Anticipatory Grief

An added burden for healthcare teams

The world has been going through an extended period of what psychologists term ‘Anticipatory Grief’, which means grieving in preparation for a loss and encompasses the same components of actual grief. Even for those fortunate not to have lost loved ones to Covid, medical staff have been well aware that this could happen, and that many hospitalised patients in their care were likely to die.

Anticipatory Grief was thought (when the term was coined after the 2nd World War) to help us cope if an actual personal loss occurred, but this seems not to be the case. If the anticipatory grief continues for more than six months people are more likely to feel unwell after a loss and suffer more severely from the effects of grief, often finding it harder to return to normal functioning. 

When we voice our fears and receive an empathic compassionate response our primitive mind is calmed, and we regain some of the feelings of safety.

Just as in the normal grieving process, Anticipatory Grief encompasses a wide range of painful emotions including: anger, depression, shock or disbelief, denial, bargaining, guilt, muddled thoughts, random crying, anxiety, irritability, negative thinking, loneliness, mood swings, hopelessness, withdrawing socially, and an overreaction to minor issues.

David Kessler, an expert on grief, said that particularly when a virus is involved, Anticipatory Grief adds to stress and confusion.

“Our primitive mind knows something bad is happening, but you can’t see it. This breaks our sense of safety. We’re feeling that loss of safety. We are grieving on a micro and a macro level.”

This is difficult for anyone to cope with but for those working in healthcare existing challenges are exacerbated by Anticipatory Grief and this can lead to eventual burnout. Help is needed to ease the huge strain of seeing large numbers of patients dying whilst fearing for their own safety and that of their own loved ones.  

A focus group of nurses highlighted that the issue of the ‘hero narrative’ further added to their burden. One nurse said: “I get irritated when people call us heroes. It is a lack of recognition of the fact that we are also human, and this has been tough.”

Talking to someone you trust about how you are feeling really does help mitigate the potentially harmful effects of such long-term pressure, stress and uncertainty. When we voice our fears and receive an empathic compassionate response our primitive mind is calmed, and we regain some of the feelings of safety.

Keeping feelings to ourselves adds to the burden, whereas talking to a colleague or friend reduces both our own burden and, contrary to common belief, reduces their burden too. People feel better when they can be of help, and this can encourage them to talk about their own feelings.  

We are modelling a constructive behaviour by getting support ourselves. It is NOT a sign of weakness – in fact seeking support is a recognised effective coping strategy whereas battling on alone is seen as an ineffective way of dealing with difficulties. 

If Anticipatory Grief is affecting your ability to cope and get on with your life, it could lead to depression, particularly if it is triggering other losses in your past. In this case, it’s important to seek professional help, such as talking to a counsellor.

Just voicing that you are sad about the deaths of strangers and the loss of the world you knew before Covid can be healing. You can also try writing about your feelings or use rhythmic breathing when feeling stressed as emotions are there to be acknowledged not ignored and will pass more quickly when attended to without judgement.

We all need to support each other to help us regain hope, joy and peace after the turmoil that suddenly tipped our world into chaos.

Dr Annie Campbell CPsychol, AFBPsS, PhD

Annie is a Chartered Psychologist with a wide range of skills to facilitate change. Her particular interest is the interaction between the mind and the body and she has developed strategies that have helped people in many settings to enhance their confidence, achieve their potential and feel more comfortable in their own skin.



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