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I have been thinking about two sessions I had recently with two different twin clients—both struggling with twin loss, physically and emotionally.

One woman has been attempting to work through her grief about the death of her twin sister, who died unexpectedly of a heart attack a few months ago. My client and her sister were incredibly close. Although they were both married with careers and children, they spoke every day and saw one another frequently. They shared an inexplicable and exquisite bond that no one else understood. My client said her sister’s happiness and well-being were more important to her than anything else. She explained that although they may have been competitive while playing games or trying to get attention, their rivalry never resulted in any sense of malice or envy. They loved one another unconditionally, just as one might love a child.

The other client, also an identical twin in her midfifties, entered treatment with me to understand turbulent emotional issues with her twin sister. She related a history of long-standing resentment, hostility, and jealousy and explained that as differences and inequalities in their life experiences escalated, her twin’s feelings of anger and cruelty exponentially increased. My patient’s economic, professional, and parenting successes inadvertently fueled her twin’s ongoing resentment and rage. In stark contrast to the other twin patient, this woman has never truly felt that her twin genuinely cares about her happiness or struggles. In fact, my patient feels that her sister seems to derive much pleasure in finding out about her disappointments and failures. When my patient has celebratory events, her twin sister often acts glum and annoyed.

Rather than having a relationship in which basking in each other’s success and sharing each other’s trials and tribulations is possible, my patient feels alone and alienated from the person she is supposed to love, trust, and cherish most in the world. Such is the nature of the twin relationship. For many, twinship is a lifelong gift of love and support; for others, it becomes a burden to manage and accept.