The Survivour Twin
I talked with Brazilian psychologist and family and marriage therapist Liana Kupferman about the sensitive topic of the Survivour Twin.
In her work, Liana supports twin families with many issues. One of these is dealing with the loss of a twin. She talked about the challenges this poses to the parents and the twin, and how we can meet the unique needs of twins and their families.
Transcript:
Smadar Zmirin: Okay, so Hello, everybody. And today I'm welcoming Liana Kupferman, who is a psychologist from Brazil and a marriage and family therapist in the United States based in Miami. And she's here today because she specialises in twins, which is what we are all about here. So Hello, Leanna.
Liana Kupferman: Hi! And thank you too.
Smadar Zmirin: So lovely to have you here and I wanted to reach out to you because I attended your workshop that you did with Dr. John Friedman a few weeks ago, and it was lovely to learn all about your work and studies, and I thought it would be nice to dive a bit deeper. So if you can just take a moment to share with me and anybody watching, how did your work end up specialising in twins? Anything that drew your attention. And yeah, how your journey ended up being specialises in twins
Liana Kupferman: Sure. So my journey with Prince began right after I graduated over 20 years ago, and I was invited to work in a portal called multiples.comd.br in Brazil. So it was a portal dedicated to families with twins. So I basically used to answer questions, promote workshops and do events for families. And then I got so interested in this topic, and then I decided to do family and marriage therapy specialization in Brazil. So then my study was about twins relationship throughout their life cycle.
And then I got more interested, and I was fascinated. And I was also working already with families in my private practice.
So I and, automatically, my colleagues, you know, everyone who knew at the time that I was specializing in twins. They were okay. Well, I have a twin, so I'm going to refer to you. So it was little by little, you know, and in my private practice, growing this niche and also connecting with my studies, you know.
And then I came here United States, and I did, master of marriage and family therapy. And here it's even I feel that it's even more this path of specialization, you know. So everyone that I know here ask me, what do you specialise? And I say, twins? Oh, why, twins in the beginning they don't understand very well, as Dr said in the workshop is exactly like this, and then explain a little bit. And then, oh, nice, interesting! And then here I also receive a lot of twins.
And it's and I feel that it's a really interesting topic as well to, to explain to people to make awareness about the importance of specialising and being having knowledge about this specialization. You know this niche that is different in some ways of seeing in private practice a singletone. No.
So I'm really passionate about this topic, and also in Brazil I participate in panel panel twins of University of Sao Paulo.
So they conduct a lot of studies, events, and you know, initiatives for these families as well.
Smadar Zmirin: Wonderful. Wow! That sounds. I mean, it's fascinating to me because I mean, it's been my life for so long, and it's always nice to to feel that there are other kind of spirits out there, but because you are also working with Singletons, as you said, and I also saw in your bio on your page, that you have twins and other specialties. What stands out for you when you walk with twins, or I suppose it started, and then it gravitated towards that. So I know your age group is quite vast. It's not just elderlies or teenagers, or kids or children. So yeah, can you tell me a bit about what stands out to you when you walk with twins versus singletons.
Liana Kupferman: Sure. Yes. So basically, what I see with twins is what for me, it's fascinating is that everything's about relationship, about human being. It's it's intense with twins. It's more intense.
So it's, for example, is subtle sometimes about competition between siblings. Or you know, a feeling that you have to take care of your sister or brother, or siblings, but in twinship this is like highlight in a way that in the way that they suffer, you know, because it's intense.
So it's not so. It's not. They are different, you know, like they are human beings, anyone, but because of the intensity they ended up suffering a little bit, you know. And so it's, for example, one of the things that for me when I started working with twins, something that I got my attention. It's about feeling this sense of loyalty right? So because of my, for example, in my my mind, I had the assumption that they would, would compete to each other. They would feel this necessity of being better, you know, and, and feeling, you know that I want to compete. I want to have more grades. I want to have more friends, but actually what I saw working with them, it was the opposite. They they suffer so much in this ambivalence, and something that Dr. Freeman said in the webinar, that it's if it one word to describe twins is the ambivalence they all the time they are suffering inside like I want. I want to do this, but I I want to protect my twin. I don't want him to, or her to to suffer, you know, but and but I want this for my life. So it's all the time this ambivalence feelings. It's it's really it's really hard, you know, and also on top of that, the journey of individualization. It's hard. It's throughout all their lives they have to go through that, you know. It's not like okay. Now, teenager. Now I'm not. I've done. I know who I am. No, it's, it's all the time and goes, and you know, and back. And so it's really fascinating, you know, because it's a lot of challenges
Smadar Zmirin: Yeah, it is. And I mean, my focus is always on early childhood education. And that's 1 of the things I always try to highlight to the families because it starts so early. And there's so much we can do right in the beginning that can mediate that ambivalence. So they know exactly where they end, and their twin begins, so that twinship doesn't swallow them whole, and that ambivalence is somewhat, I would say, easier to, to navigate, because they won't feel so torn inside when they succeed, or when they fail in relation to their twin, because that's something I talked about with Dr. Friedman. It's so hard to measure yourself up to someone else all the time, because if you succeed, you feel like it's on someone else's expense, and if you failed, it's only because, relatively, someone else succeeded. And it's very different, as I said, from regular sibling relationship. And yeah, those ties, as you noted, can be quite like the G force. There can be really, really hard, I think, to pull you in.
And, and yeah, I can see that you're working with twins in different ages, so it can become quite pathological, I imagine, especially if it's not addressed early on, or there's no awareness that there is something that needs attention. I suppose.
Liana Kupferman: Yeah.
Smadar Zmirin: Yep.
Liana Kupferman: Yeah, so, and I see a lot in my private practice, you know, they bring it to me. So they want, for example, simple things, you know. They want to, to do some something different that they used to do. For example, after school, something that varies like it's, it's simple, right? So oh, I want to try something different. But they are doing together. So they feel that if they choose something different, they are betraying their twin, you know. So each step, and also the I think that the most polemic subject when I work with families I don't know if you experience the same, but it's about class pace and where to put their twins separate or together.
Oh, this is a big challenge for parents, especially because they always struggling to decide to school, of course, and and most usually for the twins themselves, because they want in certain point they want to be together, but at certain point. They want to be separate, but it's not together that they feel the same right. It's usually one who wants before once more independence wants to their own friends and the other one. It's, it's not there yet. It's not in this stage yet. So it's always a challenging to decide, what are you gonna do. We're, gonna you know, we're gonna okay, stay them together. But one is suffering and one is not achieving their high potential. Or we're gonna split them. And then this one that it's feel more dependent.
It's gonna suffer. So it's suffering. Anyway, this is the thing. It's it's really hard
Smadar Zmirin: Yeah, unless they're both ready. It's gonna be a tough learning curve for some for some of those twins. And again, that's something I, I visit a little bit the subject with the families here in New Zealand, because some schools actually have strict policies regarding twins. It's not really up to families, not all of the schools, but it's something to consider. So some of them don't think about it early on, because I work with mainly babies and, and toddlers, and
Liana Kupferman: Okay.
Smadar Zmirin: It can be a bit premature for some of them to even think about it, and I bring the notion of independence and individualization right from the beginning, for so many reasons. But I feel like if we are setting up the groundwork in the beginning, whichever school they're going to go to, they will feel ready, and it can be good to maybe start together and then branch out after year, one or year 2. But if the school is not even going to allow that which is its own thing which I feel like is not quite considered for the families. The best thing the parents can do is nurture their independence. So when reality forces you to separate, it's not such a shock to the system
Liana Kupferman: Yes, absolutely, this is interesting, because this is another subject that we are now with panel things we are working about. We're going to have a meeting, and also, you know, a discussion about that. So we are collecting some opinions from different perspectives, so from teachers, from, from principals, from parents, and also from trains themselves, and so far we collected some, some opinions from their twins, from all their own twins, and they said, 2 of them, 2 pair of twins. One said that
“Yeah, we you were together at the same class all the our lives, but I don't think that was the good thing, because then, when we needed to separate, we suffered so much that we weren't prepared. I think that we, if you would be in different classes, we would have more this idea of who we are”.
And then the other twin said, “You know I was all my life with my twin, and I think that it was beautiful. I really love it, and I think that all the twins should be separated”, you know so…
And it's so complicated because we don't have one answer, no, it's so individual, so different for each family. And also we have different kinds of twins. Right? We have monozygotic and also different sex, right female. And so so it's different, each one also. So yeah, it's, it's vary. I think that each case it's we have to look differently. But it's interesting about the culture. Each culture, it's they approach so differently. For example, I see the difference in Brazil.
They they like to be connected, you know.
Smadar Zmirin: Part of the Individualistic culture, yeah.
Liana Kupferman: Yes, this relationship they value so much community. You know, family. They're always together, you know, for example, kids. They don't leave a house home to go to college. It's not their custom, and here in the United States the opposite is because they leave home to go to the college. They look to independence since they are born, you know
Yeah. So I see these differences, too, because I worked in both countries
Smadar Zmirin: Oh, that's interesting. I didn't really reflect on that just yet. I mean, I'm coming from somewhat mixed collectivist and individualist culture. But in New Zealand. Here there is a huge mixture, because New Zealand is multi diverse, and you have especially working in early childhood education. That's a huge emphasis that they are pointing out for teachers to understand the culture of the children. And yeah, I agree, it plays a huge part in how they are being brought up, and also where they are being brought up, because, as you say, you're yourself from Brazil. But now you're living in the States, and you can, I guess, benefit and appreciate.
I guess both worlds I mean whatever you can exercise now in Miami. But you can see the value in both, and maybe choose a little bit how you raise your own children wherever you grow up. Sorry wherever you bring them up versus where you come from.
But yeah, when it comes to school, and also just for twinning, I feel like it's great if the twins want to be super close. And as long as it's a choice. And that's something I always highlight to the families, it's wonderful if they love being the same, and if they want to spend their time together, and if they really, really appreciate each other's company as long as they know they can step back and do their own thing when they want to. So it's not forced. It's not an expectation. It's not because they are codependent, and they can't do anything else. If it's a choice. I feel like it has so much to offer them individually and as twins. But yeah, I guess you use the word suffering. I guess all those struggles, the inner conflicts usually stem when maybe they feel it's not really a choice. They don't know better, or they feel like, I want something else, and there is no room for that. How do we even talk about it?
Liana Kupferman: Yeah, yeah, absolutely. Yes. And it's why I believe in therapy. I think therapy. It's a wonderful place that they can speak out what they are feeling without feeling guilt, you know, because for most of people they think that it's lovely, you know. Oh, it's so beautiful! Twins! Oh, my gosh! You know, they get along so beautifully, and one takes to another, they take care of another. It's beautiful. And actually, it's why I like to emphasise. They suffer, it can be beautiful. It's really it's really good. They like to be a twin, you know, and they have each other to self-regulate, to have a their figure attachment. You know they have a company. A best friend forever is the big one of the longest relationship that you have in your life right? Being a twin.
It's there are a lot of positive sides, I agree. But this other side the society, the population, the people. They don't talk about that, you know.
Smadar Zmirin: No, no. of course. twins does not really reflect the struggles that may come with it. Emphasis on May. It's not always there, but it's good to give them voice and give them a space where they can actually address it? Is it an issue? Is there something that you would like to maybe. Explore. Together. Alone. Yeah.
Liana Kupferman: Yes, they, they can process these thoughts, these emotions, and make, make a safe space that they can process that, and then they can reframe. You know what they are experiencing. They can have choices as you said. And they can. They can make their own story. They don't, don't need to be like, you know, the victim of their lives right
Smadar Zmirin: Yeah. Yeah.
I wanted to ask you about a topic that that you brought in the workshop a few weeks ago, and I found fascinating, and I knew a little bit about, but hardly enough. And it's 1 of the reasons I reached out to you today. It's the topic of the survivour twin.
I wondered if you can share with me and the families watching what it is in a nutshell. I would like today to focus more on the on the pregnancy and birth incidents.
And yeah, what research says about it? Where is the research form? What does the data come across as what did you? What did you find in your work?
Liana Kupferman: Yeah. So, to be honest, I didn't have too many cases. That was a survivour train. But my 1st case that I actually I had just a few cases, but my 1st case that I had it was just after I graduated, and I started working with trains, and was such a coincidence. I don't believe in coincidence, but I'm gonna tell you, and for people outside it seems a coincidence that I was a patient. I had a patient was forties in middle forties and struggling a lot with OCD. You know, and always saying that she it was something that in this case seemed different from OCD. You know, because she used to say, “I feel that I'm missing something, and so I all the time I'm feeling that: Oh, I lost my key. I lost my glasses, you know, and I go every time to check if I closed my door, locked my door”, and there's something beyond of the OCD. You know, regular OCD. That I was so fascinating, and other examples that she used to tell me she used to feel lonely and feeling depressed and the things that was… it's something beyond. And then I was studying a lot about twins at the time, because of my study of twin relationships across the lifespan. And then the subject of a survivour twin came across me and I got interested because I got fascinated. How, like, especially about vanish twin.
And I said, “How can be like someone who didn't know that someone that it was a twin could develop this kind of symptoms?”, you know, and…
Smadar Zmirin: So when you say vanished twin, you mean in a pregnancy when only one twin actually makes it through full term?
Liana Kupferman: Yes, and usually during the 1st trimester of the pregnancy, right? So the body observed the fetus, or just a light bleeding, and at the time in the past. Most of the mums didn't know that they lost their twins, you know. But now, with technology, they can have more research to find out. And so then, so there's a lot of studies saying that this population that was a vanished swing, and that have developed some symptoms that go together, you know. And then they also had an organization dedicated for this population, not only for vanished twin, but also for survivour, twin all ages.
So, I got fascinated. And then, when I was studying about that, I started realising, you know, connecting the dots, you know. Oh, my patient maybe could be a survivour twin, because all the topics I was, you know, checking the box, you know. And then I was talking with her, and I mentioned “Were you, for instance, twins, or you know, do you know, if it was a twin when you were born?” And she said, “No, not that I know”, right. And then she asked her mum because she got to interrogate it, and then guess what? the mum never told her, because she said, “why, I wouldn't say what I would say to you something like that for what you know”. They don't realise that it's something important.
And then it was a such difference in the therapy, you know, made all of sense of her symptom. And I showed to her the website, the organisation, the books and everything. And it was such a relief that when she found out about that and I actually, she moved she at the time we didn't have online therapy. So I wasn't able to see how it ended. But the thing is, at the time that she left therapy she was feeling much better, just because she couldn't make sense of her symptoms, and why she felt that way missing someone missing someone.
And it was really beautiful, this working with this this patient and then. Now I have also just got one twin, and it's 13 years old, patient and the family also. She she's a survivour twin from vanish twin.
And all her life she's saying that she's missing someone she misses someone like I feel that someone is missing, and she needs to be with someone every time, and she developed a lot of anxiety. And she needs to take care of everyone, her friends, you know. And it's very interesting. I just received this patient a few weeks ago. So it's the very beginning. And also I think, that we can't also putting the label in the box or narrow down only one aspect of their lives, you know, all because of survivability. It's that, you know. I think, that we have to look on the context. Also because I'm family therapist with a systemic view, I like to see all the components who plays a part right who play a part like, for example, how all, all of context makes sense of their behaviour?
So in that case, and specifically this case, she went through a lot of changes. She moved 5 times. You know she's from one country. Then she went to another country also something that I don't think that was only cause and effect, but also but I believe that potentialised something that was already there, you know. And how she should deal with that, how the family deal with that. So you know, it's a comp a sum of relationships, right? It's not only one cause and effect. It's how I believe.
Smadar Zmirin: Yeah. And I mean, I totally corroborate that I feel like nothing is ever exist in isolation. And just like with twins, you can see some things might manifest more than others, especially in identical twins, and like, if you look at mental illnesses, you know some triggers may manifest in one, and not in the other, and of course they have so many other aspects to their lives. But what really fascinated me with this notion is, 1st of all, and that's what I might want you to elaborate on if you can.
There is a survivour twin, and I don't know if the definition will be a born twin that died later, or a stillbirth? Or does it matter which time in the gestational stage this happened because vanished twin, you say, is in the beginning, because it actually it's absorbed or extracted by the body versus a twin that stays in the womb for the whole pregnancy, for that matter. And so I wondered if you know about the differences in manifestations or in degrees of symptoms. And what does it look like if you know, or if you can share with us, especially for the early ages, for the children
Liana Kupferman: Yeah. So the concept is, no matter when they lose their Co twin, it's a survivour. Twin, right? So it's a vanished twin. It's a survivour. Twin. It's early. It's a survivour. Twin, right? Okay? But the thing is what they like to conceptualise is the difference of challenges, right? So really is different. Who didn't know that there were a twin, and someone who had passed this experience of was were born together with twins, had a baby, had picture, you know, and everything they knew, and then a child when they lose their co-twin and then adolescent. So in different stage is totally different. How they gonna experience they lost.
So, and also, I believe how the family deals with the this loss and the story that they tell to them. Right? So, for example, if they hide something that can affect them if they don't hide, but they tell in a way that they can feel guilty, because they usually this guilty feeling is very, you know, strong with them. It's “Why it wasn't with me?”. “Why it was my co-twin?”, so they carry with their lives, for you know all their lives with this sense of guilty it's so… For example, I've heard once from this, wasn't my patient, but someone that I knew, told me that she was a twin survivour, and she said that her mum once said to her “I wish it was you were not your sister”, you know.
Smadar Zmirin: Oh, wow!
Liana Kupferman: I lost my… It was…
Smadar Zmirin: That's harsh.
Liana Kupferman: Yeah, and another one that I also know it was someone who told me, and that actually the parents didn't, of course, didn't tell to him, but it's as the fantasy that he thought that “Oh, I wish my! My! If my brother would survive, it would make my family happier because I'm not a good kid”, you know. So there are a lot of fantasies around this. So it's usually how they deal with that. How the family deal with that. And it's how, for example, one case that I heard also it was one twin had died, and then the second one felt so guilty. Why would it was about a cancer or something, really a wellness, and that felt so bad and ended up also taking his life, and also…
Smadar Zmirin: Okay…
Liana Kupferman: Unfortunately, I'm sorry saying these stories, but it's really hard.
Smadar Zmirin: Yeah.
Liana Kupferman: It's why they, they have these organizations that they that I think that it's beautiful. They have a lot of support, you know, for between survivours because they need. They need to get in touch with other survivours, to, you know, to have support from professionals, you know, and also it's this is my heart. My passion is to spread the word, to make awareness for professionals. How serious, how deep is that for them, you know, it's not like. And they said, “It's Oh, it's if you could compare losing someone would be okay”. Children losing a children, losing a husband or a wife, but even it's not the same…
Smadar Zmirin: Category. Yeah.
Liana Kupferman: They never learned how to live without their co-twin. No, if you, for example, you have some husband, and you lose your husband, you know that you, you yourself, without him. You know at the time that you’re right. But the twins know so they don't. They don't know themselves alone. They don't know who they are, so they have to build everything from the scratch like “Who I am?”, you know. Really.
Smadar Zmirin: Identity.
Liana Kupferman: Yes.
Smadar Zmirin: Yeah.
Liana Kupferman: So it's yes, it's really a big topic to talk about. Unfortunately, I don't have so many cases that I can talk here to be honest, but it's something that I fascinated. And also this panel twin that I mentioned this morning I had a meeting with someone who does the clinic with the study. They have a lot of patients. They work in partnership with a hospital, so they have many cases that maybe what you can do interview with them, yeah, no, it's a very big topic, and of course it it. As you say, it really depends at which part in their lives the loss has occurred.
Smadar Zmirin: And well, my scope ends around 5 years old. I don't really work with twins older than that. I know twins who are older, and of course I talk with them a lot, because it's always fascinating to hear their life stories. I guess what I wanted to ask you about this, and I know it's not just about your personal experience treating patients, but because you have studied and you researched the topic. I was wondering. Well, I guess 2 main things. One is about more of the not the vanished twin, but necessarily about the twins who are born and do are not disclosed that they had a twin. They are born a Singleton, or unfortunately lost their twin shortly after birth, because, unfortunately, in multiple birth the rates do increase. So I wonder if you know about any of the symptoms that those children may exhibit, and something that maybe the parents can pay attention to and the other part. And obviously you take your time on approaching this is, do you find that the parents feel guilty? Do they share that with you? A lot of them may feel guilty that they didn't carry 2 twins to term, or they were supposed to have 2, and now they have one, and what to do with that, which is a huge decision to make whether I share this with my child or not. Yeah.
Liana Kupferman: Yes, absolutely yes. In this morning, as I said when I had this presentation, and she exactly said about that, how she noticed the guilt the feeling of guilt from the parents, you know. So she described a mum, saying that she felt so guilty that she lost one of them.
You know. So she was really struggling in asking herself, What did? What did I do wrong, you know, because I lost one and also one of another, Mum was How do I say? putting all the all the fault in the hospital? They did something wrong, you know.
Smadar Zmirin: Yeah.
Liana Kupferman: So, because it's so hard to think about why it happened, you know. Sometimes it was to happen, but it's really hard to accept the reality. So they have to put the blame in someone. And it's hard to put themselves because they are not actually their fault. But it's gonna put in someone else, you know. So the hospital was really like she was furious with the hospital, but she had another twin in a unit. How do you say you need that. They have to recover when they are very little. Nico. Yes, I'm sorry about my English
Smadar Zmirin: Okay.
Liana Kupferman: Yeah. So this is this is something that they carry, and also another story that she said, one that had a twin survivour in the hospital for a month. So the hospital did something beautiful for this baby to complete one month, and did like a little celebration. A little party for this little boy. And then the mum felt so sad at the same time, you know, and ambivalence feelings that how I can celebrate when I have someone that I lost, you know, and if I'm going to celebrate too much this one, it means that I forgot about the other one. So it was a chalk, because the hospital thought, Oh, it's the mum is going to be amazed that we're going to do this party. But she started crying and feeling really sad. And of course they had the psychologist there to understand, and, you know, to make sense of her behaviour and explain to the to the team there. But it's something that's interesting, right? It's not the same as a Singleton goes. You know, it's…
Smadar Zmirin: No, it's very complex, because it is a mixture of, you know, of beauty and life and celebration, and the same time a constant reminder that someone is missing and the twin is feeling it, but also the parents who knew there was another one. And yeah, it's kind of celebrating life and acknowledging a loss. And yeah, it's not black and white. I feel like it's obviously a mixture of everything, and especially so shortly postpartum. When the hormones are all over the place, and especially in a twin pregnancy, more hormones. You can only imagine how hard it is to accommodate all of those feelings all at once.
Liana Kupferman: Exactly. This is a big point. It's about postpartum depression. They have more incident than Singletons. Right? So it's really. And also when I started working with things, and they used to say that actually, they don't have time to be depressed, you know.
So when they are born, they're in Nicu. They? They don't have time to think about it, but when they go to home they go, you know, then start realizing and then start the postpartum depression. And also this thing of being in Nicu. It's something that also plays a role in their relationship with the twins. So again, they, this psychologist today was saying about this experience in the hospital and saying that actually, we have the triangle, a mum, parents right? And the baby's called twin. And actually, when they are usually they are in Nicu, they spend month there. So actually, it's not about that. It's about also the hospital.
Smadar Zmirin: And
Liana Kupferman: Goes in this. Yeah, so
Smadar Zmirin: Yeah.
Liana Kupferman: In these relationships. So they sometimes feel from outside of this group. And it's a barrier to them to make a relationship to bond with their twins because they feel insecure. They feel that the hospital takes care better than themselves. And they, you know. So it's very complex.
Smadar Zmirin: Yeah, a lot of twin families share with me that they are obviously didn't want to end up at Nico, but they are kind of grateful. They are there because they don't feel ready going home, or they're still processing a birth trauma, or for the babies or the mother. And yeah might feel inadequate taking care of such little infants that might have some respiratory issues, or have any kind of difficulties versus Singleton that is born full term. And yeah, it's a shock going home and then actually doing it on your own definitely. And, as you say, the hospital plays a huge relationship there. So a huge part in the relationship. And I find that when you have a good team, they really empower the parents to, you know, step in, and they know what you're doing. And you're the best caregivers for these babies, and you know best, and they want you, and they need you. And we're just here to facilitate. But you are the parent, and you are the primary caregiver and really champion their role to boost their confidence before they are going home. Yeah.
Liana Kupferman: Yeah, yeah, exactly. I agree.
Smadar Zmirin: Oh, good. So, Liana, before we go. Sorry before we're gonna finish. I guess the main 2 questions I wanted to ask you is first of all, how can we maybe bring this topic up with families sensitively? I find that nobody wants to talk about it. And the families that come my way, especially in the antenatal classes that I do here in New Zealand. Obviously do not want to talk about any of this, because we are here to talk about postpartum and birth and newborn sleep, and raising your healthy babies. How do you feel that we can bring this topic up let's say sensitively, without increasing levels of anxiety for the families who probably don't wanna even think about any of that right now?
Liana Kupferman: That's a great question. And you know, I think, that the best thing is to like taking from the place of honesty, and very like being transparent and with compassion. And what I like to say for professionals that work with twins works with twins. It's being very compassionate, very, because you know this feeling of guilty. It's so strong. I am, Mum, not with twins. So just being a mum, I always feel guilty for anything.
So, I can't imagine how it is for them and working with them. I know that they suffer a lot about this topic. So, it's really like bringing this concept of forgiving yourself, you know, like, it's okay to be flexible. It's okay. That's not going to be always perfect. You don't have to achieve these expectations. I think that bringing this awareness of expectations, and all because one thing that I learned from being a mum is that we don't have control of the life right? We don't control anything, but there are some things that I can do to help right? So one thing that I noticed working with twins, I don't know if you noticed this. Well, it's how they get organised. So people that I know that it was really a mess before, and having a twin got them very organised person, you know. And this is very important. So I'm gonna this is gonna bring peace for myself, you know. And but on top of that. This is something that the routine more practical, but going deeper. I believe that the sense of you know being a human being, you know, like being okay with you ourselves being flexible, and how, having the right to seek help, you know, allowing themselves to seek for help, and thinking that they are not gonna be independent, you know. Like enough, you know, they gonna need help.
And also, I think that touching about these struggles. I don't believe that it's going to bring more anxiety, because I think, of course, can bring some, you know, but I think that it's like a vaccine, you know, if you don't do it, it's worse. You know what I mean. It's like and bringing in also depends on how I'm gonna bring right
Smadar Zmirin: Yeah, that's it.
Liana Kupferman: Like it's gonna be the end of the world. It's gonna oh, my God, no, it's like, yeah, it it. This can happen. It's normal. You know, this is normal. And that's just a phase, just a stage of your life. It's gonna pass. It's not gonna be forever.
Smadar Zmirin: It isn’t… Yeah.
Liana Kupferman: Right. So I think that it can help a lot
Smadar Zmirin: Yeah, that's very true. And yeah, I love the main 2 things that really picked my ears was, yeah, the compassion for themselves and forgiveness. And yeah, expectations. That's something that is, it's easier to do in the beginning, before the kids are here. Manage expectations and plan for scenario A, B and C, so if something does happen, it's easier to land on your feet, and you have an idea of what you want. What your partner wants, what your family needs, and how to address that.
Of course, nothing can prepare you. Not really, but visit these topics is better, obviously, as you said, than to just block them out. And I guess, yeah, I guess it's kind of organically coming to the next. The next. And I guess. Last question is, how do you support those families who go through survive a twin or vanish twin, because there is the notion of how to support the children, which is really important. And I guess for me in my mind it's also as important. How do we support those parents to go about it because they need to process their own feelings in order to accommodate their kids. Feelings
Liana Kupferman: Yeah. So I think the same, you know, like it's really offering space for their feelings. I used to say to them, all your feelings are welcome here. No, and I'm not here to judge you.
I'm here to support you. So you know, and that's it. It's to listen to them, to hear, to offering, you know, support. It's still because there is not much to do at this stage, right? Facing a grief. It's really a stage that you have to process this thing. You can't, you know, pretend that it's not happening with you. So it's in suffering. It's part of the their journey. And so, and I think they're also respect, or of their stage of grieving, because sometimes they are not processed, because one case that they have one twin and one other one they lost.
They are some parents. They don't process this information because they have to take care of this training. And it's okay, because it's how they are going to deal with this situation, and when they are prepared, and then they were ready. Then, we are there to support them, you know, and each one have has a different reading. So it's via C, it's like, Be there for them, right? So yeah. And also, I just wanted to add something that you asked before how to support, you know. And I think 1 1 thing important is talking a lot with families, not only with the mums pregnant, but also with family, with husbands, and all the dads like this is, be ready, be prepared. If it's normal to have postpartum depression. It doesn't mean that she will have, but if she has, it's normal, and how he can support her. I think that it's important to the family. Be aware, be, be, have knowledge of what? What is that? You know?
So, and then the family plays. The families play a really big role in the mental health of the mum and the babies.
Smadar Zmirin: Yeah, definitely, it does take a village definitely, your village can look differently. But it's definitely not a job for just one person. And how do you feel at this? I'll say the family itself, and also the parents.
How can they be there for the twin, the survivour twin, especially early on to maybe mitigate some of their feelings that they can't make sense of, and maybe it won't manifest? But just what should they look out for? That can indicate that maybe they will need some support or a professional to help their journey.
Liana Kupferman: Yeah. So it's usually when they're gonna look for therapy, when you see someone suffering right? and some suffering are, yeah, this is normal. And this is across the limit. It's, you know, crossing the limits of being functional, of being healthy. And so when they feel that that it's something wrong. You know something. It's not. You know your child, you know that it's he there could be achieving them better potential. But it's something it's holding back. And you observe that it's hard to process. Or sometimes the parents seek therapy just to help. How can I tell them? How can I explain to them that they are surviving, you know. So it's different approaches that you can look for therapy. You don't have to wait until really suffering and really affecting their lives, because in the past we had this concept of you'll just look to therapy if it's affecting function of your lives, just if it's in this stage, but sometimes it's so late because it's the damage is so big it's not as you can't do anything. Of course you can do in therapy, but if you could do, you could have done before, it would be much better. So you can do in a way that you can look for help. How I can manage this situation, how I can talk to my twin about that.
So yeah. So I am a big fan of therapy. I think that it always is helpful, but it's really. I see parents looking for therapy when they are. They don't know exactly how to handle. They see that their child is not. It's not happy. It's something wrong, you know, not this in school. It's not going well.
So it's really, it's not only one aspect. I think they're seeing the whole picture bye.
Smadar Zmirin: Yeah, I think that's really good advice. I think. Awareness of the topic, awareness of what might come out of it for the parents, the family and the children is already enough to be more attentive to anything that you might want to talk about proactively or make sense notice if symptoms are popping up, and maybe you can benefit from somebody who knows about it, and they can help you go through that, and you don't have to do it alone. Yeah.
Liana Kupferman: Exactly. Yes, you always can seek for help.
Smadar Zmirin: Yeah.
Liana Kupferman: Yeah.
Smadar Zmirin: Wow! This was this was wonderful. Leanna honestly thank you so much for sharing experience and journey. And it's so good to know that someone is out there like yourself to help families with twins or of twins. And yeah, and thank you for your time today.
Liana Kupferman: Thank you so much for having me. It was really lovely talking to you.
Smadar Zmirin: Yeah, same. And yeah, I, I, yeah, having the pleasure to talk with you today. Thank you.
Liana Kupferman: Okay. Alright!
Smadar Zmirin: Bye.
Liana Kupferman: Okay. Bye. Thank you.
Smadar Zmirin: Bye.