This paper is a response to Ronald Lehrer's "Perspectivism and Psychodynamic Psychotherapy". Lehrer treats Nietzsche as promoting only a modest perspectivism according to which different cognitive strategies triangulate the truth. We argue that Nietzsche's perspectivism is much more radical, and defensible, than Lehrer admits. We also suggest that Nietzsche's bundle theory of the self has important implications for psychotherapy and the concept of mental health. According to this theory, the self is an aggregate of ever-changing drives and affects. The conditions of health for such persons are similarly mutable, with no one standard applicable to all persons, or even to the same person over time.