Let's Talk About Anticipatory Grief
Clients who are caregivers for a sick or elderly loved one often tell me that one of the more helpful concepts they learn in psychotherapy is “anticipatory grief.” So what does that mean?
Anticipatory grief refers to what we experience in our mind-body-spirit as we are losing our loved one to a life-limiting illness.
Anticipatory grief shows up as:
* feeling traumatized by caring for someone who used to care for you* dread* deep sadness as your loved one fades away from you* anxiety about caring for a loved one* difficulty allowing others to help you* mourning your loved one's loss of independence
* mourning your loved one’s personality change * panic about when "the other shoe will drop"* hypervigilance
* anger about what is happening to your loved one
* worry about how you or others could possibly manage when your loved one is gone
Yikes! That’s a lot. If this sounds overwhelming, that is because caregivers often are overwhelmed with 24-7 hands-on care, care management, and emotional reactions, many of which fall under the umbrella of anticipatory grief. Anticipatory grief is completely normal, but the feelings can be intense and even debilitating. Sometimes the anxiety of anticipatory grief can get in the way of us having perspective on a situation, particularly one that is so close to us, such as the serious illness of a parent, spouse, or child. It's like trying to read a book when that book is pressed up against your face: it’s almost impossible to read or to process the information.
So what can help with anticipatory grief? Caregiver support groups can be a great, free resource to connect with other family caregivers who are experiencing similar thoughts and feelings. Caregiving can be so consuming and so isolating: it’s important to know there are other unsung heroes and heroines out there who understand what it’s like. It’s also important to spend quality time talking with your loved one outside of going to medical appointments or the daily routine of hands-on caregiving. If your loved one opens the door to talking about their own anticipatory grief, stay present and don’t run away. Follow their lead. Having a brave and honest conversation may ultimately result in tremendous relief for you both. Some people may be carrying the belief, consciously or subconsciously, that voicing their fears or confronting the reality of death means they are “giving up” or not “having hope.” Psychotherapy can be a safe space for family caregivers to process these beliefs, and to gently shift expectations about what hope means, or what to hope for, at the end of life. In therapy, we can name, process, and grieve the many losses that families experience before a death, talk about baggage or history in the relationship that may make caregiving challenging, and give voice to fears that other family members may not be able to hear. If you are experiencing anticipatory grief, give yourself the gift of therapy and self-care.
