Twin pairs who attempt to break free of their mutual caretaking patterns and habits have a challenging task. Lifelong ways of being together with their most intimate other create havoc when they interfere with separation and individuation. In many cases where one twin interrupts the attachment by connecting with another, the outcome is fraught with jealousy and rage. However, when the twins work together to disentangle their patterns, they are more likely to do so without fear of betrayal and immobilizing guilt.

Understanding how each has been impacted—both positively and negatively—enables both to develop empathy and compassion for themselves and each other as they seek to find healthy ways to be on their own. However, if the codependent twin pair is connected primarily through conflict and competition rather than love, this approach does not work well.

I believe it is most beneficial for codependent twin pairs to develop an understanding about how parental failures contributed to their twinship conundrum. For example, how capable were their parents in demonstrating emotional understanding and empathy? Twin pairs frequently report that neither parent seemed able or willing to engage in emotional issues. Many parents were put off or overwhelmed by the twins’ fighting or preoccupied with other siblings. The parental misconception that they are needed less because the twins have each other resonates deeply with twins who felt utterly alone and abandoned, having only their twin to supply what their parents could not.

When twins enter treatment, they are usually unaware of alternative kinds of parent-child relationships. Eventually they learn from their trusted therapist that their parenting experience was less than optimal. In fact, they come to acknowledge how much they missed out on having a “good enough parent” and how that intensified the overreliance on their twin.

After this reconfigured reality is digested and acknowledged, the work of separating can begin. Usually the twins have experienced so much prior trauma in terms of social anxiety, panic attacks, and depression, the therapist must gingerly and gently begin to focus on what the twins can do together to work on defining themselves. In one particular case, young adult twins learned how to drive, found separate jobs, and signed up for different dating apps and gym memberships. After much hard work in therapy, they have made plans to attend separate colleges. Their willingness, motivation, and urgency to do so reflects their ongoing capacities to appreciate and acknowledge their separateness. Prior to this point, neither could have ever fathomed they would be capable of making such a momentous leap of faith.

Naturally, both are scared and anxious. Their relative lack of social experience is perhaps their most compelling challenge. Similar to other twin pairs, they initially attended college together; both hoped this situation would facilitate opportunities to make their own friends as well as allow individuation. Unfortunately, they were not successful in achieving these goals, which prompted the young women to contact me a few years ago.

In the fall they will be embarking on a truly pivotal experience: being separate from each other and feeling equipped with the tools to survive what they could not endure earlier—either alone or together. Their therapeutic successes along with their strong work ethic, perseverance, and motivation will help sustain their individual journeys as well as their shared experiences.