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- **Gravest?** In terms of suffering for patient and environment, yes — BPD and NPD can devastate relationships and self-image.  
- **Hopeless?** No. BPD in particular responds well to treatment — DBT and schema therapy have strong evidence. NPD is slower and harder, but there are therapeutic approaches too.  

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👉 **Takeaway:**  
- Cluster B personality disorders are **severe, complex, and slo...