In this short video, I explain why mourning often begins long before a death, and how our video sessions can hold you through the waiting.
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Online anticipatory grief therapy helps you carry the loss of someone who is still alive: a parent with dementia, a partner with a terminal illness, a sibling in long treatment. You meet me alone by video, in English, in 1-hour sessions with 50 minutes of therapy, booked in your local time, whether you live next door to them or several flights away.
I help you make room for the grief that has already begun, steady yourself through bad news and stay as present as you can until the end. This page is part of my online grief therapy, within my wider online psychotherapy.
You can book a free 30-minute call, choose a first session, look at my client policy or message me.
Online anticipatory grief therapy is for adults who are losing someone they love while that person is still here. The illness or decline may have lasted months or years, and the end may be near or still uncertain. You want a place to grieve what is already going, and the strength to stay close until it is over.
A slow loss is one kind of grief, and some situations call for a different starting point. Where one of these lines sounds more like your situation, the linked page is the closer match.
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These reviews describe clients’ experiences of working with me. They come from my wider practice and do not all relate to online sessions. Each person’s experience is their own, and a review does not promise a particular outcome.
“Across the 9 countries I have lived and worked in, I have seen many ways of mourning, and almost none of them allow you to grieve someone who is still breathing. So people wait. They tell themselves the tears can come later and that their only task now is to cope. I think that waiting costs a great deal. The grief has already started, and holding it off usually puts distance between you and the person you love. Under the coping I hear one voice asking ‘Will I still matter to anyone when this is over?’ and another saying ‘Leave me be, I can only manage this if I manage it alone.’ Letting yourself mourn now is not giving up on them. It is how you stay close.”
Mark Colclough, MA, psychotherapist and EFT couples therapist
I am Mark Colclough, MA. I have practised since 2004 and offer online psychotherapy and couples therapy in English.
My training brings together your emotions, your thoughts and your relationships. My deep passion is the moment when what happens between you finally makes sense, to each of you and to each other. I have lived and worked in nine countries, so I know something of life across languages, cultures and borders.
Read about my background, or explore online psychotherapy and online couples therapy.
I meet regularly with experienced psychotherapists to reflect on my work, question my understanding and develop my skills. Supervision is part of the professional care I bring to individual and couples work, including online sessions.
My focus is thoughtful practice, integrity and responsibility.
You are welcome to ask about the kind of support you need.
Tell me where you are based and your time zone. We can then consider whether online sessions together are suitable.
Mehmet is 49, an engineer who has lived in Rotterdam for 20 years. His father in Izmir has advanced heart failure, and the doctors talk in weeks or months. Mehmet flies down every few weeks, sleeps on a camp bed by the hospital window and flies back to meetings he cannot concentrate in. His brother, who lives nearby, says he does nothing. At night Mehmet rehearses the call he dreads, and cannot cry.
I would begin with the camp bed and the flights, and the guilt they are trying to quiet. In our first video session, Mehmet would probably see that he has been grieving for months without permission, and that he can say goodbye in stages rather than all at once.
I have presented this clinical example as a compound of 22 years of clinical practice.
You have held everything together for them, and there is no space left for your own sorrow.
You do not need to wait for a death, a certain diagnosis or a breaking point before seeking help. A feeling that you are losing someone and have nowhere to put it is reason enough. In 22 years of practice I have sat with many people through long illnesses and slow goodbyes, and I can tell when strain has become a weight you should not carry alone.
I will help you see what you are grieving, what makes it harder and what you need to stay steady. Let the 6 questions below help you weigh how much you are carrying.
If so, take that seriously. You organise appointments, translate what doctors say and keep relatives informed, all while working. You notice you have not seen a friend for months and cannot remember the last time you rested without your phone beside you.
I would look at what you are carrying, practically and emotionally, and how long you can keep going at this rate. If this is your life now, book a session with me and we can make room for you inside it.
Both are true, and both are love. You want every remaining day with them. You also want their suffering to end, and your own exhaustion with it. Many carers feel monstrous for the second wish and keep it secret.
I do not treat either wish as wrong. I help you understand what each one is guarding: your love for them and your own need to survive this. Once both can be spoken, decisions about care and visits tend to become clearer and less driven by guilt.
Living far away makes this sharper. Every unknown number feels like the call. You cancel trips, refuse invitations and sleep badly, because being absent at the wrong moment feels unforgivable.
Your wish to be there is real, and I will not dismiss it. What I help you calm is the alarm that keeps you on duty every hour of the day. We look at what the fear of missing it means to you, and you practise letting yourself rest without feeling you have abandoned them.
This swing is common. You travel to be with them, then find yourself pacing the corridor or scrolling in the car park. Closeness brings the loss too near, and distance brings the guilt.
I help you slow this down and notice what happens just before you need to leave. It may be a moment when they no longer recognise you, or when they speak about dying. I have compassion for this, and I will help you find ways to stay a little longer, or to leave without punishing yourself.
Some people protect themselves by stepping back: visiting less, staying practical, talking about medication rather than memories. It can look like coldness, and it is usually the opposite.
My view is that this distance is shielding you from a grief you fear will overwhelm you, and it deserves understanding. I help you see what it protects and what it may cost you later. Then, if you want to, we find small ways to come closer while there is still time.
Months or years of caring can swallow your identity. You become the one who copes, the one who knows the forms, the one on call. Your own interests, friendships and plans quietly disappear. That is a sign of how much you have given, not of something missing in you.
I help you look at who you are beyond this role, and what you will need after the loss. I will challenge you when you erase yourself completely, but I will not tell you how to care. The aim is to stay present for them without disappearing.
If you are living through a slow goodbye, a free call lets you talk it over, and a session time lets you begin this week if one is free.
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Tell me briefly what kind of support you are looking for.
Include your country and time zone so we can discuss whether online work together is possible and find a suitable time.
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Making sense of a slow loss helps, but the work also has to change how you rest, visit and ask for support.
Anticipatory grief therapy with me will help you understand what you are already mourning, notice the patterns that wear you down and make choices you can live with afterwards. Knowing that grief can start before a death is a relief to many people, yet it does not by itself make the hospital visits easier.
In 22 years of practice I have found that people facing a slow loss need an active therapist. I will guide you, tell you what I see and challenge the beliefs that leave you without support. These 6 questions describe what we work on.
Related reading: Why am I grieving someone who is still alive?.
A slow loss holds many losses: the shared future, the person’s memory or independence, your own freedom, sometimes the relationship you hoped to repair. I help you name each of them, because unnamed losses tend to show up as irritability or numbness.
I offer my reading of what is happening, point to what needs care first and question the rule that you must not grieve until the end. To start naming them, book a session with me.
Carers often go numb to get through, and the numbness has signals: a flat voice, a list running in your head, no memory of the drive home. Spotting them early gives you a choice about whether to stay on autopilot or let yourself feel.
In our sessions we map your own signs and what usually comes just before them. Recognising them is a start, not the goal. We practise brief ways of coming back to yourself, so you can use them at the bedside or in the airport queue.
Steadiness here does not mean staying calm about something terrible. It means being present enough to take in news, ask the questions you need and decide what to do next.
I help you notice when your body braces before a hospital call or a scan result, and what you are bracing against. We find ways to ground yourself that fit your life. I will ask you to practise them between sessions, because the hardest moments rarely fall during one.
Speaking clearly starts with knowing what you need and what is yours to decide. In a family facing a death, roles can harden: one sibling does everything, another criticises from afar, and a parent refuses to discuss what is coming.
I help you find words that are honest and proportionate, such as “I can come in March, but not every month.” I will push back when you go silent about your limits, and equally when you hope relatives will simply notice. We often prepare for a hard family call.
Decisions about care homes, treatment, moving back or staying put rarely have a right answer. Clearer choices come from separating guilt, family pressure and fear of later regret from what you and the person actually want and can manage.
I help you look at the options and what each would ask of you. You will hear my honest view, and I will name it when guilt seems to be choosing. The decision stays yours, and I will help you make one you can stand by.
The time before a death can hold more than dread. It can include conversations you will treasure, apologies, thanks and quiet afternoons. That usually needs some changes: limits on what you take on, help from others, and time that belongs to you.
I help you decide what to protect and what to let go of in this period. Your devotion is not the problem. The aim is to stay close to the person in the time that is left, and to reach the end with as few regrets as possible.
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You do not need a prognosis, a plan or the right words. We begin with the day you are having.
When you begin, I listen to what is happening with the person you are losing and with you, help you name what weighs most and give our work a clear direction. You can arrive straight from a hospital visit, exactly as you are.
Work on a slow loss is one strand of my online psychotherapy, structured individual work in which your own grief comes first. If the person who is ill is your partner and you both want help with what is happening between you, online couples therapy offers long-term relational development and healing. When the illness looks long, a therapy bundle offers real savings and the reassurance of a set plan.
In the first session I ask who you are losing, what the illness has been like, what is hardest now and what you hope our sessions can give you. You do not need to explain the whole medical history.
Before we end, I share my first understanding and suggest how we could work, including around visits and travel. You then decide whether this feels useful. To ask questions before booking, book a free 30-minute call.
Individual work is right when you need a place for your own grief, fear and exhaustion, apart from the person who is ill and the rest of the family. Many carers have nowhere else where they do not have to be strong.
With me you get continuity and honest reflection from week to week, even when your schedule is unpredictable. If the illness is stirring wider questions about your own life, online psychotherapy describes my individual work more broadly.
Couples therapy fits better when the illness is changing your partnership and both of you want to talk about it together. That may be when your partner is the one who is ill, or when caring for a parent is pushing the two of you apart.
In couples sessions I help you both see what is happening between you, voice what each of you fears and stay close under strain. Online couples therapy is long-term relational development and healing for that.
The pace depends on how fast things are changing, how much care you are giving and how often you travel.
I usually suggest weekly or fortnightly sessions, adjusted around hospital visits and flights. I will tell you if longer gaps leave you unsupported at a critical time, or if a short run of closer sessions would help around a move to a hospice or a final visit.
A bundle makes sense when you know you will want support for some months, through the illness and perhaps the first weeks after. It saves you deciding again each time, at a point when you have many other decisions to make.
A bundle lowers the cost per session and gives you a plan agreed in advance. I will tell you honestly what seems likely. See therapy discounts and bundles or the cards below.
Sometimes the work ends when you feel steady enough to carry the illness with the support around you. More often it continues through the death and into the early mourning, then eases.
I review progress openly and will not keep you longer than is useful. Sessions can space out, pause or move into online grief therapy after the death. Returning later does not mean the earlier work failed.
Unsure whether to begin here? This is how online anticipatory grief therapy compares with the options people facing a slow loss most often consider.
| Option | Choose it when | Pace |
|---|---|---|
| Online anticipatory grief therapy (this page) | Someone you love is still alive, and you are already mourning them. | Video sessions fitted around care, visits and flights |
| Online grief therapy | The person has died, and you need room to mourn. | Weekly or fortnightly 1-hour video sessions |
| Online complicated grief therapy | An older loss has never moved and now colours this new one. | Weekly video sessions over some months |
| Online burnout therapy | Years of caring have emptied you, and exhaustion is the main problem. | A focused course of 1-hour video sessions |
Online anticipatory grief therapy with me is individual psychotherapy by video, in English, for adults who are losing someone they love to illness or decline while that person is still alive. It gives your grief room now, helps you stay steady and supports the choices you will have to make.
I work in depth, with your feelings, your history with the person and the family around you. This is a branch of my online grief therapy.
Now is a good time. Come when caring is exhausting you, when you feel guilty for wishing it were over, or when you cannot grieve because you must keep coping. You do not need to wait for the end.
From 22 years of practice, I look at how much you are carrying alone and whether anything is holding you up. When the answer is very little, support now can change how you come through the loss.
Yes. Therapy cannot change the illness, and I will not pretend it can. It can change how alone you are with it, how you spend the time left and how you come through it.
In my clinical experience, people who let themselves grieve before the death often feel closer to the person in the final months, not further away. I would focus with you on what you want to say, do and protect while there is still time.
No. Almost everyone in a long illness feels this at times. It usually means you want their suffering to end and you are exhausted, not that you love them less.
I will not judge you for this wish. I help you understand it, so it stops turning into secret guilt that poisons your time together. Spoken out loud, it usually loses much of its power.
Closeness brings the loss very near, and distance brings guilt. So you move back and forth, sometimes within one visit. It is a way of protecting yourself from pain that is too big to take in at once.
I help you notice what triggers each move and what it costs you. Then we look for ways to stay present for shorter, more manageable periods, and to step back without feeling you have deserted them.
We start with where things stand: the person, the illness, your role and how you are holding up. By the end I share my first impression of what you most need and where we could begin.
You do not need to prepare, and you can tell me if a visit or a hospital call means you need to move the time. Book a first session or start with a free 30-minute call.
That depends mostly on the illness. Some people come for a few months near the end. Others come through a year or more of decline, at a slower rhythm. Many continue for some weeks after the death.
Based on 22 years of practice, I suggest we agree a first stretch and review it as things change. At each review we decide together whether to continue, adjust the rhythm or stop.
Yes, and this is one of the real advantages of working by video. You can join from your home, your parent’s spare room or a hotel near the hospital, and keep the same therapist through every trip.
You need headphones, a private space and a reasonable connection. The calendar shows times in your local time zone wherever you are that week. If you are unsure how it would work, we can talk it through on a free call.
Sessions are individual psychotherapy, each a 1-hour online appointment holding 50 minutes of therapy. The current fees in US dollars are on my prices page.
When you expect support over several months, a therapy bundle saves you 10 per cent and gives you a set plan. Sizes and terms appear on therapy discounts and bundles.
Book your first session, or ask for a free 30-minute call if you would like to talk first. A few words about who is ill is enough.
If no time fits, or bad news has just arrived, contact me directly. I hold some room for acute cases, so a time within days is usually possible, and acute online psychotherapy describes that help. Book a time, and we start with where you are today.
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I want therapy to help you understand your experience and make choices you can use in everyday life. We pay attention to feelings, needs and the responses that happen before you have time to think.
Our online room should offer enough trust and honesty to explore what is difficult. I bring attention and professional judgement. You bring your experience, questions and the right to say when something does not fit.
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