Broadening Your Mind to Include Others: The relationship between serotonergic psychedelic experiences and maladaptive narcissism

This survey study (n=414) found that feelings of awe (not ego dissolution) during psychedelic experiences were associated with increased feelings of connectedness and empathy. This was then associated with decreased levels of narcissism personality features.

Abstract

“Rationale Recent research has shown that classical serotonergic psychedelic (CSP) drugs may be used to ameliorate certain health issues and disorders. Here we hypothesised that CSP experiences, through their ability to induce awe and ego-dissolution, may result in a reduction of maladaptive narcissistic personality traits, such as a strong sense of entitlement and lack of empathy.

Objectives Our objective was to investigate whether high levels of awe and ego dissolution during recent CSP experiences are associated with currently lower levels of maladaptive narcissism.

Methods In this pre-registered high-powered (N = 414) study, we used an online retrospective survey asking participants to describe their ‘most awe-inspiring, impressive, significant, or emotionally intense experience’, as well as several validated scales to test our hypothesis.

Results A statistically significant mediation model indicated that recent CSP-induced experiences were associated with currently increased feelings of connectedness and affective empathetic drive, which in turn were associated with decreased exploitative-entitled narcissism. This relationship held even when taking into account sensation-seeking personality features. We found no evidence for feelings of ego dissolution to have the same effect.

Conclusions Feelings of awe, but not ego dissolution, during recent CSP experiences were associated with increased feelings of connectedness and empathy, which in turn were associated with decreased levels of maladaptive narcissism personality features. This suggests that CSPs hold therapeutic potential for disorders involving connectedness and empathy, such as the treatment of pathological narcissism, and that the induction of connectedness through awe appears to be the driving force behind this potential.“

Authors: Valerie van Mulukom, Ruairi E. Patterson & Michiel van Elk

Summary

We hypothesized that awe and ego-dissolution experienced during recent CSP experiences would reduce maladaptive narcissistic personality traits. A statistically significant mediation model indicated that awe experiences were associated with increased feelings of connectedness and affective empathetic drive, which in turn were associated with decreased exploitative-entitled narcissism.

Recent CSP experiences were associated with increased feelings of connectedness and empathy, and decreased levels of maladaptive narcissism personality features. This suggests that CSPs may have therapeutic potential for disorders involving connectedness and empathy.

Recently, several studies have suggested that certain drugs may be used effectively in mental health research and care, including psychedelic drugs. These studies have indicated that psychedelic drugs may also be useful for treating maladaptive narcissism through experiences of awe and ego dissolution.

Classic serotonergic psychedelics (CSPs) are a group of psychoactive drugs that have similar acute subjective effects, though the duration of these effects varies between different drugs.

Clinical research suggests that psychedelics can help alleviate psychological distress and different mental health problems, including anxiety and depression disorders. The effects of psychedelics are likely mediated by the extent to which participants have mystical-type and self-transcendent experiences during their CSP ‘trip’.

Both psychedelic and awe experiences are characterized by a reduced sense of the self, which is associated with a reduced activity of the Default Mode Network (DMN). The degree of ego dissolution experienced during a psychedelic ‘trip’ has been correlated with positive and lasting impacts on well-being.

The experience of ego-dissolution and reduced focus on the self, as induced by psychedelic drugs, may be antagonistic to high trait narcissism, since they foster humility, reduce self-focus and increase collective engagement, all of which are antagonistic to narcissism.

The American Psychiatric Association describes low empathy as one of three components of a pathological form of narcissism, and trait narcissism is also negatively correlated with empathy, in particular affective empathy. Narcissists tend to lack empathy but can nevertheless engage in empathy when instructed to take the perspective of others.

Trait narcissism is predictive of interpersonal problems such as pathological antagonism, narcissistic personality disorder, psychopathy, and externalising behaviours, but it is also positively correlated with some indicators of subjective well-being. The exploitativeness and entitlement narcissism facet of NPD is negatively correlated with subjective well-being.

Psychedelic experiences may be a promising avenue of research for psychiatric disorders involving low levels of trait empathy, such as psychopathy, as they are associated with increased self-rated altruistic/positive social effects and positive behaviour changes.

Classic serotonergic psychedelics (CSPs) have been shown to acutely increase levels of emotional empathy, but not cognitive empathy. A sense of connectedness has also been hypothesised as another therapeutic mechanism of action, and a lack of deep connections to others has been described as a core element of narcissism.

In light of this evidence, we hypothesized that a previous significant experience with CSPs would be inversely related to current maladaptive narcissism. We tested this hypothesis by looking at previous experiences of awe and ego-dissolution, which are associated with affective empathy and a sense of connectedness.

518 participants completed an online survey on the secure survey platform Qualtrics, of which 310 (74.9%) identified as male, 91 (22.0%) as female, and 13 (3.1%) as other. Of the CSP users, 179 had taken psilocybin, 129 LSD, 32 DMT, 21 Ayahuasca, 5 mescaline/peyote, and 2 5-MeO-.

We interviewed 251 participants who had taken DMT, mescaline/peyote, 2CP and 4-HO-MET, and also had taken a combination of CSPs, and another drug in addition to the CSP. Most participants were from the USA, UK, Canada, Germany and Australia.

Participants were recruited through online advertisements on psychedelics-related forums and social media.

The project was reviewed and approved through the University’s formal research ethics procedure. Participants were provided with a debrief that included information regarding sources of help relevant to the topics under study.

All participants wrote up their most awe-inspiring and significant experience of the past 5 years, and then indicated how long ago the experience took place, how spiritual and how religious the experience was, and which psychedelic drug the experience was of.

The Awe Experience Scale (AWE-S) is a 30-item measure of awe that consists of three subscales: self-diminishment, connectedness, and perceived vastness. The researchers used the self-diminishment, connectedness, and perceived vastness subscales together, and the connectedness and perceived vastness subscales separately.

The Ego-Dissolution Inventory (EDI) and Ego-Inflation measure are eight-item scales measuring the experience of a compromised sense of self, and are accompanied by a five-point Likert scale as per the Awe Experience scale.

A 20-item scale was developed to incorporate distinctions between drive and ability to engage in empathy, in addition to more classical distinctions between cognitive and affective empathy. The scale showed good overall internal consistency, Cronbach’s =.86, for the four subscales together.

We used the Inclusion of Other in the Self Scale (IOSS) to measure the currently experienced degree of connection felt to nature, humanity and the universe.

The NPI13 is a 13-item short-form of the NPI, which measures trait narcissism. It has three subscales: Entitlement-Exploitativeness (EE), Grandiose-Exhibitionist (GE), and Leadership-Authority (LA). Gentile et al. (2013) found the NPI13 to have adequate consistency overall and as regards its subscales, with the exception of the EE-subscale, which showed poorer consistency than in previous studies.

Eight-item short-form version of the 40-item Form V of the Sensation Seeking Scale was used as a control measure. Participants responded to the items using a five-point scale.

Demographics, spirituality and drug use questions were asked of participants, primarily for the purpose of measuring potential confounding variables. Participants were also asked how often they had taken CSPs in the past five years, and what typical dose they had taken.

The hypothesised model, hypotheses, methods, and analyses were pre-registered. The study was underpowered to compare CSP to non-CSP awe experiences, so only the analyses for the CSP group are reported below.

Figure 2 shows the correlations between narcissism subscales, AWE-S subscales, ego dissolution, ECQ subscales, and sensation seeking.

We examined the relationship between narcissism and empathy drive by plotting a correlational plot and using linear regressions. We found that affective empathy drive is the strongest predictor of both overall narcissism and the exploitative-entitled narcissism subscale.

We ran a regression model to predict exploitative-entitled narcissism by three measures of connectedness, and found that connectedness to nature and connectedness to humanity predicted lower levels of exploitative-entitled narcissism.

We found that sensation seeking was positively and significantly correlated with overall NPI and NPI GE, but not with NPI LA or NPI EE.

We found that NPI EE scores did not differ significantly between genders, but were significantly correlated with age and sensation-seeking. However, the effects of age and sensation-seeking on NPI EE partially cancelled out, so we retained sensation-seeking as a control variable for subsequent analyses.

We found no differences in the experience of awe or ego dissolution between CSP users taking different drugs.

We tested whether experiences of awe and ego dissolution during a CSP trip are associated with reduced levels of maladaptive narcissism through increased feelings of connectedness and affective empathetic drive. The results showed that there were two significant indirect effects.

We examined whether it mattered how long ago the CSP trip took place to predict affective empathetic drive and connectedness, and found that the moderation effect was not significant.

We checked whether the frequency of taking CSPs, or the size of a typical dose, influenced the effect of the awe experience on affective empathetic drive and connectedness. We found that the frequency of taking CSPs did not affect current levels of affective empathetic drive or connectedness.

We found that the connectedness subscale of the AWE-S was most strongly related to the positive effect of awe on affective empathetic drive and connectedness, and that the self-diminishment subscale of the AWE-S was also related to this effect.

This study investigated a hypothesised relationship between psychedelic use and maladaptive narcissism. It found that feelings of awe, but not ego dissolution, during recent CSP experiences were associated with increased feelings of connectedness and empathy, which in turn were associated with decreased levels of maladaptive narcissism.

In this study, awe was measured by two subscales of the Awe Experience Scale: connectedness and perceived vastness. AWE-S connectedness significantly predicted affective empathetic drive and connectedness to nature, humanity, and the universe, over AWE-S perceived vastness and AWE-S self-diminishment.

The level of AWE-S connectedness experienced during the CSP trip was significantly and positively correlated with perceived spirituality and religiousness of the trip. Moreover, connectedness to nature and humanity rather than connectedness to the universe predicted lower levels of exploitative-entitled narcissism.

The results suggest that connectedness rather than ego-dissolution predicts affective empathetic drive, and that awe may constitute the primary mechanism of action underlying psychedelic drugs’ therapeutic effects.

This study is a cross-sectional rather than longitudinal study, and relied on participants’ recall of their peak psychedelic experience. It found that a highly significant psychedelic experience can have enduring effects.

Since the publication of Griffiths et al.’s (2006) study, there has been a renaissance of experimental research on psychedelic drugs, accompanied by an increase in observational and epidemiological research interest. The current study showed that classic serotonergic psychedelic drugs can have lasting effects on narcissism.

Classic serotonergic psychedelic drugs may have positive effects on wide-ranging aspects of both mental health and personality, including feelings of connectedness and affective empathetic drive.