Mourning the Loss of a Twin

An Online Film Screening and Panel Discussion


Ricardo Ainslie, PhD * Mary Burke, LCSW * Joan E. Friedman, LCSW, PhD

Saturday, August 28, 2021

10:00 am - 1:15 pm Central time

Live Zoom Presentation

Register for Zoom invitation (will be emailed the day of the event)

If your twin died, would you still be a twin? This question pertains to lone twins, also known as surviving twins and twinless twins. Twins have a close bond beginning in utero, which impacts identity formation and psychological development, in turn affecting bereavement responses to the loss of their twin. Joan Woodward (1998, 2010), an attachment therapist in the UK who lost her twin at age 3 years, interviewed more than 200 twinless twins. She concluded that the loss of a twin at any age can be devastating to the survivor and may engender survivor’s guilt over the loss of the “other half.” Twin researcher Nancy Segal (2000) of the U.S., herself a twin, suggested that the loss is more severe than any other loss for twins, and especially intense for identical twins. Filmmaker Anna van der Wee of Belgium revisited these issues decades after losing her twin brother at age 20 years. Her quest for self-understanding led her to interview twins, twin experts, and significant others on several continents. She wove together their reflections along with her own insights in a sensitive documentary film, Lone Twin (2011).

Surprisingly, few psychoanalytic journal articles address twin loss. George Engel (1975) described his mourning, dreams, and anniversary reactions as part of a self-analysis in the 10 years after his identical twin’s death at age 49 years. Althea Hayton (2009) found that “wombtwin survivors” whose co-twin died before birth share many characteristics with twins born together, including preoccupation, paradox, desire for the physical presence of the lost twin, and lack of a sense of identity. Clinicians are likely to see more twin bereavement issues in their practices, given the increased incidence of twin conceptions since the advent of assisted reproduction. Hence, the purpose of this conference is to further examine twin mourning through a psychoanalytic lens. After viewing the film Lone Twin, we will have presentations from 3 discussants. Ricardo Ainslie will focus on the special bond between twins, Mary Burke will explore archetypal dimensions in twinship and twin loss, and Joan Friedman will present her clinical work with a lone twin.

Learning objectives:

After attending the conference in its entirety, participants will be able to:

  1. Identify three psychological characteristics of twin relationships that differ from other sibling relationships

  2. Describe how the twin bond might impact bereavement responses to the loss of a twin

  3. Describe some archetypal dimensions of twinship and twin loss

  4. Describe three issues that might arise in clinical work with a lone twin


Ricardo Ainslie, PhD, ABPP is a psychologist/psychoanalyst who is a professor in the counseling psychology program at the University of Texas at Austin and also has a private practice in Austin. He is an ethnographic researcher, documentary filmmaker, and author. His publications include the book The Psychology of Twinship (1997). Dr. Ainslie has presented nationally about twins and multiples. His interest in this topic originated with having a mother who is a twin.

Mary Burke, LCSW is a psychotherapist and Jungian analyst who has a private practice in Austin, Texas. She completed her analytic training through the Inter-Regional Society of Jungian Analysts. She is currently a senior training analyst and teacher in the Texas Seminar. She has presented lectures and workshops on the topic of greed, hunger, and individuation. On a personal note, she is a twin who lost her twin at age 19 years.

Joan A. Friedman, LCSW, PhD is a psychotherapist with a private practice in Santa Monica, California, specializing in twins and their families. She received psychoanalytic training at the Institute of Contemporary Psychoanalysis in Los Angeles. She completed 2 doctoral dissertations: “The Mothering of Twins” and “Raising Emotionally Healthy Twins.” She also authored 3 books: Emotionally Healthy Twins (2008), The Same but Different (2014), and Twins in Session: Case Histories in Treating Twinship Issues (2018). Dr. Friedman has presented internationally on these topics. She herself is an identical twin who has 5 children, including a set of fraternal twins.

Program Chair JoAnn Ponder, PhD is a psychologist-psychoanalyst on faculty at CFPS and in private practice in Austin. Her mother is a twin, a lone twin since she was 83 years old.


Engel, G.L. (1975). The death of a twin: Mourning and anniversary reactions. Fragments of 10 years of self-analysis. International Journal of Psycho-Analysis, 56: 23-40.

Hayton, A. (2009). Attachment issues associated with the loss of a co-twin before birth. Attachment: New Directions in Psychotherapy and Relational Psychoanalysis, 3: 144-156.

Additional References/Resources (partial list)

Ainslie, R. (1997). The psychology of twinship. Northvale: Jason Aronson.

Burlingham, D. T. (1949). The relationship of twins to each other. Psychoanalytic Study of the Child, 3: 57-72.

Burlingham, D. T. (1963). A study of identical twins—their analytic material compared with existing observation data of their early childhood. Psychoanalytic Study of the Child, 18: 367-423.

Friedman, J. A. (2008). Emotionally healthy twins. Philadelphia: Perseus Books.

Friedman, J. A. (2014). The same but different. Los Angeles: Rocky Pines.

Friedman, J. A. (2018). Twins in session: Case histories in treating twinship issues. Los Angeles: Rocky Pines.

Piontelli, A., Piontelli, A., Bocconi, L., Kusterman, A., Butt, K., Osborne, J., & O'Brien, G. (1997). Patterns of evoked behaviour in twin pregnancies during the first 22 weeks of gestation. Early Human Development, 50: 39-45.

Segal, N. L. (2000). Entwined lives: Twins and what they tell us about human behavior. New York: Plume.

Segal, N, L. & Ream, S. L. (1998). Decrease in grief intensity for deceased twin and non-twin relatives: An evolutionary perspective. Personality and Individual Differences, 25: 317-325.

Woodward, J. (1998, 2nd edition in 2010). Lone twin: Understanding twin bereavement and loss. London: Free Association.

Lone Twin (D: Anna van der Wee, 2011). Brussels, Belgium: Wild Heart Productions.

Pay Online (3 CE/CME CREDITS)

$50 CFPS Faculty, HPS Member and Alumni Group Members * $25 CFPS Candidates, Trainees, Alumni Student Member * $60 Non-members

Continuing Education Accreditation

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of American Psychoanalytic Association and Center for Psychoanalytic Studies. The American Psychoanalytic Association is accredited by the ACCME to provide continuing medical education for physicians.”

The American Psychoanalytic Association designates this Live Activity for a maximum of [number of credits] AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

The Center for Psychoanalytic Studies (sponsor number CS1391) is approved by the Texas State Board of Examiners of Social Worker Examiners to offer continuing education units to the social workers.

The Center for Psychoanalytic Studies (CE Provider Number 379) is approved by the Texas State Board of Examiners of Professional Counselors to offer continuing education credit to licensed professional counselors.

The Center for Psychoanalytic Studies (Continuing Education Provider Number 340) is approved by the Texas Board of Examiners of Marriage and Family Therapists to provide continuing education activities for marriage and family therapists.

The Center for Psychoanalytic Studies maintains responsibility for the program.

IMPORTANT DISCLOSURE INFORMATION FOR ALL LEARNERS: None of the planners and presenters for this educational activity have relevant financial relationship(s)* to disclose with ineligible companies* whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

*Financial relationships are relevant if the educational content an individual can control is related to the business lines or products of the ineligible company.

Updated July 2021