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Intrapreneurial Leadership: Innovating from Within, Failing Up, and Letting go

By Lori Knutson RN, HNB-BC

Building and leading an integrative health and medicine program within a system requires an intrapreneurial spirit.  An intrapreneur is “a person within a large corporation who takes direct responsibility for turning an idea into a profitable finished product through assertive risk-taking and innovation.”  But unlike an entrepreneur, an intrapreneur doesn’t own the product or service; the system or organization owns the creative ideas and end products produced by the individual(s).  So why do it?  Well, because you “can’t not do it.”    It’s the “calling.”

For the intrapreneur, complexity of a system with its multiple layers, matrix reporting, cultural norms, and dynamic energy is actually what stimulates their creative juices.  Climbing the organizational ladder is not the path an intrapreneuer is interested in.   They are drawn not by strategic plans but by an inner drive for transformation and broadband effects.  Typically, they see between the lines, in the white space of an organization.  This is where their creative potential lies.

Otto Scharmer, creator of the Theory U, talks about “presencing,” an act of simultaneously be fully present and sensing.  This sensing is a finely tuned intuition.  In fact, the most successful intrapreneurs have a heightened sense of intuition and through this adept skill they are able to form pathways within the organization, like a scout in the jungle, that allow them to carve new ways for “doing” within systems.   Often times they accomplish more with less energy because they are not fighting a system; they are expanding a system, stretching its membranes to create flow.

The essence of integrative health and medicine is to be an integral part of the whole.  True integration creates change, and if enough, leads to transformation.  Those of us in the field of integrative health and medicine speak to the day that we no longer use the term “integrative” because although organic and over time, the transformation will be profound enough that health and medicine will be whole.  However, this will require a delegation of intrapreneurs who have the spark, courage, energy and presencing to lead this future through the matrix of our current systems.  So the question is, can a person learn how to generate the spark and obtain the necessary skills and talents to be a successful intrapreneur?  I think the answer is yes.  And I believe this development will come more by way of an apprenticeship than an academic degree.   Even though both are important, it is more like alchemy than physics.   It is more about going within oneself to release inner knowing and ignite potential.

So if you are a person within an organization or system “trying to make” integrative health happen, I suggest that your greatest focus must be on developing your presencing skills, your innate intuitive sense.  Energy follows attention.  If you focus on what you believe your purpose is — not on what YOU want — you will find openings through which you can move.  But movement alone does not get you where the work needs to happen.

The Principles of Presencing provide a map and a course to navigate in, around, and through a system to create the greatest impact.

  • Energy follows attention: Wherever you put your attention is where the energy of the system will go.
  • Follow the three movements of: Observe, observe, observe; Retreat and reflect, allowing the inner knowing to emerge; Act in an instant.
  • Go to the edges of the self: Open Mind – suspend old habits of thought; Open Heart – empathize; Open Will – let go and let the new come.
  • Pass through the eye of the needle: Let go of old baggage. Lighten your own load.
  • Transform the three enemies: The Voice of Judgment (VoJ); The Voice of Criticism (VoC); The Voice of Fear (VoF).
  • Always start by “attending to the crack.” Attend to the openings…where we feel the past ending and the future wanting to begin.
  • Hold the space for transforming the fields of conversation from debate to dialogue and collective creativity.
  • Strengthen the sources of presencing in order to avoid the destructive dynamics of absencing (getting stuck in One Truth)

Often times the greatest potential lies in the pressure points, the acupuncture points of the system’s meridians.  Going into these pressure points requires significant skill.  It requires that one be in the pressure space but not of the pressure; in other words, the ability to shift the energy of the pressure to an opening for potential and opportunity.


Inherent in any entrepreneurial/intrapreneurial effort is failure, or perceived failure.  How does failure actually inspire one to continue on the path or adjust the path instead of giving up?

The Urban Dictionary defines Failing Up as “(verb, intransitive) to derive gain in spite of failure that would usually either preclude said gain or have adverse consequences;” in other words to capitalize on what may not have worked to understand how it might.  This is the spirit of the entrepreneur/intrapreneur.

A. P. J. Abdul Kalam, one of India’s most distinguished scientists and the 11th President of India stated, “FAIL means First Attempt In Learning, END means Effort Never Dies, and NO means Next Opportunity.” Failure is a perception that holds information. It requires one to step back and view the landscape in its broadest sense to learn what was missed or not fully understood.  It is the opportunity to ask more questions, engage in more dialogue, and fine-tune the skill of presencing.

Ignoring failure draws the individual into absencing, being stuck in one truth, which creates a self-imposed barrier to the flow and opening for the desired transformation.

This is where the practice of Informed Mindfulness becomes an imperative.  Informed mindfulness is a concept that connects mindful self-awareness and self-regulation with educated decision-making. The mindful person is aware, nonjudgmentally, of what is occurring in the present moment and understands that his or her response is a choice. With informed mindfulness, as situations arise and decision points are faced, that same person is able to place what is happening in its larger context and, having clear values and being sufficiently educated, make an informed choice within that moment. (The Pebble in the Pond)


One of the greatest challenges for the intrapreneur may be letting go once the change has momentum and effect.  In part, it is difficult to hold the vision, facilitate a transformative environment, and actually become more fully oneself while in the process and then expect to let this all go and allow it to evolve as others come into the new state and take ownership for the change.  It can be a quandary of sorts, for the hope is that the transformation will become the norm and that the collective owns this new way of being and doing.  But the investment of energy, time, and soul can create personal dilemma.  Remember the intrapreneur doesn’t own anything — they follow their calling, and yet our humanness can sometimes leave us with wondering if that’s all there is, can I do this again, and how do I just be with the purpose and calling without needing anything more?

So if you have been called to lead integrative health and medicine, or some part of it, within an organization or system I encourage you to cultivate your skills in presencing for this will allow you to simultaneously build what is needed for the environment in which you serve, and your own internal environment from which you serve.



Lori Knutson, RN, BSN, HNB-BC, is the administrative director of Integrative Health & Medicine, Meridian Health in New Jersey.


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