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Problem:
Client logged into the virtual session appearing sad. Client reported her dad's health is declining and expressed feeling overwhelming sadness despite him still being alive. Client stated, "I feel like I'm already grieving him, and then I feel guilty because he's still alive." She described difficulty being present during visits with her dad, as she is preoccupied with thoughts about how much he has changed and how little time might be left.
Intervention:
50-minute virtual session. Therapist discussed anticipatory grief as a normal response to a loved one facing serious or terminal illness. Therapist explained that grieving in advance does not signify giving up but is a way to emotionally prepare for loss. Therapist worked with the client on strategies to stay present while honoring her grief, including giving herself permission to feel both sadness and gratitude, creating meaningful moments with her dad, and journaling memories and feelings.
Response:
Client appeared relieved after learning that anticipatory grief is normal and expressed that she had been carrying guilt, thinking something was wrong with her for feeling this way. Client engaged in the discussion and expressed interest in trying the suggested strategies to manage her grief and stay present during visits with her dad.
Plan:
Client was assigned homework to attempt one meaningful visit with her dad this week, focusing on being present, and to start a journal for processing memories and feelings. Follow-up session scheduled for next week to review progress and discuss her experiences with the strategies.
We had a 50-minute virtual session today. Rachel logged in looking sad and said her dad's health has been declining and she's been feeling this overwhelming sadness even though he's still here. She said quote 'I feel like I'm already grieving him, and then I feel guilty because he's still alive' unquote. She described how every time she visits him, she's thinking about how much he's changed and how little time might be left, and it's hard for her to just be present with him.
We talked about anticipatory grief and how it's a completely normal response when someone you love is facing a serious or terminal illness. I explained that grieving in advance doesn't mean you're giving up or wishing it would happen sooner, it's your heart trying to prepare for something really painful. She seemed relieved to hear that, like she'd been carrying so much guilt about it. She said she thought something was wrong with her for feeling this way.
We worked on finding ways to stay present while also honoring the grief. I suggested that she give herself permission to feel both, the sadness about what's coming and the gratitude for the time she still has. We talked about creating small meaningful moments with her dad, things that don't require him to be the person he used to be, like just sitting together or listening to music he loves. I also encouraged her to write down memories or things she wants to tell him, as a way to process the grief without it taking over every visit. Her homework is to try one meaningful visit this week where she focuses on just being with him, and to start a journal for the memories and feelings that come up. We'll meet again next week to see how it's going.
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