Meet Lillian. Lillian is a middle aged woman who has her whole life in front of her; a career she loves, a family she adores, and a social life that leaves her feeling fulfilled and excited to wake up the next day. Her life suddenly became a little more challenging when she learned her beloved mother has been diagnosed with a terminal illness. Lillian begins to do her research on the illness to better understand not only the nature of the diagnosis but also the amount of time left she has with her mother. In her process of research and rewriting what the next few months (and hopefully years) with her mother will look like, Lillian begins to experience feelings of frustration, confusion, sadness, exhaustion, disbelief, anger, and fear. Unbeknownst to Lillian, in these moments she is grieving. “How can that be? Her mother is still alive.”
Now let me introduce you to Justin. He’s a 25-year-old graduate who recently obtained his Masters degree in engineering, got hired at his dream job where he will begin building his career, and is planning to marry the love of his life in the coming Fall. While Justin's life is unfolding many exciting milestones, he has moments of being stopped in his tracks and experiencing waves of intense grief. When Justin was 15 years old, he suddenly lost his role model, his teacher, his confidant. Justin lost his father unexpectedly at a time when he was transitioning out of childhood and into a chapter that offered more responsibility and independence. His dad was taken from him at a time when he was looking to him for guidance on how to successfully navigate this new chapter. These intense waves of grief Justin is experiencing 10 years after his father’s passing is confusing to him. He often thinks, “I already did my grief work, why do I feel similar to how I did when I first lost my dad?”
Both Lillian and Justin are experiencing grief that has shown up in times that are outside of what is to be expected. Typically, we expect grief to show up not too long after our loved one’s passing. We also expect our grief to show up less frequently and not as intense once we’ve processed what we believed was necessary in our grief work. These expectations are not wrong and paint the picture for many people’s grief journeys. However, Lillian and Justin are experiencing two types of what I like to call grief onsets.
What Is Grief Onset?
Before jumping into the two types of grief onset displayed above, let's first talk about what I mean by grief onset. I have defined grief onset as the following:
The timeframe in which symptoms and experiences related to grief arise and begin to influence one's daily functioning/routine following the death of a loved one or an ambiguous/living loss.
(To learn more about ambiguous/living losses,
visit my previous blog article discussing the different types of losses)
***Please note, this definition DOES NOT imply there is a timeline to grief. We know there is no timeline in grief. We do know grief can show up at different times for different people. The definition above refers to the expectation around when grief begins to show up in your day-to-day following the passing of your loved one.
Within this definition, there are two different onsets I encounter most when guiding individuals through their grief journeys: early onset and (what I like to refer to as) circumstantial onset. Let's break each of these down a little further.
Early Grief Onset
Early grief onset occurs when grief symptoms or experiences surface while your loved one is still alive. This can typically be seen with individuals who are experiencing something similar to Lillian; those whose loved one is battling a terminal illness. In early onset, people are typically experiencing anticipatory grief (learn more about anticipatory grief and other types of loss here) in which they begin to grieve other aspects of the loss before grieving the death.
Tools for Navigating Early Grief Onset
Below are a few tools to assist you in navigating anticipatory grief/the early onset of your grief:
Validate your experience; when your loved one is battling a terminal illness, it is very common for grief to show up despite your loved one still being phsyically present. Tell yourself (and believe) this experience is okay!
Talk to your loved one about the end; this is more than just discussing the logistics, while important, there are other areas that carry just as much importance such as: 1) asking about their wishes (not only in regards to what they want their funeral to look like [if they choose to have one] but also in life; How do they wish to be remembered? Is there anything of their's they wish to be carried on? Did they accomplish everything they wanted to in life? If not, can you still make that happen in the time that's left? What do they see as their greatest accomplishment(s)?) 2) Sharing your lived expereince with your loved one (express your own wishes for your loved one. Share your favorite memories with this person. Share how you will remember him/her/them [to dive deeper into remembering your loved one, check out my Remembering Your Loved One(s) blog article]. Share what you see as their greatest accomplishments.)
Identify what your current grief journey entails and begin to honor that journey; throughout this process, recognize and acknowledge the fact that what's involved in your grief journey will change once your loved one passes. Note, the previous point (talking to your loved one about the end) can be a very beneficial element to your grief journey.
Circumstantial Grief Onset
Circumstantial grief onset occurs when grief symptoms or experiences surface after having done the grief work (learn more about what doing the grief work means via the Exposing Grief video, Looking Behind The Grief Work Curtain) and carry the same or similar intensity it did when the loss first occurred. (It should be noted, circumstantial does not relate to grief; as we know, grief will always be present in some form. When I say circumstantial, I'm referring to the experiences in your life. When your life circumstances change and you expected your deceased loved one to be present during/involved in the life circumstances you're transitioning into/out of, you may experience more intense grief; possibly feeling the same way you did wen you first learned of the loss.) I typically see this type of onset with individuals who are grieving out of order losses (i.e. parents grieving the loss of their children; view my Child Loss speciality page for specific guidance) or for those who experienced the loss of a loved one sooner than what's typically expected (i.e. children having lost a parent at an early age like Justin).
Many who have experienced this onset often question, "how can this be? I thought I grieved my mom/dad/child." It can leave them feeling discouraged and confused. Of course it does, how could it not? In these moments, grief can show up for a few different reasons:
Approaching and/or walking through big milestones
Encountering important dates related to the deceased
Tools for Navigating Circumstantial Grief Onset
As previously mentioned, when talking about a circumstantial impact on grief I'm referring to HOW you experience grief, not IF. Below are a few tools to assist you in navigating your circumstantial onset:
Identify the changes within your life circumstances from when the loss occurred; take Justin's experience for example. Having lost his father when he was a young teen, now that he's an adult and experiencing life milestones (graduation, wedding, career, etc.) that he expected his dad to be part of, his grief has been triggered in a different fashion than what he experienced when he first lost his father.
Identify how you might want to honor your grief journey around this circumstantial onset; this will look different based on your situation. I will provide you with three different examples. Example #1: continuing on with Justin's experience, he's identified it's important to have his late father's presence at the ceremony. I'd encourage Justin (and you if this fits your scenario) to explore how he would like to honor his presence at the wedding. Example #2: if you're welcoming a child into the world and expected your late spouse (for more guidance on grief counseling for the loss of a spouse, view my Spousal Loss speciality page) to be present for not only the birth but for your child's life, how do you want to keep your spouse's memory alive for yourself and your newborn? Example #3: are there questions related to the loss you want to explore answers to? Questions such as: "Why did he/she/they have to be taken so soon?"; "How would he/she/they want to be involved in this circumstance?"; "What would he/she/they tell me/say in this circumstance?" (If you're curious about what your grief counseling journey could look like, view my Grief Counseling Approach page)
No two grief journeys are alike; the onset of grief is one of the many factors that influence your grief journey. Acknowledge the onset of your grief and begin honoring your unique grief journey. Not sure how? Explore the exercises and tools above or click below schedule your FREE 20 - 30 minute consultation with me to discuss how to embark on that journey.
Here's to living a better life as your best self.
Brittany Squillace, MA, LMFT