Understanding anticipatory grief

By Caroline Butterwick,
updated on Aug 14, 2023

Understanding anticipatory grief

Mourning doesn’t just begin when someone dies – we can often feel the growing sense of sadness and looming loss long before the dreaded day arrives

Losing someone we love is one of the most painful things we can go through. And, for many of us, the grief doesn’t start when the person dies – we can find ourselves mourning for them months, even years, beforehand, while they are still with us. This is known as anticipatory grief.

While most people understand the idea of grieving after someone has died, we tend to think less about experiencing grief while the person is still with us. But it’s normal to feel a range of emotions when a family member or friend is critically ill or dying.

As counsellor Anthony Purnell explains, this can be because humans are naturally sociable creatures. “When we become aware that we will lose a close member of our social group, we begin to grieve the potential loss of what they have brought into our lives, the roles they performed, and their impact on our family systems, friendship groups, and so on,” he says.

We may start to imagine life without them, and how hard this feels, and this can bring a range of difficult emotions.

Stages of grief

You may be familiar with the idea that there are stages of grief that are common to go through when someone dies. Many people also experience these stages during anticipatory grief. Anthony explains the five stages:


We set out on a crusade to prevent the death of our loved one, or play down the reality of the situation, because we are not ready to face the truth of the potential loss.


We may become angry with our loved one that they did not take care of themselves well enough, or at external bodies such as health organisations not being able to save or cure them.


We try to make a deal with someone to shoulder the burden of their illness (‘take me instead’) by pleading to a god, medical staff, or family.


Feeling sad, or so low you feel you cannot function.


Accepting the reality that your loved one is going to die, or the reality of what is happening.

It’s important to note that you may not experience all five stages to reach acceptance, and you may not experience them in this order. Grief is unique to everyone.

“Also, we may have to consider that we may have to endure the same process with the physical loss,” explains Anthony. “In this sense, families that have a loved one diagnosed with a life-limiting illness may grieve twice.”

How to cope with anticipatory grief

Firstly, remember that it’s normal to feel this way. Grief affects everyone differently – some people will hide their feelings, or seem to be coping OK, whereas others may be more obviously distressed. No matter where you fit on this, your response is valid, as is that of people around you. It can feel confusing when others are responding to the situation differently, but each person will experience it in their own way.

Each person’s feelings towards what’s happening, Anthony says, can be influenced by everything from their level of connection with the person dying, to their own feelings and thoughts around death, or what they fear to lose.

Anthony suggests reflecting on what the person means to you, and what you will miss when they are gone. “You may even want to thank the person dying for having them in your life, and reassure them that you will be OK,” says Anthony. “Maybe avoid sharing how them dying is affecting you. They are going through a lot, and this may make them feel bad. But do try to find someone to share these thoughts with.

“Some may choose solitude, some want to show their grief publicly,” says Anthony. “If there is no one in your social group you feel you can open up to, then counselling can help provide a space to explore how you feel. It can also help the one dying to explore feelings without burdening family members. The most common thing I hear as a counsellor is the consideration of not wanting to burden others.”

For some, we can also feel grief when we realise our loved ones, such as our parents, are getting older, and we become very conscious that they won’t be around forever. This can be incredibly hard to deal with and talk about.

“As we get older, we become not just aware of our own mortality, but that of our parents,” explains Anthony. “We may not have thought about what it will be like when they are gone, and what this will mean for us.”

There are ways to help process these feelings. “Rationalisation is not always the answer, especially when grief is an emotional response to loss,” Anthony says. “It may be helpful to self-reflect, and allow yourself to express your emotions through writing a journal, drawing or painting, or simply having a conversation with someone about what may change, and the feelings this is bringing up for you.”

Supporting someone else

You may find yourself in a situation where a friend, or someone else you’re close to, is experiencing anticipatory grief. You might not know, or be close to, the person who’s dying, and it can be hard to know how to be there for your friend.

“It is important to remember not to tell them how to grieve,” says Anthony. “Though we want to be helpful, how we may experience loss may not be another’s. Some show no emotion because they can hold the potential loss, are being strong for others, or may not have a close relationship with the person dying, whereas some may feel inconsolable, and any intervention you make may be quickly dismissed.”

Giving them the space to talk is one of the best ways you can help. Anthony points out that it’s important to gently set boundaries so you aren’t overloaded – you want to be there for them, but there’s only so much you can give. You can suggest they try exploring their emotions through counselling, and could offer to help them find the right support.

Anthony also suggests that you can do activities together that give them a break. This could be anything from a theatre trip to going for a walk in nature. Try to find something they will enjoy and will help with their self-care, while being a nice way to spend time together.

“Grief is very personal – we all deal with it in our own way,” says Anthony. “We do not ‘get over it’, we learn to sit with it.” Anticipatory grief is difficult to go through, but remember that you’re not alone.

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