To: Helene Kiser
helene@helenekiser.com
Anticipatory Grief Often Shows Up In Disguise
Dear Helene,
I'm Giulia P. Davis, LMFT, founder of Mycelia Therapy in San Francisco. I'm a systems-oriented, IFS-informed therapist, and my training in psychedelic-assisted therapy included end-of-life work and death doula training.
I work primarily with entrepreneurs and professionals in midlife — people who are often balancing demanding careers while their parents are entering a stage of illness, frailty, or cognitive decline. Because of that life stage, anticipatory grief appears frequently in my clinical work, even though most clients don't initially recognize it as grief. Two clients come to mind.
-
A CEO came to me because he was "losing his edge." Brain fog in meetings, snapping at his team, an exhaustion that sleep didn't fix. It took several sessions before we got to what was underneath — that every Sunday dinner he'd sit across from his mother and she'd look at him with no recognition. He'd started dreading Sundays. Then he felt guilty for dreading them. Then guilty for feeling guilty, because she was still alive, still warm, still his mother, just... not. He kept telling me, "I don't know why I'm so tired." He wasn't tired. He was watching his mother disappear into dementia. He was grieving someone who hadn't died yet.
-
Another client's husband received a pancreatic cancer diagnosis. A few months — that's what they told her. How do you relate to someone who's just received a death sentence? She described this push and pull I hear often — you want to crawl into the person and hold on, but something in you starts pulling away because every time you reach for them you're also rehearsing the moment they won't be there. Then you hate yourself for pulling away. She'd hold it together at the hospital, hold it together in the car, and completely come undone putting away dishes on a Tuesday afternoon. That's where anticipatory grief lives — in the ordinary moments, when there's nothing left to perform.
A few things I've learned sitting with this clinically:
This grief often runs deeper than the present moment. Families carry patterns around loss — who's allowed to fall apart, who has to hold it together. Sometimes a client's exhaustion isn't just their own. They're carrying a loyalty to how their family has always done loss, and that weight is invisible to them. Sometimes grief has a history that's older than the person feeling it. And it doesn't look the same across cultures — not every family even has language for mourning someone who's still here.
What actually helps is giving the grief permission to exist before the death. Naming it as grief, not stress, not burnout, not "just a hard time." Helping someone understand they can sit next to the person they love and mourn them at the same time — and that doesn't make them a bad person. It makes them human.
What doesn't help: "At least they're still here." "Cherish the time you have." That deepens the guilt, because the person is often already pulling away, and being told to cherish what they're withdrawing from makes them feel like a monster. Telling someone to be strong, to be the rock for the family — that just keeps everything sealed until the body breaks the contract for you.
Thank you for considering my perspective. If you’d like additional context, a different angle, or any adjustments to better serve the piece, I’m very happy to refine it. And if this ends up being a fit, I’d be glad to share it with my network.
Warmly,
Giulia P. Davis, LMFT #157653
Founder, Mycelia Therapy
LinkedIn: linkedin.com/in/giuliapdavis
Bio and Headshot
Giulia P. Davis, LMFT, is the founder of Mycelia Therapy, a private practice in San Francisco serving entrepreneurs, executives, and professionals in midlife. A systems-oriented, IFS-informed therapist, her training in psychedelic-assisted therapy included end-of-life work and death doula training. She works at the intersection of high performance and emotional life — helping clients navigate what ambition doesn't prepare you for, including grief, relational strain, and the hidden costs of carrying too much alone.
