My first session with a Gen Z identical twin woman began with her rhapsodizing about the essential godliness embedded in the “twin mystique.” Clare asserted that twins are meant to be best friends and soul mates forever. She voraciously read articles and online publications that touted the sanctity of twinship.

She had come to me seeking treatment for severe anxiety, suicidal ideation, and depression linked to her first long-term separation from her sister, Cleo. They are the only children in the family, and they have lived a tandem, enmeshed existence. Clare could not recall a time when she was not in competition with Cleo regarding grades, weight, musical talents, boyfriends—the list goes on and on.

When they separated to attend different universities, the adjustment was unbearable. As a result, they left their respective colleges, applied to the same college, and lived together for their four years of study. After graduation, Clare decided to pursue a graduate degree, while Cleo entered the workforce. These decisions dictated that the sisters would live separately from each other. While many fascinating events occurred because of their being on their own, I will focus on only one aspect for the moment.

After several months in treatment, Clare said that she had noticed inexplicable aspects of Cleo’s behavior that she had not encountered before. For example, Cleo would tell Clare what she was doing and where she was going, but Clare would eventually discover that her sister was lying about her whereabouts, as well as her boyfriends and her work life. If Clare attempted to get an explanation about this, Cleo would angrily accuse her of being intrusive, mistaken, and confused. This irrational outburst would be followed by Cleo pleading with Clare to spend time with her. Clare would repeatedly give in to Cleo’s pleas. However, after Clare reluctantly rearranged her plans to accommodate her twin, Cleo would often, at the last minute, make up a reason as to why she could not be with Clare. On the occasions that they did manage to get together, Cleo would spend most of the time on the phone, talking with her boyfriend.

Clare wrestled endlessly with trying to make sense of this gratuitous behavior. Initially, she rationalized Cleo’s selfish actions by making excuses for her. Perhaps Cleo’s need for secrecy and lies had to do with sleep deprivation owing to her night shifts at work. She brushed off Cleo’s abusive treatment by compulsively trying to get Cleo to talk with her about what was happening. This tactic proved fruitless because Cleo never admitted to the discrepancies that Clare pointed out or assumed any accountability. The more Clare pushed her sister to talk, the more defensive, angry, and mean Cleo became. She accused Clare of being crazy and paranoid.

After so many years of being enmeshed, Clare found it challenging to accept that Cleo’s behavior made her doubt herself. It took Clare several months to acknowledge the gaslighting situation. Her repeated, failed efforts to engage in a conversation with Cleo about this issue left her incredibly angry, frustrated, and sad. Cleo had always been her only friend and her best friend, and Clare staunchly believed in the notion that their twin bond would last a lifetime. She told me she “drank the Kool-Aid”—her way of saying she bought into the “twins forever” mantra, and it had usurped her entire emotional life.

This process of recognition and acceptance is a painstaking one. It is not easy to dismantle or upend a lifetime of beliefs and fantasy. The silver lining in all of this is the opening of pathways into other relationships and connections where Clare can begin to build trust and authenticity. This ugly breakdown in what was expected to be an immutable love connection has temporarily shattered her belief in herself as well as unmasked a deep grief and loss over what was supposed to be.

As I have mentioned before, many twin pairs feel as if they have been parented by their twin because of their incessant time together. Without a consistent, reliable adult presence, they have been left to their own devices to make sense of their emotional world. Many twins credit each other for their survival and well-being in a family that was unable to provide sufficient attention to them. And while this arrangement has many positive aspects, some dangerous psychological precedents are laid down as well.

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