Moving past The Last Psychiatrist's narcissism

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This post is written for readers who have read The Last Psychiatrist and vaguely recognize their own narcissism.

TLP's diagnosis is correct, but his cure is ineffective. I hope to provide a better cure.


Naively, narcissism is “selfishness, involving a sense of entitlement, a lack of empathy, and a need for admiration”. This is wrong.

The Last Psychiatrist (TLP) has written heavily about narcissism, and his diagnosis is much better. His cure isn't, but we'll get to it.

Here's a short test: Do you care heavily about how you look in others' eyes? Do you judge people primarily on how they look in your eyes and how you feel about them? Do you want to have a single consistent identity that you present to everyone? Finally — when you do something bad, are you terrified of being caught?

The more ‘yes’es you have, the more likely that this post will be useful to you. I claim that narcissism prevents you from achieving your goals, from being happy, from having awesome relationships, and — hurts people around you. It is possible to get rid of.

TLP's position

TLP is excellent at describing narcissism, even though he doesn't paint a charitable picture. So let's look at that first.

The summary of TLP's position is:

The narcissist has no intuitive notion that other people have their own thoughts and lives that are as rich as the narcissist's thoughts and lives. He knows it intellectually, but does not relate to it.

The narcissist has no goals or desires that are independent of other people. If he wants to look like Jack Sparrow, what he actually wants is for other people to see him the way he sees Jack Sparrow.

The narcissist only feels shame, not guilt. He is afraid of being caught, and will do anything to prevent it, sometimes including violence. “The reason a psychopath kills is because he is bad. The reason a narcissist kills is so that no one finds out he is bad.”

An important distinction: narcissism is not grandiosity. You don't have to think you are the best to be a narcissist. You don't have to be selfish to be a narcissist, either — maybe you are generous because you like generous people and it feels good to be one, too. As long as your good actions are about you and not the other person, they don't count.

Narcissist's most important goal is to be in control of his identity — how he looks to himself, and how he feels other people perceive himself. This, above all else.

Missing compassion

What TLP doesn't talk about much is that being a narcissist often hurts like hell.

I used to have those symptoms.

  • Whenever I was around people, I was constantly aware of how they would react to me. “No matter what I do, somebody might still dislike me” was going through my mind.
  • When I was in a relationship, I was terrified pretty much half the time. Things like “my girlfriend decided to pick up running and now she might become one of those sports people”.
  • When I was blogging, after publishing each post I would spend the next four hours hitting refresh to see if anybody has left a comment. I couldn't do anything else, even if I wanted to, because I was so anxious (and excited) at the same time.

All of that actually felt good for a while — having a lot of intense emotions was interesting. I was proud of going through an emotional rollercoaster with my girlfriend. I didn't think there was anything bad about being excited to read comments to my blog posts. And of course, “No matter what I do, somebody might still dislike me” seemed rightly terrifying — I didn't want to become a person who didn't care about what others thought, because what others thought was important.

But there is one thing TLP was right about: I was hurting other people in the process. It is hard to be around a person who is constantly anxious. It is hard to talk to a person who might get very upset if you give them negative feedback. It is hard to be in a relationship with somebody who is terrified of you changing, or perhaps — of you not changing something you don't want to change.

Problems with TLP

When I was 19, I had stumbled upon TLP — and soon got convinced that I was, inherently, a narcissist, and would hurt everyone around me if I didn't fix that. I spent the next four years wearing the “narcissist” label, internally.

It didn't help much.

TLP's cure for narcissism is: fake not being a narcissist, regardless of how you feel internally. “Your treatment isn’t for you, it’s for everyone else”. The problem with this isn't that it's hard, but that it's non-actionable. TLP doesn't provide a portrait of someone who isn't a narcissist, someone to aspire to, someone to benchmark yourself against. And so, you don't know whether you are moving in the right direction.

TLP does give another hint — he explains how people become narcissists. From The Second Story Of Echo And Narcissus:

How do you make a child know himself? You surround him with mirrors. “This is what everyone else sees when you do what you do. This is who everyone thinks you are.”

You cause him to be tested: this is the kind of person you are, you are good at this but not that. This other person is better than you at this, but not better than you at that. These are the limits by which you are defined. Narcissus was never allowed to meet real danger, glory, struggle, honor, success, failure; only artificial versions manipulated by his parents. He was never allowed to ask, “am I a coward? Am I a fool?”

This is what you actually need to focus on, but he does not give much guidance.

And he doesn't provide compassion, either. To change, you need to know that you are flawed, but you also need to know that you can get better. TLP does very well on the first point, and badly — on the second.

Next steps

Okay. What now?

The underlying conditions of narcissism are: not knowing yourself (what you are good/bad at, etc), and not having desires that aren't about yourself or your relations with other people. Once those are fixed, the symptoms of narcissism go away.

Instead of beating yourself — “how do I stop caring about my identity!” — you have to find other things to care about more. And you can still have your identity. You can still care about what others think.

Coincidentally, “not knowing what you can do” and “not knowing what you want to do” are the biggest obstacles on the path to doing what you want to do. So, we will look at those two in the next posts, and kill all the birds with one stone.

Appendix: excerpts from TLP's posts

From If This Is One of The Sexiest Things You’ve Ever Seen, You May Be a Narcissist:

The narcissist believes he is the main character in his own movie. Everyone else has a supporting role – everyone around him becomes a “type”. You know how in every romantic comedy, there’s always the funny friend who helps the main character figure out her relationship? […] But in real life, that funny friend has her own life; she might even be the main character in her own movie, right? Well the narcissist wouldn’t be able to grasp that. Her friends are always supporting characters, that can be called at any hour of the night, that will always be interested in what she is wearing, or what she did.

From This Man Killed His Family And He Doesn’t Know Why:

Guilt implies an internal sense of right and wrong. Whether it originates from your religion or your parents or the penal code or Star Wars isn’t relevant, only that external rules are then internalized, and you then build an identity around them. So that when you violate them and there is no way anyone noticed, it still gnaws at you because it conflicts with your ego, who you are. Id exists from birth, so superego has to precede ego.

Shame comes not from the action but from the exposure. You wouldn’t say you were ashamed unless you have been observed, caught. Shame is a conflict with reality: I think I’m this kind of a person, but now this other guy has external evidence that I’m not.

A narcissist can’t feel guilt because, while he admits to external rules (religion, ethics, etc) those rules are always secondary to his identity. As long as the identity is intact, you didn’t do anything really wrong.

From What The Miss USA Pageant Says About Us:

Playboy is fine. Girls Gone Wild drives us bananas. “They do it... for nothing? They’re willing to get naked on camera for nothing... yet every time I try to be nice and buy one of them a drink, they won’t even look at me... I don’t get it, I don’t get it...”

From A Generational Pathology: Narcissism Is Not Grandiosity:

Narcissism has a fail-safe: since you know you tricked [your partner] to get them, you can’t believe them when they say they love you. The fact that she loves you means she’s not smart enough to know what love is. That’s why you default to measurable quantities of love: how fast did she get into bed with the past guys?

The Last Psychiatrist on narcissism is an index to TLP's posts on narcissism. Read through it if you are interested.