Anticipatory grief
Encyclopedia
Anticipatory grief refers to a grief
reaction that occurs before an impending loss. Typically, the impending loss is a death
of someone close due to illness but it can also be experienced by dying individuals themselves. The anticipated death can also be from non-illness-related causes such as high suicide
lethality, high-risk lifestyle or gang
involvement, or from non-death-related losses such as scheduled mastectomy
, pending divorce
, company downsizing or war
.
The five stages (denial
, bargaining
, depression
, anger
and acceptance
) proposed by Elisabeth Kübler-Ross
in her model of grief
to describe the process by which people cope after a loss can also be present in anticipatory grief. Anxiety, dread, guilt, helplessness, hopelessness, and feeling overwhelmed are also common. However, it is important to note that anticipatory grief is not simply normal grief begun earlier.
Features identified specifically with anticipatory grief include heightened concern for the dying person, rehearsal of the death and attempts to adjust to the consequences of the death. The period can allow people to resolve issues with the dying person and to say goodbye. It may provide some sense of orientation and access to the grieving process. For some, it prompts conscious closure before the end/loss.
Grief happening prior to a loss presents a compounding issue of isolation because of a lack of social acceptance. Anticipatory grief doesn't usually take the place of post-loss grief: there is not a fixed amount of grief to be experienced, so grief experienced before the loss does not necessarily reduce grief after the death.
How often anticipatory grief occurs is a subject of some controversy. For example, a study of widows found that they stayed with their husbands until the death and could only mourn once the death had occurred. Researchers suggest that to start to grieve as though the loss has already happened can leave the bereaved feeling guilt for partially abandoning the patient.
Grief
Grief is a multi-faceted response to loss, particularly to the loss of someone or something to which a bond was formed. Although conventionally focused on the emotional response to loss, it also has physical, cognitive, behavioral, social, and philosophical dimensions...
reaction that occurs before an impending loss. Typically, the impending loss is a death
Death
Death is the permanent termination of the biological functions that sustain a living organism. Phenomena which commonly bring about death include old age, predation, malnutrition, disease, and accidents or trauma resulting in terminal injury....
of someone close due to illness but it can also be experienced by dying individuals themselves. The anticipated death can also be from non-illness-related causes such as high suicide
Suicide
Suicide is the act of intentionally causing one's own death. Suicide is often committed out of despair or attributed to some underlying mental disorder, such as depression, bipolar disorder, schizophrenia, alcoholism, or drug abuse...
lethality, high-risk lifestyle or gang
Gang
A gang is a group of people who, through the organization, formation, and establishment of an assemblage, share a common identity. In current usage it typically denotes a criminal organization or else a criminal affiliation. In early usage, the word gang referred to a group of workmen...
involvement, or from non-death-related losses such as scheduled mastectomy
Mastectomy
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer...
, pending divorce
Divorce
Divorce is the final termination of a marital union, canceling the legal duties and responsibilities of marriage and dissolving the bonds of matrimony between the parties...
, company downsizing or war
War
War is a state of organized, armed, and often prolonged conflict carried on between states, nations, or other parties typified by extreme aggression, social disruption, and usually high mortality. War should be understood as an actual, intentional and widespread armed conflict between political...
.
The five stages (denial
Denial
Denial is a defense mechanism postulated by Sigmund Freud, in which a person is faced with a fact that is too uncomfortable to accept and rejects it instead, insisting that it is not true despite what may be overwhelming evidence.The subject may use:* simple denial: deny the reality of the...
, bargaining
Bargaining
Bargaining or haggling is a type of negotiation in which the buyer and seller of a good or service dispute the price which will be paid and the exact nature of the transaction that will take place, and eventually come to an agreement. Bargaining is an alternative pricing strategy to fixed prices...
, depression
Depression (mood)
Depression is a state of low mood and aversion to activity that can affect a person's thoughts, behaviour, feelings and physical well-being. Depressed people may feel sad, anxious, empty, hopeless, helpless, worthless, guilty, irritable, or restless...
, anger
Anger
Anger is an automatic response to ill treatment. It is the way a person indicates he or she will not tolerate certain types of behaviour. It is a feedback mechanism in which an unpleasant stimulus is met with an unpleasant response....
and acceptance
Acceptance
Acceptance is a person's agreement to experience a situation, to follow a process or condition without attempting to change it, protest, or exit....
) proposed by Elisabeth Kübler-Ross
Elisabeth Kübler-Ross
Elisabeth Kübler-Ross, M.D. was a Swiss American psychiatrist, a pioneer in Near-death studies and the author of the groundbreaking book On Death and Dying , where she first discussed what is now known as the Kübler-Ross model.She is a 2007 inductee into the American National Women's Hall of Fame...
in her model of grief
Kübler-Ross model
The Kübler-Ross model, commonly known as The Five Stages of Grief, was first introduced by Elisabeth Kübler-Ross in her 1969 book, On Death and Dying....
to describe the process by which people cope after a loss can also be present in anticipatory grief. Anxiety, dread, guilt, helplessness, hopelessness, and feeling overwhelmed are also common. However, it is important to note that anticipatory grief is not simply normal grief begun earlier.
Features identified specifically with anticipatory grief include heightened concern for the dying person, rehearsal of the death and attempts to adjust to the consequences of the death. The period can allow people to resolve issues with the dying person and to say goodbye. It may provide some sense of orientation and access to the grieving process. For some, it prompts conscious closure before the end/loss.
Grief happening prior to a loss presents a compounding issue of isolation because of a lack of social acceptance. Anticipatory grief doesn't usually take the place of post-loss grief: there is not a fixed amount of grief to be experienced, so grief experienced before the loss does not necessarily reduce grief after the death.
How often anticipatory grief occurs is a subject of some controversy. For example, a study of widows found that they stayed with their husbands until the death and could only mourn once the death had occurred. Researchers suggest that to start to grieve as though the loss has already happened can leave the bereaved feeling guilt for partially abandoning the patient.