If you have been consuming the toxic affluence on YouTube by self-styled experts with and without academic degrees, you know by now that the cure for narcissistic personality disorder is mushrooms, fungi, psilocybin, or ketamine, or some either psychedelic such as LSD or Huxley.
Just pop a pill, consume a dried mushroom and you are on your way to complete unmitigated healing.
Today, I want to examine the question, psychedelics, hype, or a substantial hope for the future as a treatment modality, as kind of standalone medication, or in conjunction with talk therapy.
What do studies tell us?
What's the real science?
I want to disentangle for you what serious scholars, researchers, experimentalists and scientists say as opposed to nonsense and hype online, mainly online, but to my surprise not only online as you should see in a minute.
But before we go there, I will do something that self-styled experts on the internet rarely do, they rarely tell you what qualifies them to discuss narcissism.
For example, if they ever published an article about narcissism, if they ever participated in an international conference, are they known as narcissism experts among their own colleagues and peers?
So, in this case, what qualifies me to discuss?
I've been a professor of psychology for 11 years, I teach courses in neuroscience as well, I have a medical degree, but I am not practicing, and I am not licensed because I did not complete my internship.
However, I do serve as medical consultant and medical supervisor in various countries working with licensed and practicing physicians.
One of these countries is Russia, but the other.
So this is what I think I'm a bit more qualified than the majority of YouTubers who enthuse effusively about the benefits of a variety of natural remedies, whatever these may be.
Let's delve right in.
This whole, the idea for this video started when I was sent by someone in a comment, in a YouTube comment, what else, I was sent an excerpt from an article, I'm going to read it to you.
The findings of this study suggest that ayahuasca promotes well-being, no less, and self-compassion, which could have a therapeutic effect on individuals with negative affect and other psychopathological conditions.
This is the kind of detrimental, deleterious and nonsensical hype that permeates even scholarly literature because scientists are looking for grant money. They have an incentive to exaggerate, and I'm being charitable, to exaggerate the outcomes of their experiments and to make utterly unsubstantiated claims.
No single drug, no single treatment modality, no single intervention can reverse psychological conditions because psychological conditions, let alone personality disorders, are usually very, very complex entities.
Psychological conditions involve simultaneously emotions, cognitions, beliefs, personal history, environment, upbringing, early childhood trauma or lack thereof, etc.
You can't just swallow a mushroom and sweep all this away, it's nonsense.
This is especially true when it comes to personality disorders, which are in the language of the Diagnostic and Statistical Manual, all pervasive conditions, conditions that affect all areas of functioning, all areas of thinking, all dimensions of emotions and moods, etc.
Personality disorders have to do with cognitive distortions, with problems in self-regulation, with emotional disruption, with post-traumatic conditions.
You can see how nonsensical the claim is that ayahuasca or, I don't know, ketamine or psilocybin can reverse all this on a dime, even prolonged consumption, a regime of these substances is bound to have an effect which is A, temporary, reversible after the consumption stops or after the effect wears off and number two is not fundamental.
So yes, we have psychedelics which enhance empathy, for example.
Alcohol enhances empathy, believe it or not, but towards strangers. It reduces empathy towards loved ones and enhances empathy towards strangers.
Similarly, other substances, they do induce change in, for example, self-compassion, in the level of self-destructiveness and so on, but again, these changes are passing, transient and only one element of hundreds, one element of hundreds is affected by the substance.
Every psychological condition I know of is composed of hundreds of elements and every substance I know of affects at a maximum two or three of these hundreds of elements.
That's not healing, that's not cure, that's nothing.
That is mild transitory behavior modification at best, a change in internal belief system and shortly we will see that even these claims, even these claims are highly dubious.
The article I quoted from was authored by Dominguez Clavet and others and it's titled Hayawaska May Help to Improve Self-Compassion and Self-Criticism Capacities, Human Psychopharmacology published in Human Psychopharmacology, Clinical and Experimental, volume 37.
Before I go any further, I want to clarify.
The narcissist mood swings, the narcissist obsessive compulsive behaviors are reactive. They are triggered by fluctuations in narcissistic supply and I encourage you to watch the video I've made titled the narcissist three depressions.
They are not the outcomes, these moods are not the outcomes of brain biochemistry, neurochemistry. They are not the outcomes of blood sugar levels, they are not the outcomes of brain injury.
Similarly, a lack of empathy in the narcissist is structural, is constitutional.
Of course you can induce enhanced empathy for one hour or one day and of course if you consume empathy enhancing substances on a regular basis, you will have more prolonged periods of enhanced empathy.
But there are two problems with that.
These substances are mind altering, they are hallucinogenic and the second problem is the empathy is not actionable.
In other words, there is an increase in empathy but very few changes in behavior.
So the behaviors of the narcissist, the choices he makes, his decisions, his cognitions, his emotions do not reflect fully the alleged or ostensible increase in empathy.
So how do we know that empathy is increased?
Because we test the tests that measure empathy and they score higher on these tests when they are under the influence for example of ayahuasca and psilocybin.
So what does science say about this?
Forget YouTubers, forget self-styled experts, forget hypesters, forget con artists and snake oil salesmen, forget Canadian online pharmacies, forget all this BS.
What does science have to say, the only arbiter when it comes to psychopharmacology, when it comes to substances that change your psychological condition, alter your mind and have an effect on your brain, what does science have to say?
The latest discoveries have to do with a mushroom and the drug derived from that mushroom known as psilocybin and it's been linked with the reduction in depression, especially major depression.
In other words, if you have major depression and you consume psilocybin, your depression goes down, actually it goes away and the effects seem to be protracted.
In other words, the effects seem to be long term but subject to continuous consumption of psilocybin.
Psilocybin has hallucinogenic effects, it alters the mind, it's like being on a tree, it's not very far from LSD and mescaline.
And so there's a lot of hope in psilocybin when it comes to depression by the way and there's a lot of hype with psilocybin and a tendency to ignore the pernicious and nefarious effects of psilocybin on the brain.
The longer you consume, the more you have after trips and bad trips, exactly like LSD.
So psilocybin and depression are one element in a growing tendency to medicalize psychological conditions, to consider psychological conditions as merely brain conditions.
We call this approach in philosophy reductionism.
We reduce the psychology, which is fuzzy, which is immeasurable, which is out there in the cloud, we reduce it to its biological components.
We say depression is just biochemistry in the brain, gun or eye or psychopaths have disturbances or abnormalities in the functioning of some areas of the brain.
So we reduce psychological conditions and this is known as medicalization.
Addictions, anxiety, post-traumatic stress disorder are now being heavily medicalised. We have anxiolytics, we have antidepressants, these are classes of drugs intended to treat these conditions as if they were nothing but a bodily biological manifestation.
Similarly, the study of psychedelics in this context is geared towards providing a magic bullet, a magic pill or an enchanted mushroom that once you consume, takes away your fear, your fears, your anxieties, your sadness, your depression, your lack of empathy, etc.
There is big research into using even illegal drugs such as LSD or ketamine and of course the herbal mix known as ayahuasca, which is used by indigenous communities in South America.
Okay, so these are the contours of the terrain.
Doctors are looking for new approaches because talk therapy is highly ineffective and even existing medication has a plethora of problems, numerous side effects, many antidepressants are not effective, that's why people go from one antidepressant to another.
Antibiotics destroy the brain literally and so the classes of psychopharmacological substances we have now are not good, they're not good in the sense that they provide partial solutions at an enormous cost.
So researchers are trying to find new substances, it's exactly like the race in antibiotics where researchers are trying to find new antibiotics or new vaccines and so this is a race to find new psychotropic, new mind-altering substances and some of these substances compete head-on with established psychopharmacology.
For example, some of these substances, I mentioned psilocybin, compete with antidepressants but as we said antidepressants which are now offered for everything, if you have OCD, obsessive compulsive disorder, if you have anxiety, if you have depression, they're going to give you antidepressants.
There's another class, stimulants, Adderall for example, also given amphetamines and metamphetamines also given very widely but all these cause severe bodily and mental problems, anything from weight gain and a loss of sex drive, loss of libido to hallucinations, detachment from reality, impaired reality testing, paranoia, depression leading up to suicide.
Talk therapy is also very limited, it takes a lot of time and the outcomes are very very disappointing and most people can't even access talk therapy because the waiting lists are high and the prices are sky high.
So psychedelics look like a perfect storm, perfect solution to this perfect storm.
Like psychedelics are natural, people like natural things, they don't understand that everything is natural, even things manufactured in a laboratory are natural, the distinction between natural and artificial is marketing hype and most natural substances are processed in laboratories and non-natural synthesized substances are added, so it's total nonsense.
Anyhow people like natural, psychedelics are natural, most of them, not all of them, most of them, LSD for example isn't, but most psychedelics are natural, that's an advantage.
Second thing is psychedelics are like a magic solution in the sense that they're easy to consume and they have immediate effects and the effects are huge, they can reverse depression and move you into the territory of elation, can make you happy in other words, egosyntonic, they can make you very friendly, very compassionate towards others and yourself, more empathic etc etc, so psychedelics seem to have multiple effects while typical psychopharmacological drugs usually have a single effect.
Psychedelics are beginning to look like the pharmacopoeia of the future, like the future panacea, a solution for all our problems.
One issue is that most of them are illegal, as Mavichwana used to be, but I think that's not a serious issue, should medical benefits be proven I think most of these drugs would be legalized, indeed many many scientists say that these drugs, these substances I'm sorry should be investigated because they have an enormous price and very very serious scientists are saying this, so I'm not underestimating the potential of psychedelics, what I'm against is the hype, the claims that are unsubstantiated, deceiving and misleading people into assumptions and beliefs that are not supported by evidence, this is not evidence- based, for example the claim that psychedelics can reset your brain, reboot it, start it from zero, which is where most people are anyhow.
I couldn't help the dis, okay there have been claims even in scholarly literature, I've seen them with my own eyes, that if you take one dose or two at most, you know, you're going to cure long-standing mental health conditions because these doses are going to reset your brains.
I have seen claims that if you take one or two doses of ayahuasca or ketamine or other drug substances which I'll discuss in a minute, you'll get rid of your narcissistic personality disorder.
Because they're going to wipe the slate clean, they're going to restart your brain from zero, I can't begin to tell you how counterfactual, nonsensical and criminally irresponsible these claims are, they are based on very early tiny studies, sometimes with seven people and none of these studies, not one of them, had a control group who took a placebo, sugar pills, you know, each experiment in science or at least in the social sciences like psychology and psychopharmacology, each experiment requires, and in medicine of course, clinical trials require a placebo group, a group that is deceived into believing that they're receiving the real medicine when they're not or a group which receives a pill and they don't know if it's real or not.
So we have a group that is receiving the new medication and a control group, a group for comparison which are receiving sugar pills and they believe that they're receiving the real medication.
We want to see what percentage of the change in physiology, in psychology, what percentage of change is attributable to the medicine itself and what percentage is attributable to auto suggestion, to self suggestion, to people's minds altering their bodies.
So if you're taking a sugar pill and you have the same effects, you display the same outcomes as someone who is taking the medication.
The medication is worthless, is useless, it's not the medication, it's your mind that is playing tricks on you.
And this is called the control group, none of the studies, not one of the studies in many many psychedelic papers published, not one of them had a placebo group, not one of them had a control group.
This is shocking malpractice and these studies are worthless, absolutely worthless, they are not medical evidence.
And I couldn't come up with a, although I did a very thorough search of the literature, I couldn't come with a single well-designed experiment with many people, representative sample, control group, placebo versus the real thing, etc. I couldn't come with one, ketamine is very much discussed, I would say it's more discussed than ayahuasca and it is used nowadays even in mainstream settings, it's technically illegal but medical doctors and others, psychiatrists, they're using ketamine, ketamine is used as an aesthetic in any case and in parties, in parties it's given as a drug that has an intense dissociative effect.
But then people started to report that ketamine has alleviated the depression, that it had eliminated their suicidal ideation, ketamine seemed to have reversed processes which were thought to be largely untreatable, for example suicidal ideation in borderline, borderline personality disorder.
So consuming a ketamine dose, even one, elevated the mood, actually changed the mood from depression to normal or from depression to elation euphoria, mimicking a bit bipolar disorder and definitely ketamine eliminated, removed all suicidal ideation.
There'sideation, there's a form of ketamine, it's known as esketamine and esketamine is licensed actually as an antidepressant both in the United States and in the European Union, strangely in the United Kingdom the National Institute for Health and Care Excellence might refuse to recommend it for use, so I think in the UK it's illegal.
The problem with ketamine and esketamine is that the evidence is purely anecdotal, purely anecdotal and when we test, I mean people coming forth and saying I was at a party, I went to the party because I was depressed and I was even thinking of suicide, then I took ketamine and now I'm free as a bird, I'm happy go lucky, I'm happy as a lark, so we have many such stories, so the anecdotal evidence accumulated to the point that practitioners said well we've nothing to lose, let's try to dispense ketamine and see what happens, so in various settings like mental health institutions, inpatient institutions and so on, ketamine is now prescribed as antidepressant for people who have uncontrollable suicidal thinking and are planning or have tried suicide, but esketamine was possibly the only psychedelic drug that had been subjected to large placebo controlled trials, I said before that the others were never subjected to rigorous evidence-based testing, they were not good studies, good experiments, good tests, clinical trials with populations and cohorts that could tell us anything meaningful about these.
But ketamine, especially esketamine of the exception, esketamine had been subjected to multiple placebo controlled trials, trials where there was a group consuming ketamine and another group consuming placebo, that other group is known as control group and the results were very very disappointing, in these rigorous controlled studies ketamine had almost no effect, esketamine to be precise, had almost no effect, depression symptoms improved but glacially and imperceptibly and there was no difference whatsoever between ketamine and any other antidepressant, Prozac for example, SSRIs, MAOs, whatever, there was no benefit to ketamine over sugar pills, when people were given sugar pills and told that it's ketamine, their depression alleviated and they lost their suicidal thoughts, so it's not the ketamine, it's the reputation of ketamine that has this effect, we ran a similar experiment, we are mean psychologists, we ran a similar experiment with alcohol, we gave people alcohol-scented water and we told them it's very very strong alcohol, they all got drunk and many of them went into blackout on water, pure water, there's no hint of alcohol in the water but it smelled like vodka and we told them that it's a very strong type of homemade vodka or homemade something and they consumed this brew and they became intoxicated on water, it's the same with ketamine, people have heard that ketamine alleviates depression and reduces suicidal thinking, so when they are given ketamine it happens, these effects happen but these effects happen because of the reputation of ketamine, as ketamine and ketamine don't seem to have any inherent intrinsic properties, biochemical properties that affect depression or suicidal thoughts or at the most some studies suggest ketamine is comparable to mild antidepressants such as prozac.
So here's an example of the only psychedelic drug to have been tested rigorously and to have essentially failed in demonstrating any added benefits while at the same time altering the mind in dangerous ways, so psychedelics may do more damage than good, on the scales of good effects versus bad effects, psychedelics offer very little in terms of good effects or very little that other medicines cannot offer and at the same time they screw up your mind, they induce hallucinations, they impair your reality testing, they affect your executive functions, you can make very seriously bad decisions when you are under the influence, for example, of LSD, they have after effects such as bad trips in LSD and so on so forth.
We need to weigh these, there needs to be a balance between benefits and these costs.
Some psychiatrists in the United Kingdom even went as far as stating that ketamine can cause people to become addicted and to require increasing doses to attain the same effect, this is known as tolerance.
So these pretty eminent psychiatrists in the United Kingdom, what they're saying is that psychedelics can and do become addictive, the body does develop tolerance and so you need to take more and more and because they alter the mind in very dangerous ways you're taking enormous risks with these substances.
I want to make clear that, I tried, I looked everywhere, believe it or not, there are no large clinical trials with a control group available even for the most hyped substances such as psilocybin and ayahuasca.
There was a study, it was a brain scan, they scanned the brains of people consuming psilocybin and the researchers who had conducted this study with fMRI, functional magnetic resonance imaging, they said that the study demonstrated that the drug makes different parts of the brain work more in synchrony with each other which they said explains why it helps people with depression or stuck in a rut so to speak or locked into negative thought patterns also known as hands, automatic negative thoughts, hopelessness.
So what the study, this almost solitary study had shown by the way on a very small population, what it had shown is a psilocybin kind of synchronizes various parts of the brain and gets the brain to work in harmony which naturally would tend to reduce depression and negative thinking.
But then even with this study there are serious doubts bordering on accusations.
Recently there has been suspicion that many of these results were actually falsified. It's not proven yet and the researchers are out in the clear, I want to make it, absolutely.
But the allegations of false results, not that the results have been falsified by the researchers, the results have been falsified by the procedure, by the protocol.
In other words, these brain scanning studies, the way they were designed, they're likely to produce false results.
So it's not that the researchers falsified the results but they've designed the studies in ways that produce specific results or liable to produce specific results and I leave it up to you to decide whether this has been intentional or incident.
David Knapp, for example, of Imperial College in London, is a famous researcher and he said that studies looking for brain perturbations produced by powerful drugs are more reliable.
Be that as it may, there's a dearth, there's not enough information out there. Psilocybin may turn out to be a wonder drug for depression. The signs are hopeful actually and of course I'm not against any substance which can ameliorate anxiety and reduce depression.
Everyone, myself included, is hoping for such an added weapon to the arsenal but at this stage no one can make this claim because there has been no effect demonstrated in a large placebo controlled trial and anyone who is making this claim right now is scamming you.
I'm looking for another word, I'm trying to be diplomatic but I'm sorry, whoever is making such a claim, whoever is making any claim right now on any psychedelic drug, any psychedelic substance, mushroom, fungi, LSD, synthetic drugs, ketamine, anyone who is making any claim whatsoever about these substances is misleading you knowingly and there's a name for misleading someone knowingly. I leave the lawyers to attend to it.
What about narcissism? Can pathological narcissism be cured or induced by substance abuse or biochemical balances in the brain or in the blood?
I repeat what I said at the beginning. Start with moods.
The narcissist's moods change abruptly in the wake of narcissistic injury, narcissistic mortification or deficiency in narcissistic supply. Of course his moods affect his behaviors and in his case the moods are coupled with decompensation exactly like the borderline.
In the case of the narcissist it could be of course a woman or a man. In the case of the narcissist the mood liability is strongly coupled and leads to the compensation or collapse of all the defensive structures, the defense mechanisms and later on misbehavior.
But all these are reactive to the environment. They are not internal processes. Of course there's a reaction in the brain when the narcissist doesn't have enough supply or when he is narcissistically injured or mortified. Of course his brain does the reacting but the trigger is out there, is not internal.
One can easily manipulate the moods of a narcissist by making a disparaging remark or disagreeing with him, by criticizing him, by doubting his grandiosity or fantastic claims or by not watching his videos.
And so such reactive mood shifts, such reactive mood liability, this is not provoked by the fluctuations in body chemistry or brain chemistry. It's not induced by blood sugar levels or serotonin and dopamine in the brain. It's not the outcome of any presence or absence of any substance or chemical in the brain, in the gut or anywhere else.
It is possible to reduce the narcissist to a state of rage and depression at any moment. At any moment regardless of what's happening inside his body, simply by employing the above techniques, ignoring him, criticizing him and so on and so on, immediately he goes into a funk.
The narcissist can be elated, even manic and in a split second, following the narcissistic injury, real or perceived, real or imagined, he suddenly becomes depressed, sulking or even raging.
The opposite is also true. The narcissist can be catapulted from the bleakest despair to utter mania or at least to an increased and marked feeling of well-being, provide the narcissist with the flimsiest narcissistic supply, attention of some kind, he sees souls from the depths and abyss of depression to the peaks of elation.
And these swings are totally correlated to external events, narcissistic injury, narcissistic supply. They are not correlated to any cycles of hormones which take much longer. Enzymes, neurotransmitters, sugar, I don't know what, they're not correlated to any bodily function or process because these are usually, they take longer.
It is conceivable though that the third unrelated problem causes chemical imbalances in the brain, metabolic diseases such as diabetes, pathological narcissism and other mental health syndromes simultaneously.
We don't know yet. There may be a common cause, a hidden common denominator, perhaps a group of genes which are suddenly triggered and expressed. I don't know and we don't know.
Certain medical conditions we know can activate the narcissistic defense mechanism. Chronic ailments are likely to lead to the emergence of narcissistic traits or narcissistic personality style. Traumas such as brain injuries have been known to induce states of mind akin to full blown personality disorders. Such narcissism though and I'm saying quote unquote narcissism is reversible. It's reactive narcissism, it's transient narcissism. And so it doesn't qualify as the full fledged disorder in any way, shape or form. That's why we call it narcissistic defenses. It tends to be ameliorated or to disappear altogether when the underlying medical problem goes away.
There are disorders like bipolar disorder, manic depressions that used to be called. These disorders are characterized by mood swings that are not brought about by external events. The mood, the mood ability in bipolar disorder, in this cycling of the bipolar patient is endogenous, comes from the inside. It's not exogenous like with the narcissist.
But the narcissist's mood swings are strictly the results of external events as he perceives and interprets them, of course, because he has cognitive distortion.
Narcissists also are absolutely insulated from their positive emotions. They're emotionally fledged or numb when it comes to positive emotions.
The narcissist doesn't have pendular cyclical mood swings on a regular, almost predictable basis from depression to euphoria to mania.
We know that in biochemically induced mental disorders, depression included, bipolar included, numbers, even borderline personality disorder to a large extent. We know that this is not the case.
There's some kind of cycle. The cycle takes time and it's pretty predictable.
In narcissism it's not predictable, it's short and it's reactive.
In the borderline also there's a reaction to, for example, perceived or real abandonment and rejection.
But there are also cycles in the borderline personality disorder which are independent of external triggers and that reflects the abnormality of the brains of borderlines and psychopaths, possibly one in the same diagnosis.
The narcissist also goes through megacycles which last months or even years.
Of course you cannot attribute such megacycles to blood sugar levels, I don't know, or to dopamine and serotonin secretions in the brain or in the gut.
A narcissistic personality disorder per se is not treated with medication for this reason, exactly.
There are issues that can be treated, for example, empathy, lack of empathy. We know, as I've said before, that psychedelics, some psychedelics enhance empathy, but again it's a transient effect and it's not worth the risk of the mind altering hallucinogenic cause of psychedelics.
The underlying disorder is treated by a long term psychodynamic or cognitive behavior therapy, or cold therapy, which is my treatment modality.
Narcissistic personality disorder is also usually comorbid with other personality disorders. So these other personality disorders are treated separately and according to their own characteristics.
Phenomena which are often associated with narcissistic personality disorders such as depression or obsessive compulsive disorder, these can be and are treated with medication.
There is accumulating evidence that antidepressants, SSRIs such as Prozac, fluoxetine, they may have adverse effects on the primary disorder which is narcissistic personality disorder.
Sometimes they lead to what is known as serotonin syndrome which includes agitation and exacerbates the rage attacks typical of the narcissist.
So narcissists who are on antidepressants sometimes become worse, actually. They're much more prone to aggression and externalize it the way psychopaths do.
We also know that alcoholics who consume antidepressants simultaneously, their behavior changes. For example, they become much more promiscuous.
The use of SSRIs selective serotonin inhibitors, reuptake inhibitors, the use of SSRIs is associated with delirium with the emergence of a manic phase. Even with psychotic micro episodes, all these drugs have associated cause psychedelics or not. Heterocyclics, MAO and mood stabilizers such as lithium are less problematic. Blockers and inhibitors are regularly applied without discernible adverse side effects as far as narcissistic personality is concerned.
Additionally, cognitive behavioral therapies are often used to treat OCD and depression in conjunction with the medication.
So it's very difficult to tell apart the effects of the medication from the effects of the talk therapy.
Not enough is known is all I'm trying to say in this video. We don't know enough. We don't even know enough about classes of medication that had been in existence for 60 years or even a hundred years, such as lithium. We don't know enough. We definitely have no clue what's going on with psychedelics. There's been no clinical trials. But we don't know a thing.
We are at the very, very inception of the initial phases of hesitantly experimenting with tiny groups of people in very restricted settings.
Regrettably, scientists and scholars who are after the limelight, they may be narcissistic or they want money, grant money. They go out there into the mass media and they exaggerate the outcomes of these very limited excursions into scientific territory.
And this is criminal. What they're doing is absolutely criminal because they're creating false hopes and misleading the entire scientific community and all laymen in its wake. That's unconscionable, this kind of claims.
When it comes to narcissistic personality disorder, not enough is known about the biochemistry of the brain of a narcissist. We haven't found any major structural abnormalities or electrochemical abnormalities as we did with psychopaths and borderlines. The brains of psychopaths and borderlines are absolutely different to normal brains. We couldn't find this with narcissists.
There seems to be some vague link to serotonin, but no one knows for sure what it is and how strong it is. There isn't a reliable non-intrusive method to measure brain and central nervous system serotonin anyhow. So it's mostly guesswork at this stage.
So for now, the typical and recommended treatment for pathological narcissism, comorbid depression, OCD, is talk therapy. That's it. Not psychedelics, not psychotropics, not any other kind of medication.
OCD and depression can be treated with antidepressants. These antidepressants can be used moderately. I would avoid SSRIs with narcissists, but MAOIs and others can be used pretty safely and effectively.
But that's it. That's where it stops.
So next time you see a video online extolling the amazing effects of ayahuasca and how it can cure all your psychological problems with one or two dried leaf and dried mushrooms, or brew or peel. Forget it. These are nonsensical claims that cross the boundary into court artistry, crooked territory. Whoever makes these claims is a crook and a swindler and after your money, because there is no scientific body of evidence to support any of this, not even with ketamine and esketamine, which are the most studied drugs. Hold your horses. Sit back. Let scientists do their work as science does. And when the evidence comes forth, let us all hope, myself included, that such wild, fantastic, exaggerated claims will be proven right, at least partly.
I do believe that psychedelics can be used to treat depression. I think that's it. I don't believe they can do anything else except screw up your mind for good and induce in you hallucinations while you consume them and later.
So if you're depressed, if you have suicidal ideation, there is hope in psychedelics.
I think a huge caveat, huge disclaimer.
There may be hope in psychedelics in about 20 years time. Otherwise, my advice, stay away.
And if you like hallucinogenics as a party drug, go for it. Have fun.
But to consume these substances for self-treatment of psychological disorders is not merited. And in all probability would be far more damaging than any psychological condition you may have.
You have been warned. You've heard it here first.