts of your psyche are trying to cope with an onslaught of feelings and it is no surprise that unusual, or even upsetting thoughts and "mind chatter" emerge at this time. Think of dreams: you certainly should not hold yourself accountable for bizarre dreams that contain acts or feelings anathema to your true beliefs and feelings--nor should you hold yourself accountable if unusual thoughts or feelings emerge during grief.

In all cases, if these thoughts occur and become too difficult to cope with, you should seek out a good therapist or support group to help you cope.

You may experience a great deal of anger. This is absolutely normal. Venting the anger (constructively) may not help much, but acknowledging that anger is normal right now may help a great deal. Knowing where the anger is coming from will help keep you from taking it out on innocent people.

You may become forgetful and feel like your mind is in a fog. When you experience anticipatory grief, you may have to take extra measures to avoid forgetting important tasks and dates.

You may be prone to sudden tears. If you can find an appropriate place to shed tears during this time, you should. Allowing yourself to cry periodically will help release tension that is building up and may keep you healthier through this difficult time.

You may experience hopelessness and a desire to die. This is normal, but if the feelings are not transient, if they last and are interfering with your ability to function, you should speak with a therapist who specializes in grief support.

You may feel anger towards the terminally ill loved one. This is probably the most difficult feeling to cope with. You may feel frustrated and helpless--and this may feel like anger towards the person who is ill. Horrible guilt feelings may accompany this and compound the anger feelings. In truth, unless you and your loved one have unresolved strife, you are probably not angry at the terminally ill person but are reacting against the emotional pain of the situation.

When faced with emotionally painful situations, we naturally go into the Fight or Flight mode. Fear and anger overwhelm us and we just want the pain to stop. Often the anger is misdirected. If you understand the pain behind the anger, you can learn to cope with it more appropriately.

You may feel guilt about feeling such grief while the loved one is still alive. The pain of anticipatory grief may make you feel like you are being robbed of the ability to enjoy your loved one while she is still here. Naturally, this can invoke some feelings of guilt--especially if you are the caretaker of the terminally ill loved one. You may have to draw on extra strength during this time to be able to do what is necessary to help your loved one while still allowing yourself an outlet for your emotions.

You should not feel guilty for experiencing anticipatory grief. There are many times it won't be appropriate to express that grief or give in to your emotions, but this does not mean you should stuff them all. If you are able to take a few moments away each day to gather your thoughts, do so.

Not everyone experiences anticipatory grief. There is no need to worry if you don't experience it--not experiencing this grief does not mean you love any less. Everyone copes with life and death differently. For those who do experience anticipatory grief, however, I hope this small article helps you cope.

For Sophie, who passed from this life on July 31, 2008