Notes on The Last Psychiatrist

I love few things more than a great blog. My latest find: The Last Psychiatrist, an archived blog, mostly about narcissism.

I was so excited to learn his insights… I made notes.

What follows are his finest insights about narcissism and my comments.

Imagine a crowded subway, and a beautiful woman gets on. Hyper-beautiful, the kind of woman who can wear no makeup, a parka, earmuffs and a bulky scarf and that somehow makes her look even prettier. A handsome man about her age in an expensive suit gets up and says, “please, take my seat.” She smiles, and hastily sits down.

TLP (The Last Psychiatrist), as the author refers to himself, gives us two options as to how the woman should think about this:

  1. This was a sexually motivated act as far as the man was concerned
  2. He was just being nice

If you think of narcissism as grandiosity you miss the nuances, e.g. in her case the problem is narcissism without any grandiosity:

she is so consumed with her identity (as not pretty) that she is not able to read, to empathise with, other people’s feelings. Source

In another post, TLP explains why narcissism isn’t necessarily about grandiosity. This is a blatantly obvious point that escapes most people, unfortunately.

Being the main character of your own film isn’t necessarily grandiose. It is narcissistic though because all the other characters are only important because they help the viewer to understand the main story line.

Here are some less obvious traits of narcissism TLP outlined:

Shame over guilt (I think this is because shame is an emotion directed at the self, whereas guilt is an emotion directed at your victim)

envy over greed (greed would be a primary reason to look for something, whereas envy is only a desire to catch up because otherwise otherwise it’s a bad reflection on you. I liked how this was called “existential agency” here.)

He [the narcissist] thinks the problem is people don’t like him, or not enough, so he exerts massive energy into the creation and maintenance of an identity: if they think of me as X… (and that’s one of the reasons why we love brands)

The narcissist feels unhappy because he thinks his life isn’t as it should be, or things are going wrong;  but all of those feelings find origin in frustration, a specific frustration: the inability to love the other person.

And this really brings it back to the original myth that TLP broke down beautifully here:

Narcissus mother took him to a clairvoyant who said, “He’ll have a long life as long as he never knows himself.

Narcissus kept rejecting people who fell in love with him because they weren’t good enough.

One rejected lover was furious and begged Nemesis, the goddess of vengeance, for retribution.  “If Narcissus ever falls in love, don’t let the love be returned!”

Nemesis  heard the prayer and caused Narcissus to fall in love with himself: he was lead to a  pool of water, and when he looked into it, he fell in love with what he saw.  And what he saw wasn’t real, so of course it couldn’t love him back.  But Narcissus sat patiently, forever, hoping that one day that beautiful person in the bottom of the pool was going to come out and love him.

Because he never loved anyone, he fell in love with himself. That was Narcissus’s punishment.

This brings up an interesting point: how are you meant to feel about yourself?

Let’s first look at what we want. What we pay for. A huge portion of marketing directly helps us to be in love with ourselves, because we’re worth it. They’re not even trying to hide that the feeling of being in love with yourself is what they’re selling. And it’s not punishment as we see it – otherwise we wouldn’t buy it. I suppose it’s a psychic equivalent of putting a person on heroin. You mightn’t feel it’s a punishment, but it is.

Then there are the more subtle “intellectual” publications that help you love yourself (see the distinction from being in love with yourself? Cause that would be shallow.) I wonder how many pages were dedicated to helping people see Narcissus’ infatuation as Buddhist acceptance or some other high and mighty concept.

There isn’t really anywhere that would tell you that you’re meant to not love yourself.

What happened to Narcissus doesn’t really sound so horrible in today’s culture. Maybe he wouldn’t have even retaken a selfie if he lived today and been happy with the first shot? That level of self-acceptance is just enviable! He’s winning at life by millennial standards!… Indeed, TPL calls narcissism “a generational pathology”.

TLP goes on to discuss Narcissus’ parents’ role, which I thought was priceless:

He will have a long life, if he never knows himself.

Forget about whether the prophecy is true.  Ask instead, “what would the parents have done once they heard it?”…

Next time I feel insignificant and weak, maybe I need to hold on to that feeling, because my culture will obviously infuse me with my own grandiosity without me ever trying.

TLP has another explanation for why Narcissus stayed looking at the primordial selfie lake though.

He didn’t stay there for years because the reflection had pretty hair.  He stayed because daydreaming takes a lot of time.

In other words, Narcissus didn’t recognise himself and spent all that time conjuring up images of how wonderful life would be with that person in the reflection…

And the DSM says exactly that, only it adds a grandiose twist: “preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love”.

I am confused now.

Narcissus fell in love with himself, only he didn’t know if was himself.

So, as far as Narcissus was concerned, he was genuinely in love with another human being – only they were unreachable. Their personality was entirely a figment of his imagination…

Wait, that’s not Narcissus, that’s Gatsby! (Who also dies in a body of water, fair dues to FitzGerald).

Narcissus’ crime wasn’t being in love with himself at all. Phew, it’s ok to let L’Oreal and #positivethinking to get money and likes.

Narcissus’ crime was not knowing himself.

Actually, no, again.

TLP puts it better:

The moral of the story of Narcissus, told as a warning for the very people who refuse to hear it as such, is that how Narcissus came to be is irrelevant.  What was important was what he did, and what he did – was nothing.

And that’s his main crime: he never cared about anyone real. To me that’s all one ever needs to know to understand narcissism.

TLPs advice on how to not be a narcissist is to fake it. I think what TLP’s getting at is that your behaviour is much more important than your identity.

11 thoughts on “Notes on The Last Psychiatrist”

  1. We have found it so important to have an inkling of what is going on inside another person’s head, that we have evolved a system to provide us with at least a rudimentary capability of doing just that. On top of this we have studied extensively what is going on inside our own heads and that (psychiatry, psychology, etc.) has gotten us where? Apparently not very far. Our ignorance still seems immense.

    An example is the current debate over whether free will is real or an illusion. BNo conclusion has been reached but, as usual, people are using different definitions which confuses the issue. (For example, by one definition there have been 307 mass shootings this year (so far) and by another there have been 10. Guess which one the NRA uses!) Most people think of free will as conscious free will. I do not because I know that what most of us call rational, conscious decision making is usually neither rational nor conscious.

    So, if we can’t decide an issue like whether free will is real, how can be know what a narcissit really thinks?

    Liked by 1 person

    1. Ah well in answer to that I can only use the Socratic defence: I know nothing.

      “We have found it so important to have an inkling of what is going on inside another person’s head, that we have evolved a system to provide us with at least a rudimentary capability of doing just that” – I think it is very rudimentary. I really liked how one of the commentators put it “I’m not a psychic. I just pay attention.” I still think people try to mind read way too much. We just don’t know what other people think


    1. And I think that that’s the reason it is such a complicated topic. Some people, the ones called narcissists, literally deprive others of a their identity. Everyone else is a supporting actor.

      There are benefits to this world view, but it has to be balanced. The Last Psychiatrist put it well:

      “I would say that ethically you are still supposed to act as if you had unilateral responsibility; but simultaneously you have to be able to see the other as a fully autonomous, free, aware person.”

      Liked by 1 person

      1. I agree, it’s a fantastic topic (and excellent post). What the psychiatrist says deals with the overt narcissist. I suppose my question is if that person is simply the one who doesn’t have the skills to dissimulate their narcissism?

        Liked by 1 person

  2. Excellent post – made me think a lot. 2 questions that I hope you can at least somewhat clarify for me:

    1) To the earlier comment on being the main character – isn’t this simply human nature? Aren’t we all by default the main characters in our own movie? Maybe I’m just a huge narcissist but beyond a Gandhi or Ma Teresa, I can’t imagine that most people get out of bed in the morning and first think about “everyone else”.

    2) From TLP’s page, “if no one ever seems right for you, and then the one person who does seem right doesn’t want you, then the problem isn’t the person, the problem is you.”

    Can you expand on this a bit? This (unfortunately) sounds a bit close to home. But I can’t make sense of it. How is the problem you (i.e. me) that someone who finally seems “right” isn’t on the same page?!? I feel like this scenario has plagued me for some time now w/r/t romantic relationships and having a better understanding could be HUGE.

    Thanks so much and keep up the great work!

    Liked by 2 people

    1. Thanks Chad.

      1) A better metaphor would be as follows: you are the main character of your own film, but you’re in Universal Studios and the supporting characters of your film step in and out of other films where they are of higher significance. You are a supporting character in other films. There is more than one film and you need to respect your fellow actor’s other commitments.

      2) Narcissus rejected everyone who loved them for not being good enough. Narcissists want to only associate with people they consider exceptional. An NPD sufferer “believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)” (DSM). The one person who does seem right probably doesn’t exist except in the narcissist’s head. Narcissus story of falling in love with his own reflection that he didn’t know was his is a little mindbending, so I would just use the example of Daisy and Gatsby.


      Liked by 1 person

  3. Hi Doc,
    I’ve never been ‘tested’ but I hope to have tendencies. The advantages are obvious. So many of the ‘complaints’ offering negative judgement are really quite compelling considering the deficit implicit in NOT liking your self. More than a few times I’ve listened to the ‘traits’ of a n-person and have thought “God, that’s good. I should really develop that.”
    It is sad to not be aware of other’s feelings but strangely, many folks are so engrossed in everyone’s feelings that much concern for other proper life development is completely overlooked. I wonder what the DSM will say about that once TDS becomes a diagnosis!

    Much of my life’s work has been in pursuit of bringing disenfranchised souls to a workable understanding of life that allows for their personal existence, OK-ness, and opinion in light of the fact that someone MIGHT have a feeling about it.
    It would be superb to read articles from REAL narcissists to learn the more subtle nuances to be able to write quality 1st person self-absorbed narrative. (mine suck!)
    This is a fantastic article. I had to read a bunch of TLP’s page for better grip. I will be studying his work for the skill set!

    Liked by 1 person

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