Table of Contents
The current study explored the case of two previously conjoined twins, both of which who were separated at the age of 3 years old and have been living a normal life till today. Both individuals are twenty-five (5) years old and have been well known for being a successfully separated conjoined twin. In the country, it can be noted that the mortality rate of separated conjoined twins is 17.7%. The current research focuses on understanding how conjoined twins develop their personality, behavior, and coping skills through exposure to numerous environments which places them in the center of attention due to their unique condition. This case study not only focuses on the psychosocial development of a conjoined twin but it also focuses on the coping mechanisms of these individuals which would provide new knowledge to the field of Psychology and Education, as well to help other conjoined twins in further understanding how their personality is formed. The case study about the psychosocial development of two previously conjoined twins who are currently living a normal life after a successful ischiopagus operation, utilized a thematic analysis approach to further examine development of conjoined twins. A thematic analysis is a method used in determining, analyzing, and classifying the patterns wherein themes can be derived from the data or from the narratives provided by the co-researchers. The themes used in this case study consist of four (4) categories of general themes and eighteen (18) subthemes, and these are the following:
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Under the Psychological Category, the themes are: Self-Awareness, Defense Mechanisms (Sublimation & Suppression), Insightfulness, Self-Efficacy, Self-Acceptance, Self-Pity, and Perception towards twin (Pseudonym 1's sentiments towards Pseudonym 2 & Pseudonym 2's sentiments towards Pseudonym 1)Under the Emotional Category, the themes are: Gratitude, Ambivalence, Passivity, Frustration, Resiliency, and Anger.
Under Social Category, the themes are: Family Dynamics, Social Inclusion, Cultural Influence, and Social Exclusion.
And lastly, under Behavioral Category, the theme found is: Adaptability.
Applying the definition and relating it to the present case study, the psychological category pertains to the different subthemes wherein the co-researchers of the case study elicited the strengths and weaknesses of their mental state. As well as the unconscious strategies they have utilized throughout their development which have helped them to cope as previously conjoined twins. The Psychological category contains 7 subthemes.
The first subtheme for the psychological category is Self-Awareness, is defined as the ability to of an individual to be aware of who they are or what their actions are and their ability to consciously evaluate themselves and to be able to concentrate on self as an object. It is also wherein they are able to concentrate on themselves as an object or have a wider perspective of their self.
The second subtheme is Defense Mechanism, it serves as an important function that helps in crippling the emotions that affects individuals negatively and helps in maintaining a healthy mental state or restore it back to its state of mind. It also occurs in numerous forms, including sublimation and suppression which have been identified in this case study. It states that responses evolve in large to amplify negative emotions. Under the DSM V, it is most commonly known as coping styles, it is a set of automatic psychological processes that seeks to protect individuals from negative emotions and impulses such as anxiety. In relation to the case study, it entails how conjoined twins adapt to the environments they are place under by redirecting the memories which have shaped them to either a different thought or completely suppressing the disturbing memories and impulses which were previously experienced.
The third subtheme is Insightfulness, insight is perceive to be more than the thought of self-awareness, due to the fact that it involves more than just the mental awareness of the individual but it involves the emotional intelligence and motivation. Relating to the study, it is the awareness of the conjoined twins on how they perceive an idea of their selves and perception in life.
The fourth subtheme is Self-Efficacy, it refers to how an individual use their diverse coping abilities in different classifications of situations that they face, it also entails how an individual use their abilities to adapt through planning in order to attain the objective. It is present in the narratives of the co-researchers in the study through the manifestations of their stated beliefs where they aim to become a better version of themselves despite being conjoined and having numerous physical defects that limits them.
The fifth subtheme is Self-Acceptance. The sixth subtheme is Self-Pity. The seventh subtheme is Perception towards twin.
Second is Emotional Category. Emotion is a complex state of psychology that involves unique components such as the physiological response of an individual, their subjective experience, and their behavioral or expressive responses to these states. In the case study, it pertains to the observation of the narratives of the co-researchers on how they share their experiences throughout their life. This category includes 6 subthemes.
The first subtheme is Gratitude, can refer to an individual’s feeling where he or she appreciates and senses that one can make a positive response to an act of kindness. It also pertains to the feelings of being thankful based on the narratives provided by the co-researchers despite the difficulties they have faced both in their physical condition and in the experiences they have faced that shaped their development. In addition to that, this subtheme contains the co-researchers acknowledgement of receiving a better valuable benefit from their experiences which resulted to a positive feeling they acquire externally and internally.
The second subtheme is Ambivalence. The third subtheme is Passivity. Passive behavior is defined by Cognitive Behavior Therapy as the failure of an individual to express what they want, what they need, or what they feel. In relation to the present study, it entails how the co-researchers as previously conjoined twins endure the situation they are facing and at the same time considering some situation as negative aspects in their life; It is having no more choice to simply agree despite resenting the choice.
The fourth subtheme is Frustration. Frustration is an emotional response by an individual which is moderated between connection a situational restriction and a behavioral response. It refers to the co-researchers struggle in their experiences which have led to their inability to achieve their goals.
The fifth subtheme is Resiliency, most commonly known as a demonstration of the positive adaptation despite the exposure to certain adversity or high risk situations, which is a result due to the available use of the external and internal use of resources.
The sixth subtheme is Anger. Anger is a negative emotions that are often related to misery, difficulty, and annoyance. It refers to the co-researchers’ blame towards their parents and experiences, as they see that their condition is not where they want it to be due to certain factors.
This section contains all results gathered from the data gathering which would best present the case of a conjoined twin and the impacts of psychosocial development on their personality, behavior, and social skills. The gathered data was analyzed through the use of thematic analysis, by conducting separate intensive interviews and finding statements that would best describe the co-researchers experiences. Through this, the results of the case study were obtained from the themes, gathered by the researchers. The Analysis The case study on the psychosocial impact on conjoined twins were analyzed through the use of thematic analysis. Thematic analysis is a reliable method for identifying, analyzing, organizing, reporting themes found on gathered data. It represents as a foundation for methods on qualitative analysis; very reliable in the formulation of different kinds of interpretation for research. From this, the researchers found eighteen subthemes that best described the case of a separated conjoined twin. These themes were categorized into four general themes, namely: Psychological, Emotional, Social and Behavioral, each which has its own respective subthemes that explains the case of a conjoined twin.
The researchers of the case study used the term psychological as a general category to describe the derived themes from the gathered data. Relating it to the present study, it means to say that the psychological concepts found on this study is present not only on twins or those disabled but to ordinary individuals as well. The psychological impacts done on the developments of each individual would differ depending on the environment and experiences of each individual. This means that the psychological definition in this study pertains to the strengths and weaknesses of their mental state. As well as the unconscious strategies they have utilized throughout their development which have helped them to cope as previously conjoined twins. The birth of a child with a certain abnormality or the presence of being a handicap is a crisis in which parent's expectations are then turned down. When parents learn that their child is disabled, emotions would be mixed. This in turn could be the cause as to why parents play an integral role towards the development of psychological impairments or hindrance in the development. The initial reaction of parents would then affect the disabled child through psychological or emotional disintegration, meaning to say, the psychological aspect can be disintegrated.
Both co-researchers both are aware of their physical, mental, and social well-being and from it they use their previous experiences as stepping stone for further. Co-researchers of the study gave narratives wherein they show full awareness of their physical, emotional, and mental state; they describe their physical, emotional, and mental state positively and negatively, through it they were able to devise a course of action to improve themselves thus making them fully aware of the situations they are faced with and they act accordingly.
As stated by Brown, McAvoy, and Joffee (2014), insight is perceive to be more than the thought of self-awareness, due to the fact that it involves more than just the mental awareness of the individual but it involves the emotional intelligence and motivation. This definition shows that both co-researchers shows a high level of understanding of understanding the situation, perceiving themselves and ideas.
“My priority was definitely academics.. If you become good in academics you would excel in life. Eventually it changed because I saw na life is not about academics... Physical work, not just mental work.”