In the past few months, I have had the opportunity to work with three female identical twin couples who sought conjoint therapy to help them work through some of their twin-specific issues. In thinking about their separate sessions, I found some striking commonalities.

The twins range in age from their midtwenties to their sixties. In all cases, the sisters reside in different states. I believe that their geographical separateness creates more latitude for them to address uncomfortable and difficult concerns. In each dyad, one woman yearned to safeguard her special twin status or identity and appeared to anticipate preferential treatment from her twin. She expressed tremendous disappointment and sadness when her expectations were not met.

I theorize that the twin who feels more susceptible to exclusion and rejection in the twinship is the one who had the role of caretaker when they were young. When twins assume this function from a very early age, their behavior and psychological embeddedness may give rise to an exaggerated sense of superiority, power, responsibility, control, and protection. If their twin no longer wants this involvement nor needs this type of crutch, a disruption in their connection is probable. The caregiving twin is reluctantly compelled to concede her power as her twin looks forward to more autonomy.

The twin who craves more connection with her less invested sister feels narcissistically vulnerable. Both twins are entitled to their perspectives and emotions. As in most relationships, even twinships, individuals do not customarily get 100 percent of their needs met. However, twins often have an idealized, misguided notion that each of them will get what they want in equal measure, which seems to be an unspoken bargain made within their twin bubble. When they get less than what they want or think they deserve, the dyadic equilibrium is toppled, and the twins can struggle to feel connected.

Thankfully, the twins who reached out for therapeutic intervention are deeply committed to preserving their twinship from the pitfalls of estrangement and conflict. They want to develop a more expansive view of their relationship by telling the other what they feel and think. Hearing their sister’s perspective requires tremendous courage and openness. Facing new truths after living a life characterized by emotional deceptions intended to uphold the twin pact is a daunting leap not for the faint of heart.

Photo by Gerd Altmann, Pixabay