All teenagers have difficulty separating from their families and finding and establishing a separate identity or sense of uniqueness, making adolescence a time that is very turbulent for all teens and their parents. But for twins and their families, the teenage years are truly double trouble. Teenage twins can be hypersensitive about everything that is going on around them. Moody fighting between the twin pair is intense and confusing to outsiders. Even though the twin pair may understand some of what is going on, they may be unable to explain the problems they are having.

Absolutely essential is the development of separate friendships and interests that began early in life. While young twins and elementary school age twins enjoy their close bond, teenage years can be conflicted and painful. Interactions between twins that were once kind and supportive can become angry, jealous and mean spirited. Or twins can become more attached to one another and not look for separate interests and friendships.

Parents can be confused by their teen twins’ hostile antics toward one another or their over-involvement in each other’s lives. Dramatic fights and long silences are predictable between middle school twins who are so involved in their dramatics that they are not even aware of how unstable they are behaving. When do parents and their teens need help from a mental health professional?

Troubling issues in middle school that might require psychological support include:

1. Separation anxiety from the twin or parent. For example 10-, 11-, 12- and 13-year-olds can be afraid of going to school and to separate classes without their twin.
2. Problems with making or keeping friendships. This might include a lack of social skills in everyday interactions—such as an inability to make small talk. Or a twin might display misplaced anger or jealousy with new people who seem better able to explain their own ideas.
3. School or school-work fears or conflicts appear. Often an inability to concentrate on school work appropriately suggests the probability of depression or a lack of language acquisition skills related to the twin dynamic.
4. Jealousy or intense competition with their twin, which causes too much intensity. Twins can be ridiculously jealous and competitive with clothes, cars, friends and grades. Some twins need everything in their lives to be “even Steven,” which is indicative of a problematic development of the twin bond.
5. Isolated behavior that may lead to phobias can develop when twins spend too much time with each other and lack the confidence to try new experiences alone and together.

Behavioral and emotional issues that I am consulted about can be very different from one phone call to the next. “My 12-year-old daughters are pulling each other’s hair out.” Or, “my 13-year-old twins have not spoken to each other in a year.” However, the twin dynamic, or the roles twins take in relationship to one another, is in most instances contributing to their emotional turmoil and inability to feel successful and secure. For example, feelings of worthlessness and insecurity or an inability to contain anger and impulsivity, the compulsive need to always be right or the opposite, never feeling adequate, are symptoms of an imbalance of identity between twins. Jealousy, competitiveness and general unhappiness are other signs of a distorted power struggle between twins. Working out an imbalanced twin relation or twin bond is critical and takes a lot of time and effort.

And yes, you do need help! Adolescence is an important time in twin development that is the foundation for a psychologically healthy and happy life. Look to the underlying cause of your twins’ issues, because temporarily fixing a problem is only a band-aid on a more profound identity issue that needs to be uncovered, acknowledged and dealt with in an open-minded manner.