Seeing patients develop more joyful mindsets is most gratifying to a psychotherapist. This work requires significant commitment from both the patient and the therapist; a willingness to examine how painful past circumstances contributed to pessimism, hopelessness, and failure; feeling safe enough to articulate feelings of shame and anger without judgment; and recognizing the powerful influence of one’s upbringing, parenting, and personality traits. The goal is for the patient to realize how unhealthy behaviors are consciously or unconsciously replicated. For example, […]

I have worked with an identical twin woman in her fifties, whom I’ll call Dixie, for about two years. We have extensively explored how her traumatic childhood and her twinship contributed to her self-loathing, anger, and helplessness. Her improved sense of self has enabled her to access ambivalent feelings about her sister. Previously, Dixie idealized her twin—she told me that their connection helped stave off devastating verbal attacks from their mother and older sisters. When her twin decided to separate […]

A mom of eight-year-old identical twin girls contacted me for help managing one of her daughters, whom I’ll call G. The mom told me that G talks often about how she dislikes being a twin. The mother says she walks around with a scowl on her face. She becomes annoyed when someone calls her the wrong name or refers to her as one of the twins. The pandemic exacerbated G’s hostilities. While G and her sister were able to attend […]

When a twin who has seen a therapist in the past contacts me, he often tells me that his previous therapist shamed him by proclaiming that feeling abandoned, jealous, or guilty about his twin getting married, moving away, or having a better job is nothing short of selfish. This therapeutic lack of insight, empathy, and understanding about a twin’s state of mind in these predicaments drives me crazy. I imagine that if a singleton sibling were in treatment and these […]

As a seasoned clinician, I am well aware that insight is the gateway to change. I tell my patients that discovering fresh insights into our problems and ourselves is akin to opening a window that has previously been shuttered or stuck. However, in order to discover those insights, we must open that window to risk new behaviors and experiences that may feel out of reach or simply too intimating to contemplate. I was communicating electronically with an adult twin woman […]