Working With A Womb Twin Survivor Through Pluralism
Donna McDonald, Private Practice at Peaceful Grove Counselling & Psychotherapy
In 2008 I was on a workshop exploring attachment theory, when an unknown truth made itself known to me like a slap in the face. We were put into subgroups and I found myself in a group consisting of lots of twins and myself. They remarked how unusual it was to have so many twins in one group and asked if anyone else was. I sheepishly raised my hand to say well I was a twin but it died in the first trimester so it doesn’t really count…
They jumped on this to tell me it does count and that, yes, I am still a twin. They wanted to know more so I relayed the story as I understood it. That day changed my life forever as I realised– No, I accepted, finally, that I am a womb twin survivor. I researched and learned as much as I could but there is little-to-none academic writing on the subject. So I looked to change this.
A womb twin survivor is someone who lost their twin or multiple anytime through pregnancy or shortly after birth; thus miscarriage, stillbirth, failed abortion, or neonatal death. It has been estimated that 10–15% of all single births were originally a multiple, often with a twin being lost within the first trimester. As a consequence, psychotherapists will likely come in contact with clients presenting related psychological characteristics but not always recognise or understand the phenomenon and so not address one of the potential root causes.
I took this revelation to my counsellor and found she could not ‘meet’ me on this subject as she did not know, understand, or could empathise with the situation. She stated that my twin was just a bunch of cells and it was obviously not meant to survive and that I should be sensitive towards my mother who miscarried and not make a ‘thing’ of it. I felt shamed, my experience felt belittled, and that I should not discuss it. What I wanted, and what other survivors need, is to be listened to and respected. That is, to have their experience of grief and trauma (as this is how many survivors describe their experience) validated and acknowledged and learn (if they wish) on how to integrate their twin into their life/identity. It is crucial to not assume what the survivor wants to achieve from counselling. For some survivors, the shock in discovering they are a twin is hard enough as this can change their concept of themselves and their family dynamic. They may have resentment towards the twin or be angry over how this information has been hidden from them into adulthood.
Characteristics of a Womb Twin Survivor
Althea Hayton suggested people who identify as a womb twin survivor can: (a) have a feeling that all their life something has been missing, (b) fear rejection, (c) feel they are not realising their true potential, (d) feel different from other people, (e) have been searching for something all their life but do not know what it is (f) feel deep down they are alone, even when among friends, (g) have a fear of abandonment, (h) have a problem with anger; too much or too little, (i) always feel in some way unsatisfied, but not knowing why, (j) feel there are two very different sides to their character, and (k) have a preoccupation with death.
A surviving twin may unconsciously try to re-enact the twin bond in their relationships. They can struggle with survivor guilt, have a tendency to try and live their life for two, or feel that they are only half alive. Survivors can also suppress their feelings out of fear of being ridiculed and misunderstood, causing loneliness.
It may be worth inviting clients to explore any pre-birth events as research shows how our time in the womb can greatly influence us in adult life. Womb twins can be viewed as unconsciously re-enacting the connection and bereavement of their twin; looking for a replacement of the twin bond and, as this re-enactment happens, those feelings may resurface. Without exploring this time in someone’s life we potentially miss the original cause of a client’s trauma/struggles.
Whether we as counsellors agree with a client’s belief over their experience in the womb or not, we do need to be open to the possibility that a client’s presenting struggles in counselling may go further back than we anticipated and not stop at a client’s diagnosis or current challenges.
Pluralism as a Resource
In coming to terms with being a womb twin survivor I have found pluralism to be my best ally and source of connection. In my experience of being and meeting womb twin survivors, there, of course, is not a ‘one size fits all approach’. Depending on our life experience, spiritual beliefs, family systems, subsequent traumas, and personalities, how we process the information will influence if we want to integrate our twin, require support through grief, or just make sense of this knowledge. Some survivors are told of their twin as children and have grown up with this awareness. However, being still in a society where this phenomenon is not recognised, it can still create a lonely place for the client.
Pluralism places counsellors in a strong position to support clients through this as we ‘know’ there is not one right approach and with a potentially complicated set of challenges working with a womb twin survivor, we need different strategies to untangle the many different threads of the tapestry.
In my own journey I have used psychoeducation to understand and normalise my experience, I have used compassion-focussed therapy to address my guilt and anger, and I have used attachment theory in understanding how such an early loss influenced my attachment style and future relationships. I also used somatic experiencing through breathwork which took me back to the moment my twin died, so I could understand my feelings and therefore release them in a healthy way. I have also used art therapy, psychodynamic therapy, and narrative practices.
Through lots of creative activities I have satisfied an insatiable need to be close to my twin. I have painted memorial stones, found a candle that felt right, created symbols that linked me to him, a pendant and ring to wear, and created rituals for celebrating the anniversaries. I have written to him and created photos thanks to FaceApp so I can imagine what he would look like. I have done this well because I have the advantage of being a counsellor and being able to access these resources and knowledge. Our clients are not so lucky.
I am sure EMDR, Gestalt therapy, and other methods of somatic therapies would be very useful as this trauma occurred at a pre-verbal time and we now know memories are stored within the body. The body may remember our twins and unconsciously reach for them.
During my own journey my needs have changed with my views and integration of this information and my identity has developed. This makes pluralism suited to this work: with the regular reviews, setting, and resetting of goals for clients. The adaptability, creativity, and individual focus supports the client in navigating through this potentially trying time.
In my Master’s dissertation research, culture plays a huge role in how people will feel about being a twin and what support is available to them. The family narrative is crucial and an understanding of the client’s spiritual beliefs will be discussed. What I have loved about working pluralistically is the creativity and how you can shape and mould strategies to a client and tailor it to them. To also not to be afraid to ‘hold your hand up’ and say ‘I can’t assist you with that but I know someone who can’ and accept that we can’t do it all or know it all. Work like this for both the counsellor and client is a journey and you don’t know where it is going to take you. But the exploration is powerful, humbling, and a privilege to be part of.
I have not come to the end of my journey as a womb twin survivor. I have accepted this will come and go in intensity now but it is manageable. I firmly believe that pluralism is best placed to look at what it means to be a womb twin survivor and support those clients through to understanding, acceptance, and integration of this truth if that is what they wish. There is so much more to this subject and I would strongly suggest exploring more on it if it resonates with you or for a client.
Womb Twin Survivor Reflections links:
Peaceful Grove Counselling & Psychotherapy links: