Last week, a young middle-class woman consulted me. She was not unattractive, but her expression was one of frivolous earnestness, that is to say, intense self-absorption.

She approached the consultation like the oysters in The Walrus and The Carpenter, all eager for the treat. Here at last was an opportunity to talk about herself uninterruptedly and unconstrained by all those boring social conventions.

Whats your problem? I asked.

I hate myself.

And youve come for a second opinion?

Theodore Dalrymples medical column in the British publication The Spectator, 17 May 1997