How Does Being a Twin Impact the Therapeutic Relationship?

People often ask me if I have specialized in the treatment of twins my entire career. The answer is no. While I always had a need to understand how my twinship experience shaped my developmental experiences, this emphasis was more personal than professional in the beginning years of my psychotherapy practice. However, after my fraternal twin sons were born and I became a mother of twins, my psychological understanding of twin attachment deepened.

My focus on twin pregnancy, twin births, attachment, and parenting strategies garnered some attention. Riding the momentum of this success, I developed a particular interest in adult twins. I realized that very little had been written about the distinct developmental trajectory of older twins and the importance of distinguishing the emotional and environmental differences from the singleton experience.

I was asked the other day how my being a twin impacts the therapeutic relationship with patients who are twins versus nontwins. Naturally, twin patients and their families are thrilled to find a therapist who is a twin. Twin patients enter treatment with reassurance and relief that their experience will be understood and, more importantly, not judged. Many twins feel ashamed, angry, and confused about their twin troubles. Talking to a fellow twin appears safe.

I feel that having grown up as a twin has contributed to my therapeutic efficacy. I am adept at empathizing with another’s experience without much difficulty, which enables me to quickly grasp the presenting problems. Also, being exquisitely attuned to boundaries adds an important dimension to my work. I intuitively know what I can ask and what I cannot yet explore. Some twin pairs suffer tremendous shame and defensiveness around issues of dependency and inferiority.

A twin patient can identify with me as a twin, and the relationship can provide mirroring and validation to the twin struggling with self-definition. Over time, the twin gives herself permission to be a separate being. Naturally, this shift brings about complicated circumstances that have the potential to undermine the twin attachment.

I believe that my personal twinship trials and tribulations have contributed to my capacity for empathy and a healthy understanding about how differences, ambivalence, and unrealistic expectations can threaten twin intimacy and relatedness.


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