What Exactly is Inner Healing Intelligence

‘Inner healing intelligence’ is a term derived from Stan Grof that is frequently used in the context of MDMA- and psychedelic-assisted therapy. (The central idea behind the term certainly predates Grof, however.) The MAPS Manual for MDMA-Assisted Psychotherapy in the Treatment of Posttraumatic Stress Disorder (2015) – authored by Michael Mithoefer – places great importance on the concept. What’s more, it has been emphasised in clinical trials exploring MDMA therapy and psilocybin therapy.

But while many psychedelic clinicians, researchers, and advocates promote the idea of inner healing intelligence, other voices in the space have expressed doubts and criticisms regarding it. Some have called it ‘pseudoscientific’ and an article of faith. This could be problematic if the FDA approves psychedelic therapy manuals that refer to inner healing intelligence (which could easily happen since the FDA does not have expertise when it comes to therapy). Already, inner healing intelligence and similar terms have made their way into draft rules for Colorado’s Natural Medicine Act, which allows facilitators to supervise psychedelic sessions.

It’s important to delineate exactly what this concept refers to, the evidence for it (or lack thereof), and what benefits and risks may follow from relying on it in the treatment of mental health problems. This discussion is essential before manuals and guidelines become codified as laws and regulations.

The MAPS manual for MDMA therapy for PTSD uses some analogies to express the idea of an innate inner healing capacity, which has been dubbed an ‘intelligence’ of sorts:

“Seeds want to become a plant; it is the natural way”, and “A tree always grows toward the sun; it is the tree’s natural inclination.”

In MAPS-sponsored MDMA therapy trials, patients are told to trust that the inner healing intelligence will lead the way during periods of stuckness and difficulty during the psychedelic session. They are further encouraged to trust the ‘wisdom’ and ‘timing’ of this inner intelligence. Therapists must also respect this ‘intelligence’ that exists within the participant’s psyche and body.

Central to this concept is the belief that this intelligence, in conjunction with the drug, “bring[s] forth whatever experiences are needed for healing and growth, so anything that arises is viewed as part of the healing process,” as the MAPS manual states. Inner healing intelligence is considered

“much more reliable than anything you or we could figure out ahead of time with our rational minds.”

[V]arious paradigms of thought would articulate these concepts in different ways; some might reference Spirit, truth, unity, and there are many other terms that can and do carry similar meaning. I once heard a participant call it the “inner champion,” as she encountered what she experienced as its destructive counterpart, the inner critic. In this writing, I adopt the phrase “inner healing intelligence” and similar terms such as inner healer, deep knowing, innate wisdom. If you connect with the concept of an intrinsic ability to heal and grow oneself, I encourage you to consider any other name you like.

As Clare points out above, people who take psychedelics may refer to something like an ‘inner intelligence’ when they take MDMA or a psychedelic (although this can often be perceived as an outer healing presence, intelligence, spirit, or entity). One subject in a psilocybin therapy for depression clinical trial said, “It’s almost as if when you when you take the capsules, it’s like taking onboard your own psychotherapist.” So perhaps we could refer to inner healing intelligence as this sense of ‘becoming one’s own therapist’.

Beyond subjective accounts, we could also turn to conceptual frameworks that support the idea of inner healing intelligence. One example would be client-centred therapy. Client-centred (or person-centred) therapy, pioneered by Carl Rogers in the early 1940s, is grounded in the idea that people are intrinsically driven towards, and have the capacity for, self-healing, growth, and positive psycholoigcal functioning. Rogers referred to this as the ‘actualising tendency’. Because of this, the client, rather than the therapist, is believed to be the expert in their life and so they lead the general direction of therapy. The client-centred therapist is to take a non-directive approach – one that facilitates the expression of the client’s innate capacity to heal and grow. 

The concept may be one way, perhaps in a metaphorical sense, to encapsulate a Rogerian perspective on healing. It may not be that a person has a literal distinct ‘intelligence’ – like a wise homunculus or healing personality – that exists within them, waiting to be called into action. Moreover, inner healing intelligence may not refer to a specific intrinsic healing mechanism. Instead, it could stand for the Rogerian idea of a general innate ability to self-heal. Just as there are several mechanisms involved in the body healing itself after sickness or injury, so too could there be several psychological mechanisms that help people recover from trauma and distress.

The tendency to refer to inner healing intelligence in MDMA- and psychedelic-assisted therapy has led to the term’s adoption in state guidelines on legal psychedelic facilitation. In November 2022, Colorado voters approved the Natural Medicine Act (or Proposition 122), which legalises access to certain psychedelic plants or fungi for people 21 or older within a venue created for a psychedelic session supervised by a state-licensed facilitator. The Act also decriminalises personal use of natural psychedelics for those over the age of 21. Regulators will begin accepting applications for licensure by 30 September 2024.

The draft rules for this legislation, presented by the Department for Regulatory Agencies (DORA), include mentions of inner healing intelligence and similar terms. If approved, healing centres and psychedelic facilitators could be expected to follow this conceptual framework. (These draft rules will be subject to additional review, including stakeholder engagement and public comment, before becoming finalised. The first DORA stakeholder engagement meeting was held on 8 March.)

For example, in the required preparation sessions involving a facilitator and client, prior to dosing sessions, there should be “Discussion of the concept of trusting inner guidance, which may include discussion of topics such as Inner Healing Intelligence, Inner Genius, The Self, Wise Mind, Soul, or Spirit.” Some might criticise mentions of ‘soul’ and ‘spirit’ as going against the separation of church and state.

Yet perhaps the notion of an inner healing intelligence is legitimate and useful, so long as it is used in a metaphorical sense in psychotherapy (whether psychedelic-augmented or not).

One could argue that the MAPS treatment manual personifies inner healing intelligence as sentient, endowing it with personal attributes such as reliability, punctuality, helpfulness, and wisdom. (Much of the following information is derived from a preprint written by Sasha Sisko.) Mithoefer has acknowledged that although the inner healing intelligence may sound “a little New Agey or woo-woo” and “unscientific”, it is nonetheless “based on reality”.

On the Psychedelics Today podcast, the host Kyle Buller asked Mithoefer to define inner healing intelligence, and he conceded that the term ‘inner healer’ is “a little bit of an anthropomorphisation”, which isn’t “perfect”. He thinks ‘inner healing intelligence’ is better, but “people can get hung up on ‘what do you mean by intelligence?’” ‘Inner healing capacity’, he says, is therefore preferable. 

So while personifying this capacity may not be accurate or evidence-based, Mithoefer maintains that the psyche has the ability to heal itself, so long as obstacles are removed and favourable conditions for healing are created. He compares this to immunotherapy for cancer:

The idea [is] that we’re just stimulating and removing blocks to the person’s own capacity to heal this, so I think it’s very clear the same exists in the psyche.

However, we should bear in mind that clinical trial participants are given a suggestibility- and meaning-enhancing drug. In addition to these effects, ‘set’ (the expectations you have going into an altered state) can influence the outcome of the experience. Being primed to access your ‘inner healer’, alongside enhanced suggestibility and meaning, can all help to encourage a felt experience of an inner healing intelligence – a wise internal presence that is doing the healing.

So while an Iraq war veteran in a MAPS MDMA trial stated “It feels almost like the inner healer or the MDMA is like a maid doing spring cleaning,” we should be aware that such participants are prepared with concepts like inner healer. If trial participants and clients in facilitated sessions aren’t told about concepts like inner healing intelligence, then the sense of accessing an inner healer could become less common during sessions.

Devenot has referred to MAPS’ approach to MDMA therapy as “a form of faith-based healing”, due to therapists being told to ‘trust’ that difficult emotions are productive and emerge at the ‘best time’, according to the wisdom of the inner healer. Furthermore, she argues that while defining ‘inner healing intelligence’ as a person’s innate capacity to heal “sounds analogous to the body's ability to heal damaged tissue, the inner healing intelligence is a Grofian concept that attributes healing to “ordinarily hidden spiritual dimensions of existence””.

For critics, the psyche’s self-healing mechanism(s) has not been validated. The lack of an evidence base for it, therefore, would make belief in it an article of faith. And this would be a belief that trial subjects and clients in psychedelic therapy are asked to put their ‘trust’ (or faith) into. One MAPS MDMA therapy trial participant (‘Mel’), who experienced suicidality following her participation in the study, remarked [12:55] that treatment sessions involved several discussions about the

“body’s ability to heal itself”

A recent study published in the Journal of Psychopharmacology – authored by researchers at Imperial College London – is helping to make the concept of an inner healer a bit more evidence-based. This study involved creating and issuing a single subjective rating item – related to perceived ‘inner healing’ effects – to patients who received either a high dose of psilocybin (25 mg) or a placebo (1 mg of psilocybin). This was part of a double-blind randomised controlled trial of psilocybin for depression, comparing psychotherapy and psilocybin against psychotherapy and escitalopram (a commonly prescribed antidepressant). Those who received the placebo were in the escitalopram group.

The inner healer item rating reads as follows: “I felt like my body/mind/brain was healing itself, automatically/naturally/by itself.” This reflects the common way in which this intrinsic healing mechanism is framed in the psychedelic community: the mind’s ability to access and mobilise resources that facilitate healing, which are often dormant in normal circumstances.

The authors found that inner healer scores were higher after the high dose of psilocybin than the placebo dose. In addition, it was only in the high-dose group that inner healer scores predicted improvements in depression at two weeks post-session. The authors compared the inner healing process to the ‘hero’s journey’, as described by the mythologist Joseph Campbell. Tommaso Barba, one of the researchers involved, stated on Twitter:

This process could be akin to what's described in mythological terms as the 'hero's journey,' a narrative of struggle, crisis, and eventual renewal or rebirth. Psilocybin might catalyze this journey within the psyche, confronting and overcoming inner challenges.

On a brain level, this effect may be linked to an increase in entropy, essentially making the brain's activity more chaotic and less predictable. This entropy may help disrupt rigid, harmful patterns of thought and behavior associated with depression.

[T]he "inner healer" item was administered after the 1st dosing session, referring to that session only. Therefore, we don't know whether participants in the escitalopram arm had less "inner healer" experiences *in general*. We only know about the dosing session. So, the difference in "inner healer" ratings between the psilocybin and escitalopram arm might have been much smaller if the item had been administered with reference to, e.g., the whole treatment.

But is the experience of "inner healing" a unique feature of psychedelic therapy compared to other treatments? After all, the "inner healing" experience may just be a normal aspect of any successful psychotherapy, regardless of whether or not psychedelics are involved.

Wolff believes higher quality evidence for the role of the inner healer in psychedelic therapy compared to non-psychedelic treatments could be gathered by assessing “these experiences more broadly (not just dosing sessions) & with better tools (not single-item measures).” Nonetheless, he acknowledges that psychedelic-augmented treatments may still contribute to inner healer experiences – or ‘inner therapist’ experiences, as he calls them – in unique ways. And this is not so hard to imagine, given how unique the psychedelic experience is, in terms of visionary, somatic, emotional, cognitive, and spiritual aspects. The sheer intensity and novelty of these effects may, therefore, intensify and modify inner healing effects.

An article I co-wrote with Jules Evans for Ecstatic Integration includes arguments for and against the concept of an inner healer from psychedelic researchers and therapists. One of the concerns that stood out to me was how this idea could potentially be counterproductive – furthering distress, instead of healing. This might happen by trusting too much in this vague (and potentially unscientific) concept, leading therapists to disregard standard therapeutic protocols. Perhaps a serious adverse event would be ignored if it were deemed part of the ‘inner healing process’. Another potential risk is patients being gaslit, or being told by therapists that whatever they’re experiencing is the inner healer at work, even if it doesn’t feel like that to them.

Instructions to ‘trust the inner healer’ may, in some instances, help patients, but if the concept lacks clarity and nuance, there’s a risk it could be used against patients’ interests and well-being. This is not just something psychedelic therapists need to consider and be critical of. Considerations from bioethicists and people at the FDA matter too, as they will be involved in approving the MAPS protocol and similar guidelines for psychedelic therapy. It’s important not to let a concept, aimed at harm reduction, turn into a potential cause of harm.

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