THE SOCIAL CONSTRUCTION OF ANTICIPATORY GRIEF

As medical technology prolongs life and facilitates the early diagnosi s of terminal illnesses such as AIDS, the concept of anticipatory grie f requires further scrutiny. The original concept of anticipatory grie f has become widely accepted. This paper, however, argues that the unc ritical acceptance of this concept rests primarily on the authority of the biomedical model, which has focused analysis on the predictable s ymptomatology of the grief process, integrating this understanding int o health care. This paper provides a critical review of the concept of anticipatory grief, highlighting conceptual shifts which are required if the concept is to be relevant to the subjective experiences of peo ple who are confronted with life-threatening illness. The paper discus ses the relevance of understanding the conceptual confusion which exis ts in the literature between ''anticipatory grief'' and ''forewarning of loss''. It is argued that grief may be the response to a loss of me aning, and that the psychological process of adjustment to loss requir es individuals to engage in the reconstitution of purpose and meaning in their lives. Distinguishing between what is being expressed for pas t and present losses and what responses occur when individuals focus o n various aspects of their future may shed light on some of the incons istent and contradictory findings surrounding research on anticipatory grief. Copyright (C) 1996 Elsevier Science Ltd