The altruist's creed cannot be practiced fully and consistently, since it requires that a person neglect or act contrary to his or her vital needs. In its purest form, altruism requires that one become a total martyr, placing the needs of all others above one's own life, principles, and objective values. Such behavior would necessarily cripple one's own efficacy (even as an instrument of altruism) and sap one's strength, eventually bringing about premature death.

Of course, even altruists recognize that their moral code cannot be practiced in such an uncompromising manner. Reluctant concessions must be made to the practical requirements of living. As a consequence of these concessions, altruism is inevitably associated with guilt and hypocrisy. Since full moral purity as defined by this code is inherently unattainable, its practitioners feel constantly racked by guilt and obliged to hide their "sins" from their fellow altruists. Furthermore, their guilt and hypocrisy make them feel unworthy of happiness, thus seeming to offer further justification for their self-sacrificial behavior and engendering a vicious psychological feedback loop. Altruism divides an individual into two parts, requiring one part to act against one's interests while the other part struggles to preserve some remnant of life. Such a person ceases to function as a well-integrated organism.