Twins in Session

Case Histories in Treating Twinship Issues

Joan A. Friedman

• Publisher: Rocky Pines Press
• Year: 2018
• ISBN:
  9780989346467
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

Why would a twin sacrifice her own needs to make sure her same-age sibling is always cared for? What would cause a twin to have panic attacks when he and his brother go away to separate colleges? Why do some twins find it so difficult to develop friendships and romantic relationships? The "twin mystique" and twins' own expectations of their relationship contribute to their difficulties. A therapist who understands the psychology of twins can articulate what's going on between the siblings. Clients will feel validated as well as relieved to gain clarity about a defining aspect of their identity. Twins in Session shows therapists how important the twin connection is, what it means, why it's sometimes more important than the relationship to either parent, and why some twins don't know who they are apart from the twinship. It will help therapists become a trusted outsider who can give twin clients perspective about their twinship issues and assist them in developing healthy relationships.

CHAPTER 1

Twin Attachment

A concerned mother called me in a panic. Her eighteen-year-old son Nick, who graduated at the top of his high school class and had recently entered college, was in crisis. Just a few weeks earlier he told her he was doing well in his classes, loved the campus, and had already made a few friends. But in a recent email he revealed that he had brain fog, couldn’t concentrate, and couldn’t do his work. Nothing like this had ever happened to him, and he didn’t understand what was going on. His visit to a college counselor provided little insight or benefit. The counselor listened while Nick recited his symptoms—intense anxiety, inability to focus, sleeplessness—and assured him that these were very common among entering freshmen. Living apart from their parents for the first time, she told him, many first-year students initially have trouble managing on their own. She offered some advice that might help him relax and fall asleep more easily.

Nick’s sense that he was falling apart did not subside. Understandably, his difficulties were the reason for his mother’s concern. Aware of my psychotherapeutic specialty, she contacted me. I specialize in twin issues. Her son is a twin.

Nick’s distress was distinct from that of a nontwin (or singleton) adjusting to being on one’s own for the first time. Certainly many young people entering college away from home go through a period of adjustment; however, Nick was confronting something far more jarring than an adjustment to college. He was undergoing a genuine crisis of identity. For the first time in his life, he was living apart from his twin, and he didn’t simply miss his brother as a nontwin might. Without his brother, Nick really did not know who he was. Although he couldn’t articulate it to the college counselor, he felt as if he was lacking a part of himself and he didn’t know how to function without that missing piece. Off balance, scared, and unable to engage with his studies as he had previously, he was not the person he knew himself to be. He didn’t recognize these new, uncomfortable feelings and was thrown into panic mode.

Since Nick had no experience being in the world as an autonomous self and he had been related to as part of a couple throughout his childhood, his perspective on his role and function in the dyad had informed his identity. His experience exemplifies why separation for twins can be a crisis. A therapist who is unfamiliar with twin issues may not fully comprehend the complexity and intensity of that crisis.

Not every twin experiences such severe anxiety when separating from his or her same-age sibling. Many of those who do have grown up with inadequate opportunities to form a secure attachment with their primary caregiver; instead, they have developed a uniquely dependent attachment to the most available person in their familial environment: their twin. In fact, the core issue underlying the various psychological problems that twins typically bring to therapy is an unhealthy, yet culturally sanctioned, twin attachment.

Attachment Theory and Beyond

Psychoanalyst John Bowlby, founder of attachment theory, theorized that an infant’s need for physical and emotional security engenders compelling behaviors that prompt the primary caregiver to respond. A baby’s cry, smile, or clinginess signals to the parent a particular need, which then provokes a nurturing response. In her article “Can Attachment Theory Explain All Our Relationships?” Bethany Saltman concisely summarized Bowlby’s theory: “At the heart of the attachment system is a primitive kind of call and response that keeps the species alive.”¹

Donald Winnicott’s model of mother-child attachment involves two important concepts: primary maternal preoccupation and going on being. Winnicott maintained that a baby comes into the world as an omnipotent being and whenever he needs something, he is attended to by his mother, who is attuned to his needs and committed to fulfilling them. Having just experienced pregnancy and childbirth, the mother is in a state of maternal preoccupation and makes herself fully available to her child. The baby thus realizes that there is an “other” who is consistently available to him to meet all his needs. As the baby repeatedly experiences his needs being met, and as the “good enough mother” begins to reconnect to parts of her own life apart from the baby, he develops the ability to be alone, without his mother, for short periods and to exist in a state of going on being.²

Winnicott asserted that this capacity to be alone means that the baby understands that somewhere outside himself is one reliable someone who is intimately connected to him, who responds to his cues, and who knows what he needs. During this developmental process, the baby progresses from a state of omnipotence and being essentially merged with his mother to a state in which he has the capacity to temporarily go on being without her.

For the baby to reach the going on being state, a healthy attachment must occur, meaning that the parent is attuned to what the infant needs; recognizes the signals of hunger, discomfort, anxiety, and so on; and attends to those physical and emotional needs.

Saltman succinctly characterizes the mother-child attachment as “Separate, connect. Separate, connect” and points out that current research underscores its impact on adult problems:

Separate, connect. Separate, connect. It’s the primal dance of finding ourselves in another, and another in ourselves. Researchers believe this pattern of attachment, assessed as early as one year, is more important than temperament, IQ, social class, and parenting style to a person’s development. A boom in attachment research now links adult attachment insecurity with a host of problems, from sleep disturbances, depression, and anxiety to a decreased concern with moral injustice and less likelihood of being seen as a “natural leader.”³

Dr. Karlen Lyons-Ruth, professor of psychology at Harvard Medical School, suggested reframing the first two years of life as an attachment-individuation process rather than an attachment-separation process. Beatrice Beebe and Frank M. Lachmann summarize Lyons-Ruth’s concept in their book Infant Research and Adult Treatment:

The toddler’s optimal development includes affection, using the parent as a resource for help, vigorous pursuit of contact-comfort with a parent when under stress, and the assertion of initiative and opposition without the fear of rejection. Thus the child’s developmental process should be assessed by the degree to which patterns of affect regulation remain warm and mutual. At the same time, they should facilitate the child’s pursuit of goals and initiative. This model of development emphasizes assertive relatedness rather than separation to achieve autonomy.⁴

In their book, based on their infant-mother observational research, Beebe and Lachmann refer to the importance of mother and baby “co-constructing” their intimate connection by way of their facial and vocal interactions. They emphasize that this is an implicit, nonverbal interactive process—a mutual influence system contextualized by each partner.

Asserting that they view autonomy and relatedness as simultaneously co-constructed, they offer this explanation:

We reconceptualize autonomy as emerging from “good-enough” interactive regulation. Likewise, we see interactive regulation in the optimal range as emerging from “good-enough” self-regulation of both partners. Rather than seeing autonomy and relatedness as two separate poles, we see both as simultaneously co-constructed.⁵

In a normal mother-infant interaction, the mother has the time, space, and capacity to engage in such mutual influencing and to be fully attentive to her child’s emotional needs. A mother who is dependably engaged in meeting the needs of her baby generally feels satisfaction and gratification about her maternal role and responsibilities. She feels that she’s doing a good job, being a good enough mother. But how is the mother-baby dynamic altered when there are two babies?

Mother and Babies, Interrupted

With two babies, a mother may feel that she is never a good enough parent because her experience is that she is constantly falling short, never able to meet the demands of two babies at once. How does an overwhelmed mother manage to have primary maternal preoccupation with two babies? And how do two same-age siblings accomplish the developmental task of learning to go on being when they are aware that they are not the lone baby and when they are rarely, if ever, given the opportunity to be alone?

In her article “There Is No Such Thing as a Baby: Early Psychic Development in Twins,” Ruth Simon explains why mothers and twins don’t fit into Winnicott’s model of mother-child attachment.

The psychological experience of being a twin is organized by being part of a group from the moment of birth . . . and even before. The other twin creates a threesome that interrupts the experience of unity with the mother well before there are three separate people involved. For this reason, the infant twin psychically experiences a mother who is never his or hers alone and the twin doesn’t come into one’s own sense of self and subjectivity through differentiation from just the mother in the same way that single babies do. Instead, the twin comes into being in a social group that includes the mother, the burgeoning self, and another burgeoning self that is “not me” but is “like me.” This has a profound impact on the internal world of the twin, which will always include a sense of a social context in addition to coming to include a sense of self.⁶

While Winnicott emphasizes the importance of learning to go on being, a twin generally goes on being with his or her twin. A twin baby experiences always or nearly always being with another baby and thus does not have the opportunity to go on being alone. Although an essential developmental task is to learn to tolerate separation from the primary person to whom the child is attached, the task cannot be wholly accomplished when a “not me” is in a position of primary importance and is always close by—namely, the child’s twin.

In addition to the lack of experience of going on being alone, a twin also faces the unique circumstance of being impinged upon or interrupted by the other twin. He witnesses the other baby getting his needs attended to while the first twin’s are not. So the second twin is perceived as distracting the mother from her engagement with the first twin, impinging on his time with her, and interrupting his own mother-baby attachment. And when the mother turns to focus on the first twin, he then experiences the reverse: he is impinging upon his twin. So he internalizes being both the interrupted and the interrupter. Ruth Simon explains:

Each twin’s need to have the mother available to help her or him progress through their developmental stages is in direct conflict with—and therefore an interruption of—the other twin’s needs to do the same. As such, the other twin is experienced as an interruption to these important tasks, and, more important, the twins each experience him- or herself as an impingement. It is a wholly unique experience in the lives of twins to experience the self as an impingement in another’s development.⁷

Since twins are always attached to either their twin or their mother, they experience themselves in a social context—connected to each other, connected to each other and to the mother, or vying with the other baby for the crucial connection to the mother.

The mother’s experience of attaching to her babies is also interrupted by one or the other twin. She is constantly trying to balance attuning to one with attending to the other. Her attempt to psychologically internalize two babies is a challenge at best, as her process of attaching to one baby is continually interrupted by the need to focus on the other. So interruption occurs on all sides of the mother-babies triadic attachment.

In addition, the internal development of a twin identity is based on how each baby experiences attachment to the mother and to the other baby. As Simon points out, a crucial piece of the babies-and-mother attachment process is how the mother internalizes her two infants. Although she may believe that she is encountering each as an individual child, she also likely internalizes them together, as a set of twins. This resonates within both babies, leading to their experiencing themselves as a “we” in the mother’s eyes and in their own:

The mother’s preoccupation with two rather than one baby is an internal psychic phenomenon that changes how she holds (concretely and metaphorically) each of the babies. They are not just individuals yet in her mind and so they experience themselves through her experience of them as a dyad. Infants’ sense of feeling real develops, in part, through the experience of the mother’s gaze. The dyadic mental hold of the mother changes how twin babies come to experience themselves. Whereas an individual baby constitutes the mother’s entire psychic universe, the individual twin is never the mother’s whole universe. They are each “baby and mother,” “babies and mother,” and “baby and baby.” Because the mother’s internal experience includes the fact that the twins are a twosome, it is also the experience of “twosomeness” that is available for internalization. For twins, this translates to a deep psychic experience of “we-ness” that is fundamentally different from that of single babies.⁸

So the process of attachment between a mother and two same-age babies is multilayered. It often starts with the mother meaning to attach to each baby as an individual child but is impacted by the impracticality of attending to two same-age infants, as well as the mother’s internalization of her t...