Narcissism No Longer a Personality Disorder - New York Times 11.30.10

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#1 Nov 30 - 6PM
Tinker
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Narcissism No Longer a Personality Disorder - New York Times 11.30.10

http://www.nytimes.com/2010/11/30/health/views/30mind.html?_r=1&nl=healt...

According to the NYT today, narcissts are becoming an extinct species:

"Not that they face imminent extinction — it’s a fate much worse than that. They will still be around, but they will be ignored.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (due out in 2013, and known as DSM-5) has eliminated five of the 10 personality disorders that are listed in the current edition.

Narcissistic personality disorder is the most well-known of the five, and its absence has caused the most stir in professional circles."

This means that insurance companies won't have to cover treatment for narcissists, not that many seek treatment. But it undermines the damage they do, making them appear more normal than they are, and, I think, the reaction to them, less so. What do you all think??

Dec 1 - 4AM
michele115 (not verified)
Anonymous's picture

Is it possible

That what they probably would do is streamline all the subcategories of PD's... IE, Narcissism, Anti-Social, Etc, all under one umbrella of sociopathy?
Dec 1 - 4AM
jen79
jen79's picture

I bet 100 dollar

that 99 % of this commitee has NPD as well, and thats why they are so eager to get it eliminated. What could be a bigger success for a narc to become member of a elitary group who decides what exists and what doesnt. Everyone who is drawn to that, power, playing god, has probrably narcisstistic traits or is even a full blows narc. So it doesnt suprise me at all.
Dec 1 - 12AM
betty2020
betty2020's picture

Lisa and I have been

Lisa and I have been monitoring this closely. There are other professionals in the field that we are also talking with to try to get better clarification to what their intentions are. Its still early and as we know everything is subject to change. Myself or the other mods will keep you posted on what we find out as this progresses. The APA is receiving a massive uproar from even considering this. So it will be interesting to see what happens in the end. only one way to go...Forward (tm?)

only one way to go...Forward (tm?)

Dec 2 - 1AM (Reply to #19)
M
M's picture

Lisa & Betty

I trust you both will closely monitor this. I just read an article on msn.com about baby names--how parents try to create "unique"names for theri kids as a reflection of the parents. They cited an author, Jean Twenge. She wrote "The Narcissist Epidemic:Living in the Age of Entitlement". If it helps us victims with our children in court, I am all for it. Keep us posted! :)
Nov 30 - 10PM
Hunter
Hunter's picture

NYT is crap. Call it what

NYT is crap. Call it what you want. A duck is still a duck!
Nov 30 - 10PM
MsVulcan500
MsVulcan500's picture

Hmmm,

Sounds like DSM has gone NC on narcs!
Nov 30 - 10PM (Reply to #16)
lynn61
lynn61's picture

MxVulcan

hilarious! you crack me up!

really??

Nov 30 - 10PM (Reply to #15)
Briseis
Briseis's picture

I can't help but treasure

I can't help but treasure the poetic justice of it :D
Nov 30 - 9PM
Briseis
Briseis's picture

I'm on the fence . . .

I don't think getting rid of NPD in the DSM is going to make Narcs disappear :D . I don't think it will make OUR plight less real at all. Basically what they'll be is a "personality disorder with narcissistic emphasis" or something. I'm still gonna call a Narc a Narc. Personality disorders have this weird irony (I'm speaking from working for 17 years as a psych RN) that they OBVIOUSLY exist, but no one agrees on what they are, what causes them, or even how to treat them. So, a lot of psychiatrists IGNORE them. Or give the raging Narc/Borderline/Sociopathic person a desultory "Personality disorder NOS" (meaning, nonspecific, IOW, "I don't wanna go there"). What's really ironic? The major symptoms of these disorders are experienced by OTHER PEOPLE, not the person with NPD!! I don't care what they do, as far as the DSM. I sort of agree with the "dimensional" approach to diagnosis. It is very different than how illnesses and disorders are diagnosed in general. No big shock there will be some old battle ax psychiatrists out there prediction the end of the world, but SOMETHING needs to change. If you have a so-far unsolved problem, sometimes you have to look at the problem from a different angle in order to see what you haven't seen before. IF there is anything new to see. Personally, I think they are going to have to approach this from a purely neurological standpoint. Find the ferking genes. They've found genes for unbelievable things, maladies, crooked little fingers . . . There's absolutely no interest to fund research, except by the victims, who if they heal up a bit, just want to get away from the Narc forever. And we all know there's got to be money to be made or no one will touch it with a ten foot pole. So I'm not worried this will undermine what we do here. If someone wants to split hairs then they have an agenda that isn't helpful.
Nov 30 - 8PM
michele115 (not verified)
Anonymous's picture

Makes Sense

If these basket cases are incurable, the expense in the eyes of the insurance companies isn't worth it... The upside is they also help big pharma being untreated...How so... Well, then there's us...the NORMALS...
Nov 30 - 7PM
onwithmylife
onwithmylife's picture

It is a terriible injustice

pretty pathetic how it can be recognized for years and then suddenly NOT recognized DUH?!!It is a personality disorder plain and simple. The whole group of them should be locked in an elevator with a NARC and maybe jut then they will put back the disorder where it belongs!!!
Nov 30 - 7PM
Susan32
Susan32's picture

When NPD was diagnosed...

It was back in 1980. The concept of NPD is only about 3 decades old. The twisted irony is that psychopaths were diagnosed back in the 1800s... and along with sociopaths, a recognizable disorder. Psychopaths/sociopaths are more extreme forms of NPD. The autistic have similar brains to psychopaths, so there's a neurological basis. Narcs, on the other hand, can have a sense of conscience. My Narc grandmother never had me fearing for my life. Fleeing the ex-Psych professor was an entirely different matter. My Narc grandmother doesn't have the characteristics of a serial killer and she has a sense of reality. The ex-P, on the other hand, does. NPD should still be in the books. Maybe the problem is that the current definition is too vague to be of any help.
Dec 1 - 1AM (Reply to #2)
M
M's picture

I agree with Susan

in that the current description is vague ...especially in the eyes of the public. I think NPD is too often discarded under "he's just wired different" or as I heard so often, "oh that's just 'N'-accept it". Why should we "accept" it? These people have patterns---they will do it again. They do not want to change. Why does my gut tell me that this sounds like a Narc campaign to eliminate them being "discovered" and put further blame on the victim?
Dec 1 - 5PM (Reply to #10)
michele115 (not verified)
Anonymous's picture

But the other thing is that TERMS/SEMANTICS CHANGE

And that may be what this is...a change - so Narcissim as we know it may not make it in there because they're gonna call it something else... There is too much confusing information - that DSM is changing all the time, gets streamlined, re worded etc... Medicine is a business, they're not in the industry of healing - anymore...treat 'em street 'em Fibromyalgia was Fiboromyositis about 50 years ago - back then folks probably thrown in the basement of a mental hospital and given electric shock for hysteria...oops I mean WOMEN...but I digress... Many diseases have name changes through the years... Its politics, PR, if you want to know more, you got to follow the money trail...
Dec 1 - 4AM (Reply to #3)
jen79
jen79's picture

M

Why does my gut tell me that this sounds like a Narc campaign to eliminate them being "discovered" and put further blame on the victim? Your gut is right, I just posted the exact same thing.
Dec 1 - 5PM (Reply to #4)
Susan32
Susan32's picture

My mother feels the same way....

After being at the receiving end of my Narc grandmother's rage for no reason. The ex-P wanted to blame the victim- the whole time-ESPECIALLY during the D&D. He hated being exposed. For some reason, the thought of him being exposed and gaslighted sounds particularly delightful.... I was ready to instill some remorse and apology from enhanced interrogations... I've watched waaay too much CSI. My Narc grandmother and my ex-Narc bosses have consciences, which makes NPD different from psychopathology. They did NOT have the tendency towards violence for the most part. I'm not holding them up as examples of humanity... but having dealt with a psychopath, Narcs tend to be tamer. All psychopaths are Narcs, but not all Narcs are psychopaths.
Dec 1 - 5PM (Reply to #5)
michele115 (not verified)
Anonymous's picture

Narcissim may not be but

I have a feeling they will lump a lot of the PD's under a major category...we still have time.
Dec 1 - 5PM (Reply to #6)
Susan32
Susan32's picture

Isn't it already Cluster B?

That would be a good thing. There are a number of psychologists willing to put up the Good Fight. What I've read is that psychiatrists/psychologists dread working with Cluster Bs (NPD, sociopaths, psychopaths). Of all the personality disorders, Cluster Bs have the highest rate of self-harm (75%) and the highest rate of suicide (10%) What makes them frustrating is their unwillingness to face their own condition and feelings.
Dec 1 - 9PM (Reply to #7)
Lisa E. Scott
Lisa E. Scott's picture

One opinion

Yes, this has my mind reeling. I'm trying to figure out what they are thinking. It's still too early to tell, however, one fellow author that writes on the topic of narcissism offered the explanation I'm posting below, which I prefer over other explanations I have wrestled with in my mind. As Jody said, we will be following this closely and update you accordingly, but for now, here's Sarah Strudwick's, author of "Dark Souls" view on the matter: "Narcissists can now be given the ultimate title they deserve – a Psychopath" In a recent article written by the New York times entitled “A Fate That Narcissists Will Hate: Being Ignored” according to some professionals Narcissists are about to become an endangered species. When I first read his article, like most other people who are trying to educate people about narcissism I was somewhat alarmed especially as I know how much damage those with Narcissistic Personality Disorder can do to their victims. However on further investigation I had a look at the new guidelines outlined in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (due out in 2013, otherwise known as DSM-5). The work group is recommending that this disorder be reformulated as the Antisocial/Psychopathic Type. It appears that some of the traits of the narcissistic personality have now been included in what they call the psychopathic type. Apart from recklessness, impulsivity and aggression which may apply to the narcissist in varying degrees. According to the new list below the majority of the new traits would fit into the both the psychopathic AND the narcissistic personality. From my own experience and those who have had relationships with those who have had NPD many have the following characteristics although often they may be loath to admit that their partners were in fact psychopaths. My own personal opinion has always been quite different. To highlight this I have listed the new guidelines and and highlighted those in blue that a narcissist are most likely to have. You can see the full criteria changes here The new list comprises a number of psychopathic traits i.e. 1. Antagonism: Callousness Lack of empathy or concern for others’ feelings or problems; lack of guilt or remorse about the negative or harmful effects of one’s actions on others; exploitativeness 2. Antagonism: Aggression Being mean, cruel, or cold-hearted; verbally, relationally, or physically abusive; humiliating and demeaning of others; willingly and wilfully engaging in acts of violence against persons and objects; active and open belligerence or vengefulness; using dominance and intimidation to control others 3.Antagonism: Manipulativeness Use of cunning, craft, or subterfuge to influence or control others; casual use of others to one’s own advantage; use of seduction, charm, glibness, or ingratiation to achieve one’s own end 4.Antagonism: Hostility Irritability, hot temperedness; being unfriendly, rude, surly, or nasty; responding angrily to minor slights and insults 5.Antagonism: Deceitfulness Dishonesty, untruthfulness; embellishment or fabrication when relating events; misrepresentation of self; fraudulence 6. Antagonism: Narcissism Vanity, boastfulness, exaggeration of one’s achievements and abilities; self-centeredness; feeling and acting entitled, believing that one deserves only the best; preoccupation with having unlimited success, power, brilliance, and/or beauty 7.Disinhibition: Irresponsibility Disregard for, or failure to honor, financial and other obligations or commitments; lack of respect and follow through on agreements and promises; unreliability; failure to keep appointments or to complete tasks or assignments; carelessness with own and/or others’ possessions 8.Disinhibition: Recklessness Craving and pursuit of stimulation and variety without regard for consequences; boredom proneness and unplanned initiation of activities to counter boredom; unnecessary risk taking; lack of concern for ones limitations; denial of the reality of personal danger; high tolerance for uncertainty and unfamiliarity 9.Disinhibition: Impulsivity Acting on the spur of the moment in response to immediate stimuli; acting on a momentary basis without a plan or consideration of outcomes; difficulty establishing and following plans; failure to learn from experience Under the older model. The diagnostic criteria for NPD was that a person had to have 5 or more of the following traits: Has a grandiose sense of self-importance (e.g. exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements) Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions) Requires excessive admiration Has a sense of entitlement, i.e., they have unreasonable expectations of especially favourable treatment for themselves or automatic compliance with his or her expectations Is interpersonally exploitative, i.e. they take advantage of others to achieve his or her own ends. Lacks empathy and is unwilling to recognize or identify with the feelings and needs of others. Is often envious of others or believes that others are envious of him or her. Shows arrogant, haughty behaviours or attitudes Under the new model they have a rating system. ie. The person would be either mildly psychopathic with low levels of psychopathic traits or significantly psychopathic with high level traits. What's interesting is that they have called Narcissism an 'Antagonistic' trait. In the past narcissism has always had a somewhat glamorous title to it which is reflected in the media all the time. We often hear headlines where the press say so and so is a narcissist. Its flouted around almost as flippantly as if saying that someone is a flirt and that actually narcissism is OK. Healthy narcissism is but unhealthy narcissism is extremely antagonistic as most people will know having lived or had an encounter with someone who has NPD. At the extreme end of the Narcissistic Personality whereby someone does have some of the aggressive traits listed above which would might otherwise been known as "narcissistic rage" they can easily kill someone. Perhaps the new rules and regulations are actually a good thing. Its certainly not going to be very glamorous for people to say they are a psychopath and as the New York times article rightly says the last thing a narcissist wants to be is ignored. In my opinion the narcissist is now being given the ultimate honour and a title they should have been given a long time ago, that of a psychopath. It also means that with education more and more people will be able to spot these dangerous predators and instead of saying “oh they are harmless because they have NPD” people will start to take them and their victims more seriously. Sarah Strudwick www.darksouls-thebook.com
Dec 1 - 10PM (Reply to #9)
michele115 (not verified)
Anonymous's picture

Thats kinda along the lines I was thinking

They'd throw it under a broader umbrella - oddly enough I wondered if he might have been APD and now we see that they are very similar - I also think it depends on how current the articles are that we are reading - an older article might call it sociopathy say maybe 2000 and later they're called narcissists and just recently I read about APD they all kinda overlap...
Dec 1 - 10PM (Reply to #8)
Lisa E. Scott
Lisa E. Scott's picture

Another opinion

by Dr. Tara Narcissistic Personality Disorder and Histrionic Personality Disorder To Be Eliminated in the DSM-V: Starbuck’s Diagnostics 101 Written by Dr Tara J. Palmatier on December 1, 2010 - 2 This article will try to interpret the rationale for the elimination of 5 of the 10 currently recognized DSM-IV-R personality disorders with a specific focus on the Cluster B or “dramatic” personality disorders (NPD, BPD, ASPD and HPD). The New York Times reports in A Fate that Narcissists Will Hate: Being Ignored that: The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (due out in 2013, and known as DSM-5) has eliminated five of the 10 personality disorders that are listed in the current edition. Narcissistic personality disorder is the most well-known of the five, and its absence has caused the most stir in professional circles. The DSM is used by psychiatrists, psychologists, counselors, social workers and other mental health professionals to diagnose different mental illnesses like schizophrenia, bipolar disorder, depressive disorders, anxiety disorders, personality disorders and other behavioral and cognitive disturbances. As stated in the NYT excerpt, the 5th edition of the DSM is “eliminating” half of the currently recognized personality disorders including 2 of the 4 Cluster B personality disorders; Narcissistic Personality Disorder (NPD) and Histrionic Personality Disorder (HPD). Does this mean that there will no longer be such a thing as narcissists, histrionics, borderlines and antisocials? Hope springs eternal, but no. The APA (American Psychiatric Association) seems to be collapsing the existing 10 diagnoses into 5 diagnostic buckets, which means it will probably be even more difficult for the average Joe or Jane to figure out what is going on with their loved one/tormenter. Just because the current members of the DSM committee are doing away with a particular disorder in the Manual doesn’t mean it no longer exists. If only it were that easy! For example, there used to be a Passive-Aggressive Personality Disorder in the DSM-III, but it was removed from the DSM-IV because women’s groups felt it unfairly pathologized women. This doesn’t mean that these behaviors ceased to exist; it’s just that the APA terminated a specific cognitive-behavioral phenomenon and hid it in Personality Disorder Not Otherwise Specified due to political pressure. Another example is the APA’s failure to officially acknowledge Parental Alienation Syndrome (PAS) and Hostile Aggressive Parenting (HAP). Numerous studies have been done by credible researchers documenting and quantifying these behaviors. Individuals who have been the target of these pathological and malicious behaviors know full well how real they are. Yet, the APA won’t touch it with a 10-foot pole, probably because it would also assign pathology to a great many women. Never forget that both the American Psychiatric Association and the American Psychological Association are very political organizations and the DSM is in some ways a manifestation of political infighting, allegiances, prejudices, zeitgeist and feminism. Don’t even get me started on the blatant sexism and male bashing engaged in by Division 35 of the APA; the Society for the Psychology of Women. Apologies for my digression. What’s staying and what’s going. I visited the APA’s website to try to understand their rationale for reformulating the personality disorders, but it was the usual mental masturbation that is meaningful only to their planning committees and unfathomable to most practitioners and non-clinical individuals and professions. Currently, the DSM-IV-R recognizes 10 personality disorders plus Personality Disorder Not Otherwise Specified: Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder Antisocial Personality Disorder (ASPD) Borderline Personality Disorder (BPD) Histrionic Personality Disorder (HPD) Narcissistic Personality Disorder (NPD) Avoidant Personality Disorder Dependent Personality Disorder Obsessive-Compulsive Personality Disorder They plan to collapse these 10 into the following 5 buckets: Antisocial/Psychopathic Type Avoidant Type Borderline Type Obsessive-Compulsive Type Schizotypal Type The APA seems to be folding NPD and HPD into the Antisocial/Psychopathic Type; while the Borderline Type shares 2 of the 3 traits I view as being the most sociopathic with the Antisocial/Psychopathic Type: Antagonism: Aggression and Antagonism: Hostility. Aggression is defined as “being mean, cruel, or cold-hearted; verbally, relationally, or physically abusive; humiliating and demeaning of others; willingly and willfully engaging in acts of violence against persons and objects; active and open belligerence or vengefulness; using dominance and intimidation to control others.” Hostility is defined as “irritability, hot temperedness; being unfriendly, rude, surly, or nasty; responding angrily to minor slights and insults.” I am surprised that Antagonism: Callousness is not included in the Borderline Type, which is defined as “lack of empathy or concern for others’ feelings or problems; lack of guilt or remorse about the negative or harmful effects of one’s actions on others; exploitativeness.” Interestingly, I was lambasted a few months ago for stating on the old Shrink4Men WordPress blog that many narcissists, borderlines and histrionics exhibit sociopathic traits. A group of self-identified BPDs and their cohorts cyber-bullied and harassed me for several weeks as a result of what I viewed simply as a statement of the obvious. It would seem that the DSM committee agrees with my viewpoint, at least in this case. So, why is the DSM committee doing this and what does it mean? Starbuck’s Diagnostics: I’ll take a Non-Suicidal Ideation, Non-Substance Abuse and Non-Physical Violence, Half-Antisocial/Psychopathic—Half-Borderline Type with Entitlement, Rage, Meanness and Blame Latte to go, please. Here’s the rationale for reformulating the Cluster B personality disorders from the APA website: Considerable research has shown excessive co-occurrence among personality disorders diagnosed using the categorical system of the DSM (Oldham et al., 1992; Zimmerman et al., 2005). In fact, most patients diagnosed with personality disorders meet criteria for more than one. In addition, all of the personality disorder categories have arbitrary diagnostic thresholds, i.e., the number of criteria necessary for a diagnosis. PD diagnoses have been shown in longitudinal follow-along studies to be significantly less stable over time than their definition in DSM-IV implies (e.g., Grilo et al., 2004). The reduction in the number of types is expected to reduce co-morbid PD diagnoses, the use of a dimensional rating of types recognizes that personality psychopathology occurs on a continuua, and the replacement of behavioral PD criteria with traits is anticipated to result in greater diagnostic stability. I know, shrink-speak is needlessly difficult to understand, so let me break it down for those of you who aren’t fluent in academic, semi-scientific psychobabble. The DSM committee’s reformulation seems to be trying to address a problem many of the Shrink4Men community members and my coaching-consulting clients have raised repeatedly. Namely, that your wife, girlfriend, ex, husband’s ex, boyfriend’s ex, mother-in-law, sister-in-law, etc., seem to have traits from more than one disorder. This is why many practitioners/authors in this field, including myself, explain these disorders as lying on a continuum; different traits manifest under different conditions and in different settings. Not all narcissists behave the same; not all borderlines behave the same and many share diagnostic criteria from one or more disorders. Essentially, the DSM committee is taking a Starbuck’s approach to diagnosing personality disorders. For example, you take a base beverage like coffee or tea and you can order dozens of variations of it like a half-caff, non-fat, soy, chai, decaff, double espresso, cinnamon, mocha latte with extra sugar or no sugar or specific increments of sugar. Apparently, diagnosticians will now be able to do the same with PDs. New PD diagnoses might look something like this: Alexa seems to be a Borderline Type with extreme Aggression, Emotional Lability, Separation Insecurity and Hostility, mild Self-Harm and Impulsivity and very little Dissociation Proneness and Callousness. Monica seems to be a Sociopathic/Psychopathic Type with extreme Callousness, Hostility, Aggression and Maliciousness, moderate Deceitfulness and Narcissism and very little Recklessness and Impulsivity. I suspect that individuals who have traits from multiple types will continue to receive multiple diagnoses. Keep in mind, they haven’t finalized the DSM-V yet, so all of this may change. Therefore, the APA isn’t really getting rid of NPD and the other PDs, but rather trying to define them with more specificity by using descriptive traits that they can rate based on their presence/absence and degree of intensity. Hopefully, this will eventually make it easier to get an accurate diagnostic assessment of personality disordered individuals—that is if you can get them into treatment and if they they’re unable to pull the wool over a clinician’s eyes. Criticisms of Starbuck’s Diagnostics Two of the most strident critics of the proposed PD diagnostic system are esteemed Harvard psychiatrist, Dr John Gunderson, a leading researcher and practitioner in the field of personality disorders and University of Colorado Medical School psychologist, Dr Jonathan Shedler. The NYT article reports Dr Gunderson’s reaction to the changes: Asked what he thought about the elimination of narcissistic personality disorder, he said it showed how “unenlightened” the personality disorders committee is. “They have little appreciation for the damage they could be doing.” He said the diagnosis is important in terms of organizing and planning treatment. “It’s draconian,” he said of the decision, “and the first of its kind, I think, that half of a group of disorders are eliminated by committee.” Dr Gunderson’s primary complaint in NYT: The dimensional approach has the appeal of ordering à la carte — you get what you want, no more and no less. But it is precisely because of this narrow focus that it has never gained much traction with clinicians. It is one thing to call someone a neat and careful dresser. It is another to call that person a dandy, or a clotheshorse, or a boulevardier. Each of these terms has slightly different meanings and conjures up a type. And clinicians like types. The idea of replacing the prototypic diagnosis of narcissistic personality disorder with a dimensional diagnosis like “personality disorder with narcissistic and manipulative traits” just doesn’t cut it. Dr Jonathan Shedler states in the same NYT article: “Clinicians are accustomed to thinking in terms of syndromes, not deconstructed trait ratings. Researchers think in terms of variables, and there’s just a huge schism.” He said the committee was stacked “with a lot of academic researchers who really don’t do a lot of clinical work. We’re seeing yet another manifestation of what’s called in psychology the science-practice schism.” The bottom line. Oh look, more political infighting amongst and between both APA factions. Yawn. Only time will tell if this will be helpful or harmful. Although, at this stage it’s unclear whom this change will harm and/or help. If, like me, you’re of the mind that many PD individuals are treatment resistant, these changes don’t really matter. My primary concern is, always has been and always will be helping the targets who are abused by individuals with PDs—regardless of however the DSM decides to classify them. If the changes help non PD individuals protect themselves and their children in family court, for instance, that would be great. If it helps men and women avoid becoming involved with abusive PDs–super. However, this seems like more political-academic infighting and a new scheme to create diagnoses and treatment plans that Managed Care companies will reimburse. Whatever. http://www.shrink4men.com/2010/12/01/narcissistic-personality-disorder-and-histrionic-personality-disorder-to-be-eliminated-in-the-dsm-v-welcome-to-starbucks-diagnostics/