As a Ph.D in Experimental Psychology (not a clinical psychologist or a psychiatrist), my belief is that certain psychological disorders such as depression and anxiety should be treated with medication so that the individual has the stability to learn improvement to character.
The OP description of the personality disorders of sociopathy (no empathy) and (narcissism) are notoriously difficult to treat from a psychiatric intervention. Perhaps that why Haimy refers to them as best treated by spiritual growth–in this I think I must agree.