It seems to me like the tool you want to use is to give him other drugs and interventions and physical interventions on his brain.
I would likely mix somatic interventions like Feldenkrais that give him perception of his body so that he has something that grounds him in relation to his hallucinations with mental self-identity finding (Transform Your Self by Steve Andreas).
But I haven’t worked with a person with a similar mental health background as your brother (this is not medical advice).
Thank you for these pointers. I had not heard of the Feldenkrais Method, and I definitely feel like integrating intentional physical movement and breathing would be necessary to becoming aware of the somatic context within which mental self-identification emerges...when reflecting on my own habits with respect to this, I am realizing how critical my own habit of going running is, to my ability to function...
I was reading Nassim Taleb recently, and the idea of biophysical fitness (or fitness in general) seems to me to relate to this idea of”becoming anti-fragile”. I think, when faced with health issues or the potential for health issues, mainstream epistemic narratives imply that we should seek to create predictive models that focus on antecedents of said health issues, with the teleology being that ‘knowing the etiology’ could help one to reverse or avoid the initial events that lead to harm. Taleb’s view on this (from what I may understand) is that this idea of etiology is not necessarily something that is comprehensible given the way that non-linear dynamic systems function. According to him, rather than focusing on factors that one cannot predict, it is more useful to engage in actions that increase resilience/fitness so that if unpredictable exposures that are potentially harmful, do interact with some entity, the impact on that entity does not reach a tipping point where it functions such that net, chronic harm, is emergent. See the section titled “148 The Central Idea: the conflation of event and exposure, or difference between f(x) and x” for a mathematical framing of this idea
Breathing has it’s positive effects on some issues, but it doesn’t build general perceptive awareness. Part of what makes breathing a tool to deal with an emotion like fear is that it’s harder to feel the fear and the breathing at the same time.
To build general perceptive awareness slow movement that’s exploritive in nature instead of focused on having to express a fixed form, seems to me the way to build it. There are a variety of methologies that do this and somatics is a term coined by Thomas Hanna for them.
There are claims in Korzybski’s Science and Sanity (the book that coinend the map is not the territory) that schizopheria is due to dealing to much with abstraction instead of base reality and that conflicts of abstractions are partly the cause of the problems.
Steve Andreas makes a more specific claim that schizophrenia often comes with schizopherics having a self identity of not having quality X, Y and Z instead of positively having specific qualities.
Those neurolinguistic approaches don’t have peer reviewed evidence to back them up as they aren’t studied by academics but they have a community of practice behind them.
This kind of work is also likely benefitial to becoming less fragile in Taleb’s sense.
One word of caution: If you help someone to feel their emotions better, they can have an increased sense of agency in a state where they also feel strong negative emotions. So it’s good when they have a stable enviroment around them.
From a more Talebian perspective I wouldn’t expect modafinil and MDMA to increase resilience.