Dr. Allan Schore is a well-known neuroscientist and psychologist who writes prolifically about the topics of attachment and emotional regulation. He believes that the primary caretaker’s ability to regulate an infant’s up and downs enables the growing baby’s capacity to self-soothe. The notion that emotional regulation is an outcome of a caretaker’s consistent emotional attunement has been well documented by other attachment theorists.

Of course, this process does not go well for some babies. In addition, a parent of twins may struggle when attempting to regulate two infants simultaneously. However, twins seem to be able to utilize their twin attachment to compensate for what the overwhelmed parent cannot provide.

Becoming and acting as each other’s regulator can be advantageous in twin development. Twins help each other feel safe and protected in new situations or with new people, and their twinship staves off loneliness and fear. Most twin pairs successfully individuate over time, eventually learning how to take care of themselves psychologically without their twin. However, for those who cannot, the outcomes can be dangerous and unhealthy.

Eating disorders are an obvious harmful effect of emotional dysregulation. I have consulted on a case involving 16-year-old identical twin girls whose problems began when they were 11 years old. A peer commented that one sister appeared a bit heavier than the other. The so-called heavier twin took that observation to heart and restricted her eating. Her sister followed suit, not wanting to be bigger than her twin. Unfortunately, their health battle rages on. Despite a brief hospitalization and ongoing treatment interventions, their behaviors have not improved.

The fascinating albeit sad aspect of this situation is that both girls feel compelled to regulate each other to keep their food restrictions equalized. For example, they always eat together, even if they are not physically near each other. Both girls say that they must check what each is eating and how much. They often go food shopping together while on a video call to be sure they are buying the same foods. Both are fearfully convinced that they cannot eat without the other’s presence. This is the outside regulator at work. For now, they have no capacity or desire to build an internal regulator. Their family dynamics, as well, contribute to perpetuate this problem.

Self-regulatory behaviors can be learned later in life. It can be beneficial to establish a therapeutic relationship that enables the patient to understand how specific self-soothing behaviors can help minimize anxiety and depression.

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