Ayn Rand is known as an advocate of rugged individualism and unregulated capitalism, which has led to a scholarly focus on her influence on neoliberal and right-wing politics. This article focuses on the psychologically unrealistic conceptualisation of self-esteem in Rand's ethics, which arguably prevails in today's self-help culture. Rand endorsed Nathaniel Branden, her acolyte and lover, as official therapist for her circle. In this role, he promoted the positive effects of living according to Randian principles on mental health. Rand's so-called objectivism therefore provides not only a questionable philosophical framework for neoliberal politics but also, and perhaps predominantly for its followers, a set of guidelines for the project of self-optimisation. The fact that Rand's ideal of radical self-sufficiency is ultimately psychologically unliveable makes its use in applied psychotherapy ineffective and harmful. The article offers a cultural-historical case study about the ideological entanglements of philosophy and pop-psychological concepts and of clinical malpractice.