Narcissistic personality disorder (NPD) is a controversial diagnosis. It came close to being eliminated from DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), and is not listed in ICD-11 (International Classification of Diseases). The threat to drop NPD created dismay among several researchers (Miller & Campbell, 2010; Miller et al., 2010b) and expert clinicians (Pies, 2011; Ronningstam, 2011). Even The New York Times (Zanor, 2010) weighed in, suggesting wryly that narcissists don’t like being ignored. Then, in June 2011, the DSM-5 work group reversed itself. This decision seems to have occurred because of feedback from influential clinicians that NPD is a useful construct that describes a characteristic group of patients seen in practice.