Womb twin Survivors. that is the sole survivors of a twin or multiple pregnancy, are often born under traumatic circumstances, including delivery by Caesarian section. A healing therapy is needed. Details are provided of how therapists can provide appropriate help for womb twin survivors.

1. WOMB TWIN SURVIVORS
HOW C-SECTION DOUBLES THE TRAUMA

2. THE PRIMARY TRAUMA:
THE LOST TWIN
• A sense of something missing
• A sense of only being half a person
• A traumatic loss

3. THE SECONDARY TRAUMA:
EMERGENCY CAESARIAN DELIVERY
• Emergency
• Dead twin blocking the cervix
• Abruption of dead twin’s placenta (or shared placenta)
• Surviving twin in breech presentation, dead twin already
delivered/miscarried/aborted
• Twin-twin-transfusion: delivered early to save life of one or
both twins
• After death of one twin, fetal distress in surviving twin
• Maybe premature – normally 34 weeks, but can be earlier if
emergency arises
• Pre-eclampsia linked to death of one twin
• Toxaemia linked to death of one twin

4. THE SECONDARY TRAUMA:
ELECTIVE CAESARIAN DELIVERY
• Elective
•
•
•
•
•
Prematurity
Risk of injury to babies on removal from womb
Infection and complications for mother
Uterus may be scarred, complicating further pregnancies
No difference in risks from vaginal birth (2013 research)
(Only if first twin is in cephalic presentation)

5. TERTIARY TRAUMA:
TRAUMATISED FAMILY
• Toxemia and pre-eclampsia after-effects – sick
mother
• Shock/post-traumatic stress in mother
• Increased post-natal depression (six times)
• Medical care needed: Sole survivor very small
and/or vulnerable
• Survivor reminds parents of loss (one dead, one
alive)
• Over-anxiety in parents
• Over-protectiveness in extended family
• Jealous/neglected siblings

6. OH NO! NOT AGAIN!
• The loss of twin is repeated in some similar form
•
•
•
•
Loss of sibling of same sex as twin
Loss of parents same sex as twin
Loss of sexual/marital partner same sex as the twin
Loss of friend same sex as twin
• The caesarian delivery repeated in emergency situations
•
•
•
•
Near-death situation
“Get out to save your life!”
“There is someone still in there! I must not go!”
Survivor guilt

7. SIX RS
WORKING WITH WOMB TWIN SURVIVORS

8. THE PSYCHOLOGICAL PROFILE
OF A WOMB TWIN SURVIVOR
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
All my life I have felt as if something is missing
I fear rejection
I know I am not realizing my true potential.
I feel different from other people
I have been searching for something all my life but I don’t
know what it is.
Deep down, I feel alone, even when I am among friends
I fear abandonment.
I have a problem with anger, there is too much or too little.
I always feel in some way unsatisfied, but I don't know why
There are two very different sides to my character

9. THE LOST TWIN
IN THE THERAPY ROOM
• Recognition
• Reality
• Response
• Ritual
• Retreat
• Revival

10. 1. RECOGNITION:
WHO KNOWS ABOUT THE TWIN?
• Known but not
discussed
• Known but not
connected
• Not known but
guessed
• Unknown

11. 2. REALITY:
A REAL LITTLE PERSON

12. 3. RESPONSE:
THE “DREAM OF THE WOMB”
Womb twin survivors spend their lives reenacting the life and death of their womb twin.
Nothing appears to be more important than
that, even life itself.
Once the real pre-birth scene is made clear
then the re-enactment tends to diminish or
cease altogether greatly to the benefit of the
individual.

13. 4. RITUAL:
A CHANCE TO SAY GOODBYE
•
Ideas
•
Support
•
Presence

14. 5. RETREAT
AND RESISTANCE
• resistance to
healing
• dependency
• clinging
• missed sessions
• non-appearance
• abrupt end

15. 6. REVIVAL
• Existential issues
• Survivor guilt
• Dialogue with the
twin
• Forgiveness
• New purpose

16. RESPONSIBILITY:
THERAPISTS BEWARE!
• Be clear on the biology of
twinning
• Notice the twin in the dialogue
• Beware of the twinning
transference
• Be clear about boundaries
• Beware of dependency
counter-transference

17. WOMB TWIN
The voice of womb twin survivors
www.wombtwin.com