When the Loss Hasn't Happened Yet — Understanding Anticipatory Grief

"The risk of love is loss, and the price of loss is grief. But the pain of grief is only a shadow when compared with the pain of never risking love." — Hilary Stanton Zunin

There is a particular kind of grief that doesn't wait for the loss to happen.

It arrives early, sometimes months or even years before. It sits alongside you while you are still holding someone's hand, still making their meals, still hearing their voice, still hugging them, still smelling their skin. It is the grief of knowing what is coming, of loving someone you are already, slowly, beginning to lose.

This is anticipatory grief. And it is one of the least talked about, least supported forms of grief there is.

What is anticipatory grief?

Anticipatory grief is the emotional, psychological, and physical response to an expected loss. It can arise when someone you love has received a terminal diagnosis, when they are living with a degenerative illness, when they are ageing and declining, or when you are facing the end of your own life.

It is grief that exists in the present tense, not as a rehearsal for what is to come, but as a real and legitimate response to what is already happening. The relationship is changing. The future you had imagined together is changing. And you are already mourning.

What anticipatory grief can feel like

Anticipatory grief rarely announces itself clearly. It tends to arrive as something more challenging to name or describe, an undercurrent of sadness that doesn't quite make sense, an exhaustion that sleep doesn't fix, a sense of dread that lingers beneath ordinary moments.

You might notice:

• A deep, aching sadness that comes and goes without warning

• Guilt, for grieving someone who is still here, for moments of frustration or resentment, wanting it to be over sooner, for needing things or time for yourself

• Anxiety about what is coming, the practical realities, the final moments, the afterwards

• A sense of emotional numbness or disconnection, as though you are going through the motions

• Difficulty being fully present with the person you love, even while you are sitting beside them

• Mourning not just the future, but versions of the relationship that have already changed, like the walks you used to take, the conversations that are no longer possible, the person they used to be

• Feeling tearful at unexpected moments

  
  

And underneath all of this, often: an immense, exhausting, aching love.

The particular weight of caregiving

If you are caring for someone who is dying, you are carrying something extraordinary.

You are managing the practical, medications, appointments, logistics, the endless administration of serious illness. And at the same time, you are managing the emotional, your own grief, your fear, your love, and often the grief of other family members around you.

Many caregivers describe feeling invisible in this process. The attention, understandably, goes to the person who is ill. But caregivers grieve too, deeply and often alone.

There is also a particular kind of grief that comes from watching someone you love change, losing their memory, their mobility, their personality, their ability to recognise you. Each change is its own loss. Each loss deserves to be acknowledged.

And yet caregivers are often told: "At least you still have them." Or: "Try to stay strong." Or: "Make the most of the time you have."

These words, however well-intentioned, suggest that grief before death is somehow premature, that you should be grateful rather than sad, present rather than mourning.

But grief and gratitude are not opposites. You can be deeply thankful for the time you have, and still be allowed to grieve what is being lost each day.

I remember a particular client, a daughter in her mid-thirties, after losing her mother, put it simply: "When Mum was sick, no one was checking in on me. I was the one holding everything together for her. Then she died, and suddenly everyone turned up with casseroles. Honestly? I could have done with those casseroles before."

The support arrives after the loss. But the weight was there all along.

When it is your own life

Anticipatory grief is not only experienced by those around the person who is ill. It is also experienced by the person themselves.

If you are the one facing a terminal diagnosis or a serious illness, you are carrying something of a different order entirely. You are grieving the life you expected to have, the years, the milestones, the ordinary Tuesday mornings that suddenly feel precious. You may be grieving your own body, your own future, your own sense of who you are becoming.

And underneath all of this, there is often a particular ache that is rarely spoken aloud: the pain of imagining those you love navigating the world without you. The children, the partner, the friends. The grandchildren you may never meet. The life that will continue after yours.

This is profound existential territory. It is not something that reassurance can even touch. What it calls for is honest, compassionate accompaniment, someone who can sit with you in the uncertainty, in the fear, in the love, in the unbearable pain, without needing to resolve any of it.

It is not resolvable.

You deserve that kind of presence. And you deserve it now, not only at the end.

What can help

Anticipatory grief does not need to be fixed. It needs to be witnessed.

Some things that can help:

Allow yourself to grieve now. You do not have to wait until after the loss to seek support. The grief you are carrying is real and present, and it deserves full attention.

Name what you are losing. Not just the person, but the specific things, the routines, the roles, the version of yourself that exists in relation to them. Grief is always particular, and naming the particulars can bring some relief.

Find spaces where you do not have to be strong. Caregivers especially need permission to be human, to be scared, tired, angry, and sad, without having to manage the feelings of others at the same time.

Stay connected to yourself. It is easy, in the midst of caring for someone else, to lose touch with your own needs, your own body, your own inner life. Small moments of self-attunement matter.

Seek support that understands this kind of grief. Not all therapists are trained in grief work, and fewer still are comfortable with the existential dimensions of dying and death. Finding someone who is can make a significant difference.

A note on meaning

One of the things I have witnessed in accompanying people through anticipatory grief is the possibility, not guaranteed, and never forced, of finding meaning in this crucial time.

Not meaning that makes the loss okay. Nothing makes it okay. But meaning in the depth of the love being expressed through the caring. Meaning in the conversations that become possible when time feels precious. Meaning in the way that proximity to death can clarify what actually matters.

Irvin Yalom writes about death as a "boundary situation", a confrontation with mortality that, when faced rather than avoided, can awaken us to life. Anticipatory grief, as painful as it is, can be one of those moments.

If you are caring for someone you love, or facing your own mortality, I want you to know that what you are carrying is so real, and so immense, and that you do not have to carry it alone.

Sandrine Lonchampt is a grief counsellor and psychotherapist at Colibri Counselling & Psychotherapy, offering online sessions across Australia, in English and French.

If this resonated with you, I offer a free 25-minute consultation. Book a Free Consultation.

References

Stroebe, M., & Schut, H. (2010). The dual process model of coping with bereavement: A decade on. OMEGA — Journal of Death and Dying, 61(4), 273–289.

Worden, J. W. (2018). Grief counselling and grief therapy: A handbook for the mental health practitioner (5th ed.). Springer.

Yalom, I. D. (2008). Staring at the sun: Overcoming the terror of death. Jossey-Bass.