They - like Lasch before them - attribute pathological narcissism to "a society that stresses individualism and self-gratification at expense of community, namely United States." They assert that disorder is more prevalent among certain professions with "star power" or respect. "In an individualistic culture, narcissist is 'God's gift to world'. In a collectivist society, narcissist is 'God's gift to collective'".

Millon quotes Warren and Caponi's "The Role of Culture in Development of Narcissistic Personality Disorders in America, Japan and Denmark":

"Individualistic narcissistic structures of self-regard (in individualistic societies) ... are rather self-contained and independent ... (In collectivist cultures) narcissistic configurations of we-self ... denote self-esteem derived from strong identification with reputation and honor of family, groups, and others in hierarchical relationships."

Having lived in last 20 years 12 countries in 4 continents - from impoverished to affluent, with individualistic and collectivist societies - I know that Millon and Davis are wrong. Theirs is, indeed, quintessential American point of view which lacks an intimate knowledge of other parts of world. Millon even wrongly claims that DSM's international equivalent, ICD, does not include narcissistic personality disorder (it does).

Pathological narcissism is a ubiquitous phenomenon because every human being - regardless of nature of his society and culture - develops healthy narcissism early in life. Healthy narcissism is rendered pathological by abuse - and abuse, alas, is a universal human behavior. By "abuse" we mean any refusal to acknowledge emerging boundaries of individual - smothering, doting, and excessive expectations - are as abusive as beating and incest.

There are malignant narcissists among subsistence farmers in Africa, nomads in Sinai desert, day laborers in east Europe, and intellectuals and socialites in Manhattan. Malignant narcissism is all-pervasive and independent of culture and society.

It is true, though, that WAY pathological narcissism manifests and is experienced is dependent on particulars of societies and cultures. In some cultures, it is encouraged, in others suppressed. In some societies it is channeled against minorities - in others it is tainted with paranoia. In collectivist societies, it may be projected onto collective, in individualistic societies, it is an individual's trait.

Yet, can families, organizations, ethnic groups, churches, and even whole nations be safely described as "narcissistic" or "pathologically self-absorbed"? Wouldn't such generalizations be a trifle racist and more than a trifle wrong? The answer is: it depends.

Human collectives - states, firms, households, institutions, political parties, cliques, bands - acquire a life and a character all their own. The longer association or affiliation of members, more cohesive and conformist inner dynamics of group, more persecutory or numerous its enemies, more intensive physical and emotional experiences of individuals it is comprised of, stronger bonds of locale, language, and history - more rigorous might an assertion of a common pathology be.

Drought often conspires with man-made disasters. Macedonia experienced its second worst dry spell during civil strife of last year. Benighted Afghanistan is having one now - replete with locusts. Rapid, unsustainable urbanization, desertification, exploding populations, and economic growth, especially of water-intensive industries, such as microprocessor fabs - all contribute to worst water crisis world has ever known.

Governments reacted late, hesitantly, and haltingly. Water conservation, desalination, water rights exchanges, water pacts, private-public partnerships, and privatization of utilities (e.g., in Argentina and UK) - may have been implemented too little, too late.

Rising incomes lead to exertion of political pressure on authorities by civic movements and NGO's to improve water quality and availability. But can authorities help? According to World Bank, close to $600 billion will be needed by 2010 just to augment existing reserves and to improve water grade levels.

The UNDP believes that half population in Africa will be subject to wrenching water shortages in 25 years. The environmental research institute, Worldwatch, quoted by BBC, recommends food imports as a way to economize on water.

It takes 1000 tons of water to produce 1 ton of grain and agriculture consumes almost 70 percent of world's water - though only less than 30 percent in OECD countries. It takes more than entire throughput of Nile to grow grain imported annually by Middle Eastern and North African countries alone. Some precipitation-poor countries even grow cotton and rice, both insatiable crops. By 2020, says World Water Council, we will be short 17 percent of water that would be needed to feed population.

The USA withdraws one fifth of its total resources annually - proportionately, one half of Belgium's drawdown. But according to OECD, Americans are most profligate consumers of fresh water, more than double OECD's average in 1990's. Britain and Denmark have actually reduced their utilization by 20 percent between 1980 and 1996 - probably due to sharp and ominous drops in their water tables.

Stratfor, a strategic forecasting firm, reported on May 14 that Mexico and USA are in throes of a conflict over Mexico's "failure to live up to its water supply commitments under a 1944 treaty", which allocates water from Colorado, Rio Concho, and Rio Grande among two signatories.

Mexico seems to have accumulated a daunting debt of 1.5 million acre-feet over last 8 years - result of a decade long drought. Each acre-foot is c. 1.2 million liters. Mexico's reservoirs are less than 25 percent full. Some of water, though, has been used to transform its borderland into a major producer of fresh vegetables for American market - at expense of Texas farmers.

Faced with worst drought in more than a century in some states, Bush administration has announced on May 3 that it is considering sanctions, including, perhaps suspension of water supplies from Colorado to Mexico. Texas lawmakers demanded to re-open NAFTA and amend it punitively.

Mexico is a typical case. Only 9 percent of its streams and rivers are fit for drinking. Its underground water is almost equally polluted. Its infrastructure is crumbling, leading to severe seepage of more than two fifths of water. Half of rest evaporates in open canals.

Moreover, water is under-priced, thus encouraging wasteful consumption, mainly by farmers. Stratfor cites an estimate published in May 5 issue Fort Worth Star-Telegram - more than $60 billion will be needed over next decade to refurbish Mexico's urban and rural networks.

William K. Reilly, former administrator of EPA, writing in "ITT Industries Guidebook to Global Water Issues", mentions human cost of water scarcity: a million dead children a year, a billion people without access to treated water, almost double this number without sanitation.

More than 11,000 people died in a cholera epidemic induced by polluted water in Latin America in 1990's. Every year, according to World Bank, amount of water polluted equals quantity of water consumed. In many parts of world, notably in Africa, people walk for hours to obtain their contaminated daily water rations.