Anticipatory Grief Part 1: When My Client Died

“Tricia, my friends are praying for me. I will be well.”

“We are praying for a miracle—we want you to be well. But have you considered… what if healing doesn’t come? What then?”

Silence pierced the air. No one was talking. In that suspended moment, time seemed to fracture as we sat together, grappling with the fragile boundary between hope and surrender.

As a grief therapist, I’ve sat across from many clients consumed by anger and disillusionment after losing loved ones without the miracles happening. Yes, miracles do happen—but they rare, unpredictable, and never guaranteed. Well-meaning friends and family members urge faith, as if belief alone could bend God’s will. But what happens when it doesn’t? What becomes of those left behind, stranded in the wreckage of unmet expectations? Could we have better prepared—not just for death, but sacred quality time spent together in a more meaningful manner?

Losing someone we love doesn’t just break our hearts; it shatters our assumptive world (Janoff-Bulman 1992)

The invisible framework through which we understand self, the world, others, life & health, and even spirituality. Rebuilding takes time, patience, and space to reassemble the fragments of self, relationships, and faith. Without this, grief can calcify into anger, depression, or a paralysis that lingers for years. Unprocessed, it festers, evolving into the shadowed labyrinth of complex grief.

Sigmund Freud, mourning his daughter, profoundly wrote:

“We find a place for what we lose. Although we know that after such a loss the acute stage of mourning will subside, we also know that we shall remain inconsolable and will never find a substitute. No matter what may fill the gap, even if it be filled completely, it nevertheless remains something else”

How to support our terminally ill friends or family?

Supporting terminally ill loved ones demands a blend of clear communication, compassionate presence, and emotional sensitivity. Here are some handles that will help in the arduous time:

1. Walk in Their Reality

• Be present. Don’t rush to fix or minimise their pain and suffering with hollow assurance like “You’ll be fine.”, “Don’t worry.”, “God will heal you.”
• Pray gently. Fervent declarations don’t guarantee miracles. If healing comes, rejoice. If not, honour the sacredness of now—quiet prayers often mean more than performative ones.
• Be gently honest.
  • This must be really hard for you. I’m here with you.
• When you visit them, you may ask:
  • “Is there anything you need that would make you feel more comfortable?”
  • “ What would bring you peace today?”

2. Be Comfortable with Silence

• Sometimes, the most comforting thing is just being there quietly.
• You don’t have to force conversation. Sit with them and let them lead the topic. Follow their cues, whether they want peace and silence, or conversation and memories.

3. Honour their Autonomy

• Respect their choices: Treatments, visitors, daily routines, or end-of-life wishes.
• Gently broach hard topics: funeral or memorial plans, legal directives (e.g., Do Not Resuscitate, power of attorney and will.) If they’re not ready, wait—but don’t avoid.

4. Manage their Pain & Discomfort

• Collaborate with palliative care teams to manage their physical symptoms.
• Ask: “What does ‘quality of life’ look like for you?” (e.g., being pain-free, comfort, connection with loved ones).

5. Address their Emotional, Social, & Spiritual Needs

• Normalize their emotions and turmoil.
  • They may go through a rollercoaster of emotions such as fear, anger, sadness, guilt, or peace.
  • Listen more than you speak. More often than not, patients want to talk more about their fears or regrets rather than their illness.
  • Provide access to people that they may want to meet, including religious leaders, counsellors, or therapists, especially if they experience existential distress.
  • Offer closure: “Is there anything you need to say or hear before you go?
    • Gather around to express love, gratitude, forgiveness, and goodbyes.

6. Take Care of Your Emotions

• Caregivers, family members and friends can feel burnout, a sense of sadness, or helplessness. Take time for self-care and personal support.
• Release your guilt. Caring or loving doesn’t mean carrying all their pain alone. Do what you can. Boundaries matter.

7. Facilitate Connection & Legacy

• Encourage meaningful conversations with loved ones.
• Create a legacy: Record their stories, or write down special memories, letters, or messages. Make a scrapbook, photo collage, or videos together.

8. Support the Family

• Anticipatory grief is a storm. Prepare them for death and loss.
• Offer space for them to ask questions or express frustration and helplessness.
• Educate them on what to expect in the dying process—e.g., appetite changes, sleepiness, withdrawal.

Epilogue

In her final months, I witnessed my client forgive old wounds—her father and ex-bosses. She was at peace with herself. She contacted Ambulance Wish Foundation, ensuring her wishes were fulfilled, miracle or not.

Six months later, she was gone. The sadness remains, but so does the peace of knowing she left ready. We hope for miracles, yes—life is what it is but we can still love and fight on.