Re: the DSM: LOL
I don't know about the bodybuilding. But my mother is narcissistic and having her children look well-cared for was part of her own image of herself as a perfect mother. She sewed us adorable outfits, took lots of photos, bought us toys and treats, kept us clean, fed, etc., etc. She did those things because you are supposed to, and also because despite her self-absorption, she had no reason not to, if that makes sense--she's not a monster, she does have decent values about how to raise children, I know that sounds like a contradiction. Believe me, I'm confused too! But she forgot to read the chapter on unconditional love, emotional support, etc.
I think for my mother, the effort to appear perfect overwhelmed her. She was a single mom. I bet if she could have been a SAHM (a wish she expressed to me--"I'm not a career girl", she said) things would have looked even better.
If you scratch the surface, you would find out that we were raised in complete squalor. A lot of energy was spent presenting the picture of the perfect family. But the pictures don't show Mom's complete inability to see us as separate people, the playing of favorites, the hyper criticism, the scapegoating, the rageaholism, not to mention the filthy living conditions, etc., etc.
She would never admit that the way were raised was at all harmful. My siblings and my problems she blames on others (or in my case, my own "poor character"). I don't know if it's because she truly believes she did nothing wrong, or she knows it was wrong but is unable to face it. First is scary, second is really sad.
Anyway, it looks like TH's kids had it far better than I did, but despite outward appearances, we don't know what sort of emotional climate TH created for her kids. Emotional abuse can be subtle and easily explained away. Again, I'm not a psychologist, just a survivor, I make no claim that conditions in the Horman home were at all like those in mine. JMHO, YMMV.