For a twin who has functioned as a lifelong caretaker, embracing the notion of “healthy selfishness” can take quite a while. Attempting to figure out what it means and what it feels like can involve many hours of therapy and soul-searching. A twin whose major identity has been predicated upon living for another finds it incredibly difficult to all of a sudden begin to embrace life for oneself on one’s own terms.

If the caretaking behavior has been interrupted by losing one’s twin to death or to another relationship, the ramifications can be similarly traumatic. I have worked for a number of years with a young man whose twin died in a car accident. One might assume that a tremendous amount of survival guilt arises in such circumstances. While that is true in many cases, one must probe beyond this psychological surface to access deeper emotional issues.

A caretaker twin from an early age often does not have the freedom or opportunity to dote on himself. His job requires exquisite attunement to another—both nonverbally and verbally. The notion of “self” does not enter his consciousness. When it does, he is highly susceptible to the judgments of others and can become paralyzed with fears of disapproval or failure. He is so defined by another’s needs that he cannot yet entertain the healthier notion of feeling entitled to do something for himself.

His conflict centers around “What can I get out of this?” versus “What will others think about my getting something for myself?” While singletons certainly can encounter this same insecure conundrum, they do not attach it with guilt and shame as twins are prone to do. Singletons do not necessarily worry that their successes will hurt or betray their closest ally, friend, or soulmate. Sibling competition feels like an expectable aftermath rather than a deadly and dangerous situation.

Helping a twin develop healthy selfishness is a long overdue developmental milestone that should be celebrated and enjoyed.

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