Working with twins can be difficult and confusing if the therapist does not understand the profound nature of twin primary attachment. Actually, it can be shocking for a nontwin therapist to try and take seriously the commotion that is created when twins fight and then make up. Working with adult twins will always be easier if you understand the importance of the following issues:

• How twin development is different than the development of a single child. And the ensuing effect on personality development because twins share their parents.
• The pattern of twinship that is shared will determine to some extent the degree of separation that adult twins can handle from a psychological perspective.
• A twin’s sense of self is qualitatively different than a single birth individual. In young twins some aspects of personality are shared, which makes young twins develop their own language and nonverbal communication. With shared aspects of personality, twin identity has to develop into an individual identity in adult twins.
• Twins have expectations to be deeply understood when they invest emotionally in another person. The therapist will need to set limits and expectations so that idealization and devaluation are minimal.
• “Immediate and close understanding” are expectations twins have for therapy. The therapist has to keep this issue at the front of his or her mind.
• Therapeutic goals should be established with the therapist so the patient does not become distracted by what their therapist thinks will work out.
• The therapist will be a container for the patient’s loneliness but not a twin replacement who is required to function in day-to-day life.

Conclusions

Adulthood struggles go on and on. Twins will work through their conflicts with each other if they try to develop a mature twin attachment. Clearly, this is not an easy thing to do. Sometimes getting along for twins is impossible if traumatic events and abuse have dominated childhood experiences. A commitment to respecting yourself and your twin is a basis for establishing a strong bond in adulthood.