Separation Anxiety for Twins
Separation anxiety is defined as a psychological condition where a person experiences excessive anxiety due to a separation from home or caregivers. In particular, it is a mental health disorder that is characterized by worry, which is out of proportion to the situation of temporarily leaving home or otherwise separating from caregivers.
Separation anxiety is sometimes referred to by its more historical name, school phobia, since it typically occurs in children during the school years. With twins and multiples, the definition of separation anxiety may be extended to include separation from the other twin or other multiples.
Separation anxiety is normal and common in infants and toddlers. For example, when an infant or toddler cries because a parent leaves the room or a stranger enters the room, the crying is a normal expression of separation anxiety. This type of separation anxiety represents a developmental milestone not necessarily a disorder since the child has begun to recognize that something or someone is different than that to which he or she is accustomed. The child has simply achieved a level of cognitive development that enables the child to differentiate persons who are familiar from those who are strangers. However, this normal type of anxiety should subside by the age of about three years.
Separation anxiety is considered to be problematic when a child over the age of three cannot function academically or socially due to the anxiety. When separation causes such anxiety that a child is not able to go to school or any other place without a parent, caregiver, twin or other multiple, the anxiety is then considered a disorder. The early onset is thought to be 6 years of age and it may present itself until 18 years of age. Typically, when this type of anxiety exits beyond 18 years of age, another diagnosis may be warranted.
Twins are at risk for separation anxiety because their individuality and uniqueness as individuals is often times challenged. In some instances, one or both twins will develop a dependency on the other twin as opposed to the parent or caregiver. This dynamic is thought to be an attachment to the parent or caregiver via proxy, with the proxy being the other twin. One expert suggests that the fear of separation is more concentrated on an insecure attachment to the parent rather than an over dependent attachment to the other twin. Sometimes the reasons for separation anxiety in twins are irrational, but most cases are due to twins that are not able to easily comprehend the concept of individuality.
Parents and caregivers need to start in the very early years communicating individuality for twins. Despite the fact that twins form a unique unit, each twin has his or her own individual talents and personality, but they need assistance in enhancing those individual talents and in understanding that it is acceptable to have and display differences.
Young children are not able to verbally express their anxiety. Instead, they will act out their anxiety. As such, parents and caregivers need to be aware of the symptoms of Separation Anxiety Disorder and they need to be able to distinguish a potential disorder from a life event that may be cause for temporary anxiety. For example, a child may refuse to go to school for fear of a bully, not because of the fear of separation. According to the Diagnostic and Statistical Manual IV, the symptoms of separation anxiety disorder include the following when the symptoms persist for more than four consecutive weeks:
1. Recurrent distress and worry when separation from home and parents is expected.
2. Persistent worry that something terrible will happen to parents when there is a separation.
3. Refusal to go to school for fear of being away from home and parents.
4. Refusal to go to bed out of fear of loss of or separation from parents.
5. Following parents around from one room to the next for fear of separation and being alone.
6. Constant complaints about headaches, stomach aches, nausea, vomiting, etc. when separation is expected.