An Introduction to The Last Psychiatrist

The Last Psychiatrist (TLP) is a pseudonymous blog that ran from 2005-2014. He is one of those contentious elite intellectual figures who is compelled to write a blog because no one today would consider publishing what he has to say. He is informal and profound; politically incorrect and philanthropic; he effortlessly brings together truths he has grasped from high and low culture; and most importantly: he has won for himself the kind of intellectual independence that lets him notice and observe more than most of us can. He talks about almost every important human question, and helps us see how these questions emerge out of our every day experience. One thing he is especially adept at, is finding clever ways to show us to ourselves, and to show us how we are getting in our own way. I will articulate three key obstacles he draws our attention to: narcissism, finding ourselves trapped asking the wrong questions, and aspirational thinking.

To summarize his teaching into a vulgar formula: it is not about you, you are looking in the wrong direction, and stop thinking and just act!


Usually when we think about narcissism, we think of some selfish person who looks in the mirror too often. This impression is not entirely incorrect; but, it doesn’t indicate to us how deeply narcissism can become ingrained into our psyche.

In one of his articles on parenting, TLP discusses a woman who claims that the movie she had played in her head about being a parent is completely discordant with the reality of being one. In response, he says: “For the new readers, that’s your sign that there’s a contagion nearby, suit up.  When a person sees their life as a movie, that means they’re the main character and everyone else is merely supporting cast.  And when one of the extras– in this case, the kid– goes off script, she doesn’t just get upset, she has a full blown existential crisis.” By imagining ourselves in a movie, we inflate our importance. We see ourselves at the center of everything and cannot understand at all how or why others don’t see things the same way–why don’t they see how this makes ME feel? This is one reason why so many people attribute very shallow or facile psychological motives to others, but are deeply offended when others fail to return the favor. About ourselves we think: “I see things in a complicated and nuanced way and I after carefully weighing competing goods, I did what I thought best.” About others we think: “He just wants power; Or, he is just out to get me–why doesn’t he like me?, etc. It is a great challenge to genuinely try to see the world as it looks to someone else.

He describes narcissism in a similar way in an early article on honor killings: “The general problem with the narcissist is that he can’t see the other, he only sees others in relationship to him.  It’s a movie, or a video game.  It’s Grand Theft Auto.  Sure, the other characters are real characters, but what matters is you.  You don’t even have to be a good guy, or the best guy– just the main character.  It is impossible to conceive that any of the characters in GTA can have thoughts that aren’t about him.  “But it’s a game, it’s not like real life.”  No, to the narcissist, “real life” isn’t real either, it’s simulacrum.   Every action is about him, positively or negatively.” Think of the difference between going to a restaurant by yourself vs going with someone else. By yourself, you imagine that everyone in the bar is watching you. But: do you give a shit about people alone at a restaurant when you are with a group? Being alone in a public space magnifies our sense that everyone in the restaurant is somehow orienting their behavior in light of you being there. For the hardcore narcissist, though, life is like being at a restaurant alone even when you are with the people you think you love. You see every action, reaction, word, smirk, decision to use the restroom, as a direct response to how they are seeing you. And you delight when that action is in accord with how you want to see yourself and despair when you think it exposes the soft underbelly of the real you that sits, toadlike, beneath the facade you have tried build in front of it.

In an outstanding article on the public reaction to the Iraq war, TLP points out our deep desire to have control over how people see us: “Narcissism is identification without identity.  It’s making something up and then fighting to the death to maintain it.  It’s “the zeal of a convert.”  It’s not really you, but boy oh boy don’t let anyone tell you that.  You’ll sacrifice anything– happiness, money, comfort– in order to maintain control, to get people to think you are who you say you are.  All that matters is people see you how you want to be seen– even if you’re really something else.”

The principle problem that emerges in a mutually re-enforcing feedback loop with narcissism is our inability to genuinely connect with other people. We don’t have deep connections with others, so we subtly try to manipulate them into seeing how complicated and different we are. The other person sees through these not so subtle manipulations because they are smarter than we give them credit for. They treat us politely, but they don’t get too close. We feel just as lost as before.

We might begin to ask the question: can I cure myself of narcissism?

Why do we ask the wrong questions?

TLP says this about the question above: “this is the wrong question.” In an imagined or real dialogue, TLP has a reader say this:

unlike other people, I can’t seem to make meaningful connections with people, and when I try it indeed seems unreal, scripted.  Other people seem to have legitimate emotions, be happy, or in love, or angry, or guilty, and to me it always seems like I’m– just a little bit–  faking it.”” TLP replies:

Narcissism says: my situation is different.  I am not like other people, who are merely  automatons, shuffling towards oblivion.”

Narcissism is so deadly precisely because even when we know we are in it’s grip, we can’t ask the right question about it. We proudly think to ourselves, “Now that I know about the problem, I will solve it!” That isn’t how this problem works. Indeed, asking if we can be cured of narcissism might be the moment when we fall into its clutches forever, falsely thinking we have freed ourselves from it, but in reality, we are now in a cave beneath the original cave, and think we are on the outside in the sun–“Other people are so obsessed with themselves.”

And to make matters worse, while we are inclined to get in our way without being pushed, the environment we grow up in doesn’t give us any help. TLP commonly points out the way that the main stream media sets the terms of any debate. As he often puts it, the media let’s us debate the conclusions of its arguments, but not the form of the argument. Consider one of his last articles, on Randi Zuckerburg. She wrote about how we need to “untangle our plugged in lives.” She sets the terms of the argument by asserting that it is natural or normal or good to be plugged in, From that premise, she argues for swinging things back a little, answering a few less emails during family time. The wrong question: should we be less plugged in? TLP supplies us with a better question: “One of our time’s great sociological questions is why we filled downtime back up with work, and the reason is it’s better than alcoholism.  At some point during the Truman Administration home life became more stressful than work life… If home is stressful for adults, think about how bad it is for teens, all they want to do is hang out and talk about how phony everything is and instead they’re stuck upstairs with Snapchat while listening to their parents masturbate in separate rooms.  Better than listening to them divorce, I guess.”

In other words, we often find ourselves asking a superficial question: how do we find the balance between unplugged/plugged? Instead, we need to ask: why are we plugged in at all?

In in article on Occupy Wall Street, TLP points to a number of questions asked by the protesters. They ask: what happens when the 99% can’t afford a college education? TLP responds with better questions: “I very, very much empathize with this woman, but her aside, what if I don’t believe education is they key?  What if I think there should be no such thing as student loans at all?  What if I think that it, not Wall Street, is a far greater enemy of civilization?   Do I get to be in the 99%?  Do I get a choice?

And indeed, TLP knows that even a man with good judgment like himself can be temporarily fooled: “I was once going to write something about what Amanda Knox’s innocence revealed about our earlier media  prejudices, and then I realized I still have no idea if she’s innocent or guilty, only that the media tells me she isn’t.  And then I wondered, why do I even care if she is guilty or innocent, why do I even know her name, what’s that got to do with me?  Because the media decide not just truth and falsehood but existence and non-existence.” As he points out repeatedly in this article, the media moves too fast for protests to mean anything other than what the media wants them to mean. It is hard to understate how much the MSM does to set the terms, not only of acceptable conversation, but even of what kind of questions come to mind.

Aspirational Thinking

To aspire is far from being inspired.

In an article on motivation, TLP shows how easily we make excuses for our failures to create things: “All artists– and probably all people– have in their minds the fantasy workspace.  “If I could only work in…”    Forget it.  This is always going to fail.  Always, every single time.    They are distractions, they sap emotional and creative energy.” We think to ourselves: if only I was in a better space than I am now, then, I would be better. We wait for the perfect and forgo the possible. Spending time planning to make plans, or thinking about how our essay on contemporary politics will “own the Libs” is not only or merely a waste of time. As TLP striking puts it: “No matter how carefully you plan something in your mind– work through details, procure materials, etc– it can’t take into account everything that happens. Try imagining having sex with Paz de la Huerta; and then try actually having sex with her.  The first is masturbation, the second is very tricky, although rewarding, business.” When we plan things in our mind, we operate in a world without friction. We smooth over or conceal difficulties with our ideas. There is no replacement for action, for action reveals who we are. Through action we discover our limits, or we see that we are in possession of more resource than we thought.

When we begin to think of working out, we imagine how beautiful our fyzeek will be when we finish. We buy a gym membership and some exercise clothing. We quite like the idea being stronk and beautiful. We then say: I am going to lose 10lbs by Valentine’s Day! TLP responds: “it’s easy to cheat on your goals and say, “well, I’ll just make it up next week.” Try, instead, taking a photo of yourself in a bathing suit each week and putting it on the fridge. Or mailing it to me. Or putting it on a blog. Force the idea– your goal of weight loss- to confront reality regularly, repeatedly, instead of once (at the end). You might say this is going to fail, but if this is going to fail, then you weren’t going to succeed anyway.” Confront the ugliness in reality instead of masturbating to the beautiful false image of the future.

TV and movies often show us what love looks at the beginning. It is always exciting and thrilling. We also see the end of these relationships, ending in break ups or death. What we see much much less of, is the middle. The majority of our lives exists in between the bigger moments. If we can make the most of the middle, we will find ourselves in bigger important moments more often. But, don’t be fooled into aspiring to make the middle exactly like things are in the beginning or during the big moments. Make the most of the situation you find yourself thrown into.

Again: there is no alternative to action. You are the kind of person who does the things that you do. So often we try to evade the person we are. “I’m not the kind of person who turns things in late–this isn’t who I am.” If you turn things in late, you ARE the kind of person who turns things in late. You already KNOW what you should be doing. Stop thinking about whether you should or shouldn’t do something–act. Don’t weigh the pros and cons; don’t think about what you look like in the eyes of others; don’t fear that you won’t succeed. Act. This isn’t a call to be a deadbrained idiot who capriciously flutters from thing to thing. No. This is a call to do–to act according to the instincts that you have endlessly talked yourself into distrusting.

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