Siblings in Development

A Psychoanalytic View

Vivienne Lewin, Belinda Sharp, Vivienne Lewin, Belinda Sharp

• Publisher: Routledge
• Year: 2018
• eBook ISBN: 9780429919220
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Siblings play an integral and essential part in our psychic development. Traditionally in psychoanalytic thinking, sibling relationships are regarded as secondary in developmental importance to the relationships with the parents. The authors in this book challenge this view and explore the impact of sibling relationships on internal psychic structures, family and social relationships. They suggest that siblings play a primary part in psychic development, even for an only child, and that infants are born with an expectation of siblings, an innate pre-conception similar to those relating to the breast and parental couple. Through infant observations and psychoanalytic treatment, the authors in this book examine sibling relationships from the most profoundly close, as in conjoined twins, through other twin and sibling relationships and deliberate on the wider context of social and tribal brotherhood and sisterhood.

Conference 1

Chapter One
When two become four: A two-year observation of dizygotic twin infant girls in their family setting

Toby Etterley

“All Fords are exactly alike, but no two men are just alike. Every new life is a new thing under the sun; there has never been anything just like it before, never will be again.” (Henry Ford)¹

“There are two things in life for which we are never truly prepared: Twins.” (Josh Billings)²

Introduction

Liz and David were a very warm, affable married couple living in suburban London. They were both Caucasian in origin, in their early thirties and university educated. Though they worked in quite different spheres, creativity and the arts were highly valued by both of them—personally and professionally. I made contact with them through a mutual acquaintance who informed me that the couple were having twins, that this was their first pregnancy, and that they were keen to participate in a mother–infant(s) observation. Liz was in the 36th week of pregnancy when I first went to meet her and David. They greeted me warmly, and after mutual introductions Liz patted her (very large) bump and said, “And these are the twins.”

During this meeting I learned that there was no history of multiple births in either Liz or David’s families. Moreover, due to a late first scan, they had only discovered that they were having twins at 20 weeks gestation. Liz’s pregnancy had been a good one, though there was a recent (and as it turned out founded) concern that she had preeclampsia, a disorder that can be highly dangerous to both mother and infant(s).

Liz was (perhaps unsurprisingly) anxious and overwhelmed in this introductory meeting. She talked of how they were having twins and yet they had no experience as parents. She also revealed her concerns that due to this condition she might now be damaging her unborn babies. She said, “I just want them out now,” and added that there was nothing that she could do for them whilst they were “inside”. She said that once they were born she and David would know if they were okay and would be able to comfort them if they weren’t.

In this first meeting, and even before the twins were born, there was a sense of a couple working together and as a unit. David stayed and acted as a “gatekeeper”, as he often did in later observations (as he worked from home). He asked practical questions about the observation—what I was looking for, how it would work, how regularly I would need to come etc? After this he left us (and returned to decorating the nursery). Liz informed me that whilst they had wanted to, they hadn’t been able to find out the sex of the babies. She added that she was, however, sure that at least one of them was a boy and would be “very surprised” if they were both girls. Liz’s certainty about this was striking and remained unclear. Although inevitably multi-faceted, I came to understand that the issue of difference and differentiation was a central one for Liz and a fundamental factor in the decision to admit an observer to such a special and private period of their lives. Indeed, later on when reflecting back on the observations Liz said, “It’s strange but it gives me a space to think back over the girls’ weeks and to think about their development and the differences between them.” She also told me of identical twin boys she had known as a child and how they were always dressed alike and treated as if they were two copies of the same person. I had the sense that this story conveyed a fundamental anxiety of Liz’s—would she have the space in her mind to meet these two new individuals as such?

”Divide and conquer!”— meeting “the girls”

I first met Katie and Jo when they were 26 days old. On my journey to the house I became increasingly aware of my own doubts and concerns over my ability to observe two infants simultaneously. I was worried about how it would work out practically and excited at the prospect of finally meeting them. My fears seemed to have been realized when I finally arrived at the house. David greeted me telling that Liz was over at the shops but was aware that I was coming. As we stood in the hallway David pointed toward a recliner on the lounge floor and said, “One’s in there” and then toward another recliner on his study floor and added, “…and one’s in there!” He exclaimed, “It’s divide and conquer today!” I realised that each baby was settled next to a speaker and that soft relaxing music was playing in the background. I felt momentarily thrown, feeling that I had to choose one infant over the other and aware that I couldn’t really see either from my current position.

David now beckoned me through to the lounge and carefully carried the recliner from the study through saying, “This is Jo.” He then motioned toward the other baby adding, “…and this is Katie”. He placed the babies side by side in front of the sofa and said, “There, now you can see them both.” I smiled and took them in, immediately being drawn to the differences between them.

26 days

I stood looking at the two infants. Both were still sleeping. Jo seemed to be in a less deep sleep. Her left arm was held straight outward and her right arm was by her side. Her left hand slowly opened and closed, pausing in each position before repeating the movement. She seemed to be experiencing the difference between skin touching skin and then not touching anything. Her right hand was cupped, almost into a fist but not as tight. The ends of her fingers were lightly touching the palm of her hand. Her face and mouth were also in constant motion. Her eyes remained shut.

Katie lay with both her elbows bent and her forearms held upward. Her right hand was inside her sleeve and not visible. Her left hand was cupped in a similar way to Jo’s right hand. Her eyes seemed shut more tightly than Jo’s and her face expressionless and still. Her head was bowed and most of her mouth and chin was hidden beneath the top part of her dungarees. She appeared to have the material of her dungarees between her lips but was not sucking. I noticed that their faces were very different. Jo was also physically bigger. Neither had a lot of hair, though Katie’s scalp almost resembled a shaven head and was darker in colouration than the very fair strands of hair on Jo’s head.

I was very aware of my anxiety about mixing them up, whether I would be able to tell them apart if they were moved from their positions on the floor and whether I would be able to hold onto the detail that I was observing. Indeed, on leaving the observations I used to urgently speak into a Dictaphone, not trusting my own mind to hold onto the mass of material.

I had been aware that there had been some complications around the births and David informed me that whilst Katie’s birth had been very straightforward, Jo’s delivery (17 minutes later) was a very different matter. He explained that she had been in a transverse position across the top of the womb and had to be delivered with the aid of forceps. However, she didn’t start breathing naturally and had to be resuscitated. Jo subsequently had to be taken to the special care baby unit (SCBU), whilst Katie had remained with Liz in a completely different part of the hospital. David described how torn he had felt and added that Liz had felt very guilty, as she wasn’t physically able to get to see Jo initially. Later on the hospital staff had suggested that Liz take Katie home and leave Jo in the SCBU to complete her course of antibiotics. David added with some pride that Liz had refused to come home with only one of the girls.

In contrast with this striving for togetherness I was struck by David’s sense that this twin unit had still to be physically divided—wrenched apart and defeated. I wondered about the battle in his “divide and conquer”. Was he harbouring a sense of rivalry or envy at their closeness, at the exclusive and hidden experiences that they had shared together in utero? It also occurred to me later that perhaps there was a concern about each twin’s individuality and uniqueness—did they need to be kept apart to exist as individuals? Indeed, on her return Liz described her daughters as “the girls” and told me that they were going to avoid calling them “the twins”. She added that she understood that this could lead to resentment in later life “due to each child not being seen as an individual”. As if responding to the anxiety aroused by this thought, she said that she was beginning to be able to discern one baby’s crying from the other and to understand the communication behind at least some of their cries.

Liz wondered about their experience of twinning—were they aware of one another and of the fact that they were sisters? It struck me that she was pondering the symbiotic aspects of twinship (both for them and for her). She went on to talk of them almost as one, wondering whether I had noticed how long their fingers were and adding that David felt that they were going to be pianists when they were older.

What became increasingly apparent, even at this early stage, was how the process of differentiation in the parental minds involved an over-compensation for Jo. For example, Liz said that Jo was much more aware and expressive than Katie. She and David felt that she was the more developmentally advanced twin and believed that she was actually conceived first. Both parents also commented that they felt that Katie had looked more like a baby who should have been in the SCBU as she was somewhat smaller than her sister.

Additionally, and as the following vignette illustrates, Liz seemed to resort to a defensive denial against the pain of this traumatic beginning.

Jo was still sleeping and began to stir, both arms moving around a little more frantically. She pulled a face resembling a grimace. Liz placed her left hand gently on Jo’s tummy saying, “You like that, don’t you.” Jo’s eyes remained shut. Liz said that she wondered what babies dreamt about. She said that dreams, as she understood them, were a way of working things out, but what could a baby possibly have to work out? She said that she knew about the baby’s tongue and sucking movements in its sleep and that it was imagining a feed, but she couldn’t understand what other experiences they had to draw upon.

There was an unspoken anxiety about Jo’s traumatic birth—the experience that she did have to draw upon or might need to work out. Soon after this interaction Liz looked at Jo and said, “You’re perfect, aren’t you?” and I had the sense that this was both an affirmation and a question. Later in this same observation Jo suddenly froze, her eyes staring blankly up at the ceiling when Liz placed her on the changing table. Liz responded initially by saying, “Look at you!” and then quickly lowered her right ear to Jo’s mouth to check that she was still breathing. I was struck by Jo’s response; what could it mean? Had the cold changing table been reminiscent of the early, traumatic hospital experience? However, equally striking was Liz’s response; the sense of precariousness that surrounded Jo’s “going on being” and the unspoken terror associated with this. In my seminar group fears of long-term brain damage were raised (though proved unfounded).

In this early visit I also learned that whilst Liz was breast-feeding Katie, Jo was being bottle-fed. It wasn’t clear how supportive the hospital staff had been in helping to try and establish breast-feeding in such difficult circumstances. However, Liz’s ambivalence around this development was clear as she said that she wasn’t sure how much difference breast-feeding made. She also noted that actually the bottle-fed Jo was a lot bigger than her breast-fed sister and added that the main difference probably wasn’t a nutritional one but instead concerned the quality of the feed. She said that anyone could feed Jo whilst only she could feed Katie. However, following this admission she quickly said that, of course, it did make feeding two babies somewhat easier.

Breast-feeding never took place during any of my observations and on my fourth visit I learned that Liz was supplementing Katie’s feeds with a bottle, maintaining her breast-feeds only at night. The rationale for this was that Liz had an insufficient milk supply, though I wondered about the impact of having a male observer, in addition to having a twin who was being exclusively bottle-fed. Though there is insufficient space within this paper to fully explore the significance of my gender, I feel that it was a further focus of rivalry, competition and twinning.

Due to the difficulties around the birth and the early separation, Katie’s first week post-partum was spent with mother as a singleton, whilst Jo was in an incubator. In my seminar group we wondered about Liz’s guilt at “choosing” one baby over the other in addition to the sudden rupture experienced by Katie and Jo and the huge contrast in their early lives. Liz commented on how David was “more natural” with the girls than she was and said that she didn’t know how anyone coped with twins on their own.

Jo seemed to be endowed as a “daddy’s girl” and as rejecting of the symbiotic closeness with her mother (“she refused the breast”). Liz talked about how it had been Jo who had kicked her inside the womb as it was she who was lying across the top and there was a sense in which she felt that Jo was still kicking her on the outside (“She doesn’t want me, she wants food”). I also wondered if something competitive between the parents was being played out with the girls (another kind of twinning relationship).

As an extension of this, the parental attributions ascribed to Jo centred upon her size, strength, activity, and outgoing nature, all very masculine characteristics. It struck me that the diminutive of her name by which she was known was a rather boyish one, in contrast to her sister’s very feminine name. Katie meanwhile was smaller and seen as more fragile and generally more passive. Similarly, Liz’s twinning with this infant seemed apparent as she described an interaction where Katie had turned away from her sister when they were lying on the play-mat together. Liz added that maybe Katie had been angry that Jo had taken up all of the room in the womb. It struck me that the parental projection toward Katie seemed to be that she too, like her mum, had had to suffer Jo’s kicks.

The first 6 months

As the early weeks went by I was struck that Katie would have more physical holding from her mother, and also that their contact seemed more sensual. For the first eight weeks Jo was generally with her father and often in his study when I arrived and was quickly brought into the lounge with Liz’s insistence that, “Toby comes to observe both of the girls, not just one of them.” During this time I noticed that Katie seemed to sleep much more heavily than her sister and I wondered whether this was a developed response to being with a more active twin in utero. However, whilst Jo seemed an innately more physical baby, I wondered to what extent this might have been a reflection of (and in response to) the different quality of mothering that she was experiencing. Indeed, in this early period it seemed as if David undertook the “environment mothering” for Jo and he would feed, carry, and soothe her whilst Liz dealt with Katie. However, the first feed that I observed David giving Jo felt quite distressing and very different from her twin’s experience.

5 weeks

Jo’s tongue began to protrude from her mouth and it looked like it was making circling motions inside. David carefully put the teat to her lips and she hungrily took it and began sucking vigorously. She looked up at David’s face and he awkwardly picked up a newspaper and opened it out on the coffee table in front of him. He didn’t return Jo’s gaze but instead began to read, occasionally commenting on a story and reading it aloud. Some of Jo’s milk began to spill out of her mouth and down her cheeks and he did not notice and did not wipe it away. I felt very moved as Jo continued to gaze up at his preoccupied face.

…Liz was far more attentive to Katie. She gazed at Katie as she sucked and gently stroked her head. Katie gazed up at Liz and her body stilled. She moved her cupped hands in toward her body and placed them together under her chin… Jo continued sucking vigorously and looking upward. At one point she held her right hand up, as if seeking attention. David took hold of her hand between his thumb and forefinger but did not make eye contact with her.

I was struck by how Katie seemed so much more possessive with her eyes, as if she really grabbed her mother and drew her in with them. In contrast, the active Jo seemed to become much more passive during her feeds and needed to work much harder physically to grab her object. Indeed, later in this same observation as David stood over a crying Jo, he commented: “Its amazing how quickly you get immune to a baby’s cry, particularly when you know that they just want physical proximity.” Although very competent and clearly aware of her communications, David was preoccupied with other things. It seemed that Jo, more than her sister, had to compete with a twin for her object’s attention. Her “environment mothering” in these early weeks, whilst good enough, lacked the emotional intensity of her sister’s and had a much more practical or rudimentary feel to it.

A number of weeks later I observed a particularly intense feeding interaction between Katie and her mother, in addition to a simultaneous feed between Jo and her father.

9 weeks

Katie showed some delight, moving her arms and legs as Liz put the teat of the bottle to her mouth. She hungrily took it and sucked frantically a few times. She stilled and her sucking slowed to a more rhythmic pace, her heavy breathing interrupting the pattern periodically. Katie gazed up at Liz, who smiled back at her. Liz maintained her eye contact with Ka...

Table of contents

• Cover
• Half Title
• Title
• Copyright
• CONTENTS
• ACKNOWLEDGEMENTS
• ABOUT THE EDITORS AND CONTRIBUTORS
• INTRODUCTION
• CONFERENCE 1
• CONFERENCE 2
• CONFERENCE 3
• CONFERENCE 4
• INDEX