A woman in her late twenties, Alice, contacted me for some help managing her fraternal twin sister, Ruby. Alice declared that Ruby was ruining her life. Ruby calls her multiple times a day, even though both women work full-time and live in different states. Alice told me that Ruby had a severely traumatic relationship in high school. Since then, she has struggled to date or trust men. Alice also stated that Ruby lives in a delusional world where she fabricates having connections with nonexistent males.

Alice is in a committed relationship with her boyfriend, which she believes will ultimately result in marriage. However, Ruby has somehow managed to turn all their mutual friends against Alice’s boyfriend, making it difficult for Alice to believe that anyone is happy for her. Ruby once told Alice not to bring her boyfriend to a holiday party at home, saying that he is not welcome because he is not nice to Alice. Alice is angry and frustrated by Ruby’s behavior, but she feels guilty that she is happy while Ruby is not.

Ruby has told Alice that she loves being a twin more than anything in the world and wants to be able to live close by and raise their children together. Alice feels quite the opposite. She said she could not wait to separate from Ruby and graduated from college a semester early to ensure her getaway.

Alice responds to Ruby’s phone calls and demands with monotone lectures. She wants to help Ruby, but her long-winded responses, although rational and reasonable, convey little compassion or empathy because she is understandably hurt and frustrated by Ruby’s callous behaviors. After Alice described her lengthy advice-giving conversations with Ruby, I remarked that she sounded like a punitive and rejecting parent. I suggested she keep her conversations short and compassionate. Her well-meaning guidance and recommendations fall on deaf ears—Ruby does not listen to a word she says.

Alice is terrified about setting boundaries with Ruby because she loves her sister very much and doesn’t want to hurt her. I acknowledged those sentiments and conceded that taking this step must seem very difficult. However, if she doesn’t do something different, the situation will worsen over time, contributing to more enactments and enmeshment. She can think of parenting her twin in these circumstances as tough love. If things do not change, Alice’s relationship with Ruby will eventually turn ugly, polarized, and unforgiving.

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