Can Your Twin Have a “Normal” Childhood If She Has a Special Needs Twin?

specialA mom recently wrote this about managing twins with different abilities:

I have identical boys, but one will never be able to do everything his brother can, due to a brush with Twin-to-Twin Transfusion Syndrome in the womb. Although both are healthy, bright kids, their physical accomplishments will always be at a different pace, and as a result, I’ve had to mull this over many times.

Thinking about this mom’s situation led me to learn more about how children with normal functioning may be adversely impacted by growing up with a sibling who is compromised, either emotionally or physically. Reading The Normal One: Life With A Difficult Or Damaged Sibling by Jeanne Safer helped enormously. I believe that what I am about to write may be construed as controversial, insensitive, and decisively not politically correct. However, I am of the opinion that an unaffected twin may be at risk for developing emotional difficulties when her twin’s special needs dictate the family’s psychological organization. Often “normal” children are given short shrift in terms of time, understanding, and opportunities to be authentic and honest about the difficulties of being raised with a sibling with special needs.

I grew up with an older cousin who lived nearby, and I witnessed second hand how her mental illness affected her siblings and family. Her siblings were covertly coerced into being good girls, so that their parents would not have any additional burdens or worries. Their own needs were invisible to themselves. These younger daughters had to be the children who made up for their older sister’s deficits and for shattered parental dreams. They were not able to act out as adolescents or be naughty little girls. They did not dare generate any more guilt and blame for their parents, who suffered mightily with their eldest child’s self-destructive behavior, depression, and psychosis.

Safer highlights the challenges faced by siblings of children with special needs:

  1. Maturity beyond their years
  2. Fear of becoming sick
  3. Tremendous feelings of guilt and anger
  4. Need to be perfect to make up for the family’s struggle and loss of perfection

So often, children who have grown up with special-needs siblings go into the helping professions. Their needs are met by helping others. They watch their parents struggle and suffer and do not make demands. In a twin relationship, the unaffected twin may feel that competition is unhealthy and that her successes are not praiseworthy. She may struggle with the envy of her affected sibling, feeling as if her hard-won gains are destructive and undeserved.

Conventional wisdom says that the sooner the compromised sibling’s condition is explained and understood, the easier it will be for her twin to feel less disturbed by the situation. Since the survivor guilt is fierce, however, parents must take great pains to help the healthy child realize that she had nothing to do with what happened. Parents need to reassure her that no one can undo an accident of fate and misfortune.

Since twin relationships are prototypes of future peer connections, romantic interests, and professional connections, it is vital that we help nonaffected twins develop feelings of love and caring for their twin that do not become intertwined with self-sacrifice or self-destructive motives or choices.


Photo credit: Image courtesy of David Castillo Dominici at

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