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George Krasadakis

The
Innovation
Mode
How to Transform Your Organization
into an Innovation Powerhouse
The Innovation Mode
George Krasadakis

The Innovation Mode

How to Transform Your Organization
into an Innovation Powerhouse
George Krasadakis
Dublin, Ireland

ISBN 978-3-030-45138-7 ISBN 978-3-030-45139-4 (eBook)

https://doi.org/10.1007/978-3-030-45139-4

# The Editor(s) (if applicable) and The Author(s) 2020

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Preface

At the time of writing, it is estimated that there are 4.5 billion active Internet users
along with 30 billion connected devices. We live in an era of unprecedented access
to knowledge, talent, and digital resources. Our modern times are characterized by a
massive, ongoing transformation that impacts every aspect of human life—from
education and healthcare to entertainment, travel, and transportation. In the business
world, digital technology drives an equally dramatic impact by changing the way we
work, how we build products, and operate services.
This revolution is the result of breakthrough innovations in many fields such as
hardware, software, networking, and technologies like big data and artificial intelli-
gence. The Internet and the Web empower the formation of online communities and
distributed teams that collaborate in entirely new ways. Movements such as the open
source, open innovation, and open collaboration reshape the way we think about
business. At the same time, flexible and remote working models emerge in the
so-called gig economy, while entrepreneurship and startup initiatives are on the
rise. This cultural shift, along with the general availability of some of the greatest
technologies of all time, set the stage for radical innovation across sectors and
geographies—and this stage is available to all, enabling relatively small companies,
startups, or even individuals to disrupt the status quo and challenge established
services and companies. Typically, these “outsiders” see the world through a digital
lens and are faster in adopting the latest technologies; as a result, they tend to be
more innovative when designing products, services, or business models. Conse-
quently, established companies are at risk of being disrupted and outperformed.
Corporate leaders realize that innovation is the only way to stay relevant and stay in
business.
This “new order” in terms of technology, culture, and connectivity creates
tremendous opportunities for both incremental and radical innovations. At the
same time, the process of innovation itself is now faster than ever. Companies that
have both the knowledge and the willingness to innovate have a distinct advantage
over the established ones that take a more risk-averse position. Innovation-led
organizations have the chance to stay ahead of the game and thrive. Companies
that overlook the value of innovation or treat it frivolously will eventually get
disrupted. Leaders need to transform their organizations toward a new model that
incorporates innovation as a fundamental capability—fully embedded in operational

v
vi Preface

aspects and well-aligned to the purpose of the company. To stay relevant, companies
need to adapt fast and reset the way they work, communicate, collaborate, and
pursue financial success.
The purpose of the book is to help business leaders rethink their corporations as
agile, innovation-led organizations. At the same time, it aims to guide innovation
leaders on how to design, initiate, and execute a robust transformational program.
Through concrete proposals, original ideas, and best practices, it offers actionable
guidance on how to drive the cultural and technological change through a structured
transformation program and a continual innovation improvement process.
The book takes a holistic view of innovation—by examining the role of people,
culture, technology, and processes. Innovation is seen as a fully integrated function
that is powered by people and streamlined by technology. While it emphasizes the
importance of culture, it also presents how digital technologies can redefine the ways
companies innovate. The book introduces a robust innovation framework, a set of
capabilities that empower the company to systematically capture market signals, spot
opportunities, and react wisely through streamlined innovation processes such as
ideation, prototyping, and experimentation. Furthermore, it presents a detailed
innovation transformation program—a masterplan of work streams, events, and
activities that help the organization move fast toward the innovation mode—the
state where great innovation happens naturally, in an optimal balance with opera-
tional activities. By adopting the innovation-led model presented in the book,
organizations can become more innovative and eventually gain competitive
advantages. The content is organized into four parts.
Part I presents the fundamentals of innovation. The main goal is to provide clarity
on terms such as innovation and novelty. The first chapter presents the modern
meaning of innovation and its basic typology. It analyzes the importance of these
terms and introduces new definitions, including the innovation function. The next
chapter sets the focus on people—it presents the core values that form a solid basis of
a good innovation culture and then analyzes the typical innovation blockers—what
usually prevents capable individuals and teams from engaging with innovation.
Following the discussion of common innovation blockers, the book proposes
techniques and strategies to remove them and gradually change the culture toward
a state of openness, sharing, and creative collaboration. Beyond culture, Chap. 4
introduces the innovation framework—the set of components and capabilities that
empower companies to streamline innovation and integrate it with the core business
processes. It explains how this framework helps teams to obtain signals from the
broader economic environment, identify opportunities, react and adapt through
innovations, in a “continuous” mode.
Part II introduces effective methods for managing ideas and discovering
innovation opportunities. Chapter 5 presents the universal idea model as a more
effective way to capture, intake and distribute ideas. Chapter 6 helps organizations to
design an end-to-end ideation process that benefits from agile principles. At the core
of the process is a robust assessment model that evaluates the potential of ideas and
accelerates the discovery of opportunities. Chapter 7 proposes a blueprint of an
always-on ideas channel—that uses the universal model of ideas and the proposed
Preface vii

ideation process to offer a unified ideas store for the corporation—where ideas live,
evolve, and get discovered in the right context.
Part III presents how to generate and act upon ideas. It introduces improved
variants of brainstorming and provides a thorough guide for organizing corporate
hackathons. Chapter 10 explains how to set up a prototype factory—an entity that
allows the organization to convert innovation opportunities to functional prototypes
and expose them to users for testing. It covers the makerspace as a place for
experimentation and technology exploration and explains how design sprints can
benefit from the enhanced prototyping capability of the organization. Chapter 11
goes beyond prototypes: it introduces the basics of agile product development and
describes how those successfully tested innovation opportunities can be defined as
great products, using the agile approach and the notion of the minimum viable
product.
Part IV explains how to reach the “innovation mode.” It proposes a measurement
framework as the means for better orchestration of the innovation function and the
basis for steering the innovation transformation program. The final chapter of the
book combines everything into a single, detailed masterplan. It provides innovation
leaders with actionable guidance on how to start and how to get there. It begins with
the architecture of the transformation program and then it uses a roadmap of six
phases, blending all the technological, cultural, and process-level activities and work
streams that need to happen to get to the “innovation mode.” It presents how to put
everything into action, in the right order, and accelerate the transformation journey.
This book is intended for business, technology, and innovation leaders. Readers
will find essential information and unique insights on technologies, processes, and
methodologies that can help them embed innovation into their corporate reality.
Engineering managers can use this book to identify the technological components
required to empower fundamental processes of innovation such as ideation, idea
evaluation, innovation measurement, gamification, and knowledge management.
Innovation and digital transformation managers will find practical advice, ideas,
and recommendations on how to design a winning innovation transformation strat-
egy, inspire people, and grow a vivid community of innovators. Corporate leaders
will get answers on how to measure success and orchestrate the end-to-end
innovation process.
Additional content on innovation, along with templates and other artifacts, can be
found online at www.theinnovationmode.com

Dublin, Ireland George Krasadakis

Acknowledgments

Writing a book is not easy. While extremely creative and rewarding, it may disrupt
the life of many people. I am incredibly grateful to my family for their support and
understanding and, above all, to Christina, Ariadni, and Nicholas—my source of
truth and inspiration. I am thankful to Perikles Rammos, Alex Papageorgiou, Periklis
Drougkas, Gaurav Kaila, Sergiu Hamza, and Alexandros Tzoumas for reviewing this
work. Special thanks to Steven O’Kennedy for his valuable feedback and
suggestions.

ix
Contents

Part I The Fundamentals of Innovation

1 Innovation (Re) Defined . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.1 Novelty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
1.2 Invention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.3 Innovation as an Outcome . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.4 Innovation as an Opportunity . . . . . . . . . . . . . . . . . . . . . . . . . 8
1.5 Innovation as a Function of the Organization . . . . . . . . . . . . . 9
1.6 The Innovative Organization . . . . . . . . . . . . . . . . . . . . . . . . . 10
1.7 Classification of Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . 10
1.8 Innovation in the Era of AI . . . . . . . . . . . . . . . . . . . . . . . . . . 17
1.9 Why Companies Fail to Innovate? . . . . . . . . . . . . . . . . . . . . . 21
1.10 The Innovation Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
2 The Culture of Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
2.1 The Value System of Innovation Culture . . . . . . . . . . . . . . . . 26
2.2 The True Innovator . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30
2.3 Blockers of Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
2.4 What Innovators Expect . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
3 Fixing the Innovation Culture . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
3.1 Contextualize Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
3.2 Redefine Failure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
3.3 Hack the Organizational Structure . . . . . . . . . . . . . . . . . . . . . 45
3.4 Educate Innovators . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
3.5 Become Responsive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
3.6 Connect with the Community of Innovators . . . . . . . . . . . . . . 55
3.7 Join a Continual Improvement Mode . . . . . . . . . . . . . . . . . . . 56
4 A Framework for Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
4.1 Innovation as a “Black Box” . . . . . . . . . . . . . . . . . . . . . . . . . 60
4.2 Inside the Black Box: Innovation Capabilities . . . . . . . . . . . . . 61
4.3 Innovation Inputs: Context . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
4.4 Innovation Outputs: Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . 76
4.5 Innovation Behaviors and Micro-Roles . . . . . . . . . . . . . . . . . . 80

xi
xii Contents

4.6 The Role of Office Space and Equipment . . . . . . . . . . . . . . . . 85

4.7 Innovation Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86
4.8 The Innovation Hub . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90

Part II Managing Ideas

5 A Universal Model for Ideas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
5.1 The Universal Idea Model . . . . . . . . . . . . . . . . . . . . . . . . . . . 97
5.2 A Graph of Ideas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
5.3 The Extended Idea Model . . . . . . . . . . . . . . . . . . . . . . . . . . . 103
5.4 The Problem, Defined . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
6 Managing Ideas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
6.1 Idea Management: The Classic Way . . . . . . . . . . . . . . . . . . . . 108
6.2 Idea Management: The Agile Way . . . . . . . . . . . . . . . . . . . . . 109
6.3 Assessing Ideas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
6.4 Challenges and Risks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124
7 The Always-On Ideas Channel . . . . . . . . . . . . . . . . . . . . . . . . . . . . 127
7.1 A Streamlined Ideation Process . . . . . . . . . . . . . . . . . . . . . . . 129
7.2 A Smart Idea Intake Experience . . . . . . . . . . . . . . . . . . . . . . . 130
7.3 The Idea Evaluation Toolkit . . . . . . . . . . . . . . . . . . . . . . . . . . 133
7.4 Content Discovery APIs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 134
7.5 Idea Discovery and Distribution . . . . . . . . . . . . . . . . . . . . . . . 135
7.6 Smart Collaboration Surface . . . . . . . . . . . . . . . . . . . . . . . . . 137
7.7 Performance and Insights . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138

Part III Innovation Opportunities

8 Brainstorming . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
8.1 The “Classic” Business Brainstorming . . . . . . . . . . . . . . . . . . 141
8.2 The Enhanced Brainstorming . . . . . . . . . . . . . . . . . . . . . . . . . 143
8.3 The Data-Driven Brainstorming . . . . . . . . . . . . . . . . . . . . . . . 145
8.4 Brainstorming with a Little Help from AI . . . . . . . . . . . . . . . . 146
9 Hackathons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
9.1 The Structure of a Hackathon . . . . . . . . . . . . . . . . . . . . . . . . . 148
9.2 The Design Time: Shaping the Right Hackathon . . . . . . . . . . . 151
9.3 The Lead Time: Getting Ready for “Hacking” . . . . . . . . . . . . . 162
9.4 The Run-Time: “Hacking” in Progress . . . . . . . . . . . . . . . . . . 165
9.5 The Pitch Time: Selecting the Winners . . . . . . . . . . . . . . . . . . 167
9.6 Post-Hackathon: Measuring Success . . . . . . . . . . . . . . . . . . . . 168
9.7 The Connected Hackathon . . . . . . . . . . . . . . . . . . . . . . . . . . . 170
10 From Ideas to Opportunities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
10.1 Building Prototypes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174
10.2 The Makerspace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 186
10.3 Design Sprints . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 196
Contents xiii

10.4 The Prototype Factory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 200

10.5 How All Fit Together . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
11 From Opportunities to Products . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
11.1 The Waterfall Way . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
11.2 The Agile Way . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
11.3 The Power of User Stories . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
11.4 What Is the “Minimum Viable Product”? . . . . . . . . . . . . . . . . 212
11.5 From a Big Problem to Solve, to a Great Product to Build . . . . 214
11.6 Continual Product Improvement . . . . . . . . . . . . . . . . . . . . . . . 221

Part IV Towards the Innovation Mode

12 Measuring Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 227
12.1 The Macro View: Innovation Performance at the Corporate
Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228
12.2 The Micro View: Innovation Performance at the Individual
Level . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238
12.3 The Innovation Insights Store . . . . . . . . . . . . . . . . . . . . . . . . 240
13 The Innovation Transformation Program . . . . . . . . . . . . . . . . . . . . 243
13.1 The Innovation Masterplan . . . . . . . . . . . . . . . . . . . . . . . . . . 244
13.2 The Seven Innovation States of a Corporation . . . . . . . . . . . . . 245
13.3 The Path to the Innovation Mode . . . . . . . . . . . . . . . . . . . . . . 247
13.4 The “Dream Team” of Innovation . . . . . . . . . . . . . . . . . . . . . 249
13.5 The Structure of the Innovation Program . . . . . . . . . . . . . . . . 257
13.6 Prepare the Innovation Program . . . . . . . . . . . . . . . . . . . . . . . 259
13.7 Bootstrap Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265
13.8 Ignite Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
13.9 Connect Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
13.10 Empower Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 288
13.11 Scale-Up Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 296
13.12 Embed Innovation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
13.13 Final Remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
 Part I
The Fundamentals of Innovation
Innovation (Re) Defined
1

Innovation means different things to different people. In fact, it is considered to be

one of the most overused business terms of our times.1 There are hundreds of
definitions available, coming from various angles and different disciplines. Some
refer to the process; others focus on the outcome.
Clarity on the terminology is essential for the success of the innovation transfor-
mation program: it fosters a shared understanding of the underlying principles and
accelerates the adoption of related methods and practices. Using the right innovation
terms, in the context of the company, helps to better shape and communicate the
innovation agenda; it enables people to obtain a clear view of where the organization
stands in terms of innovation, where it should be, and how it can get there. Moreover,
consistent use of such terms is crucial for identifying, measuring, and reporting
innovation activities, outputs, and performance, which, in turn, allows effective
orchestration of innovation. Thus, organizations must clearly state and communicate
what innovation is and how being genuinely innovative looks like in their environ-
ment; they must not only understand but also contextualize innovation—adapt those
generic definitions to reflect their own principles, priorities, and strategy.
To illustrate the need for solid definitions of innovation, consider a hypothetical
company that is relatively innovative—it runs an ambitious innovation program, and
has an engaged community of innovators. There is a flow of ideas—originating from
within—which are managed through a diverse innovation portfolio. The company
evaluates prototypes, tests ideas, and occasionally builds minimum viable products
or new features for existing solutions. Even though this hypothetical corporation
looks innovative—there are ideas, innovation portfolios, assessment processes—it is
not easy to tell how innovative it is, or how the level of innovation evolves. As
innovation activities blend with typical business routines, they cannot be easily

1
https://www.wired.com/insights/2013/11/innovation-the-most-important-and-overused-word-in-
america/

# The Author(s) 2020 3

G. Krasadakis, The Innovation Mode, https://doi.org/10.1007/978-3-030-45139-4_1
4 1 Innovation (Re) Defined

tracked or identified. Apart from specific threads that are tagged or named as
“innovation,” identifying innovation as it happens is not an easy task.
This is due to the various forms of innovation—it may be “hidden” in certain
features of a product, or it may appear as a novel business model on top of an
otherwise conventional service. Ambitious and hi-tech projects may be addressing
known needs with standard solutions and thus not literally novel. Others may be
truly novel, but also risky, with questionable feasibility and market fit. At the same
time, specific ideas may have potential as inventions and intellectual property assets,
thus of strategic value for the firm. Spotting innovation as it happens becomes more
complicated, if we consider that even the most innovative, promising, and well-
tested projects may still fail—whether in development or post-market launch.
Having precise definitions in place helps to clarify if such scenarios should be
measured as innovation and how. In the following sections, we discuss existing
definitions, their properties, and, where necessary, we introduce new ones for the
purposes of the innovation mode.

1.1 Novelty

Novelty is essential for innovation. It is not easy to find a definition of innovation

without terms such as “new” or “novel.” The actual verb innovate is defined as
“Make changes in something established, especially by introducing new methods,
ideas, or products.”2
The notion of novelty is straightforward—it is defined as the “state or quality of
being novel, new, or unique; newness.”3 In practice, though, examining if a given
concept is new is not a simple task: what appears to be a novel and disruptive idea in
the mind of an ambitious innovator may prove to be known to the team or the
organization. Similarly, an idea that is considered groundbreaking in the microcosm
of a corporation may be already implemented elsewhere in the market. Novelty
depends on the point of view of the observer, and any attempt to estimate it
prerequisites a good awareness of the state of the art. Even strict processes run by
professionals do not always conclude on the novelty of a concept in a definitive
manner.
At the macroeconomic level, the notion of novelty is essential since it is a
condition for identifying innovations and measuring how companies, markets, and
industries innovate. It is also important for the patent ecosystem since novelty is one
of the criteria defining the patentability of an invention. The newness of a solution is
estimated through analysis against the knowledge that is already available to the
world. This is a lengthy process known as the prior art search, which is usually
conducted by patent analysts or patent attorneys.

2
https://www.lexico.com/en/definition/innovate
3
https://www.dictionary.com/browse/novelty
1.1 Novelty 5

At the microeconomic level, within the corporation, novelty may be seen differ-
ently depending on the context. For example, one company may only measure as
innovation opportunities those novel-to-the-world ideas, while another may also
count those that are known to the market but applied for the first time in the specific
industry. Variations and adaptations of these definitions are common and accepted—
to better reflect the nature of the organization. It is crucial, though, to ensure that
these adapted views on novelty are communicated with clarity and used consistently:
everyone in the organization should understand how novelty is defined, measured,
and used.
When it comes to a specific concept, novelty usually refers to the core idea,
individual features, or the enabling technologies. However, it may come into play in
less coherent forms, for example, in the way a solution combines existing knowledge
to solve a challenging problem in a more effective manner, or through a non-obvious
adaptation of a known concept from another industry or technological domain.
Novelty may appear in the way the product is introduced to the market or even as
a new monetization model. A non-novel concept may be executed or offered in a
unique way that leads to massive impact—for example, through a new servicing
model or other forms of business model innovation. Hence, when assessing the
potential of a concept, novelty should not be taken literally or used as the sole
criterion for prioritization or other decisions: even if an idea is not literally novel, it
may still qualify as an innovation opportunity. Nevertheless, tracking and measuring
novelty at the idea level can be beneficial for corporations, in the following two
directions.
First, it helps in the early discovery of intellectual property opportunities that
could otherwise be missed. This can speed up the lengthy patent process and protect
referenced inventions before they are exposed to the market.
Second, consistent estimation of the level of novelty of ideas sets the basis for
measuring innovation, improving prioritization, and balancing the innovation port-
folio. It is an insightful metric enabling a deep understanding of the overall
innovation activity and output of the organization. While knowing the novelty, of
a specific idea, may not be actionable beyond triggering the IP protection process,
the ability to obtain the distribution of a portfolio of ideas in terms of their novelty
can be very insightful from a strategic point of view.
In an ideal scenario, the estimation of novelty should be encapsulated into the
idea assessment process during which the evaluators apply their knowledge regard-
ing the state of the art and estimate the level of novelty of each idea. These are
typically product and domain experts who follow closely the rapidly moving
technology landscape and use the latest signals from the market and global technol-
ogy hubs to make sound judgments on the novelty and feasibility of new idea
submissions. This way, new ideas, solutions, and proposals get tagged with a
quick estimation of the degree of novelty—which may be expressed in an ordinal
scale like “new to the world,” “new to the industry,” “new to the company,” or “new
to the product.”
6 1 Innovation (Re) Defined

In general, the definition and scope of novelty should be adjusted to match the
nature of the organization. Beyond the scenario of intellectual property rights,
novelty should have primarily an informational role.

1.2 Invention

An invention is an idea, a solution to a problem that is novel and proven workable—

without necessarily being implemented. It may be just a detailed, validated technical
description of a solution, a new, non-obvious way to achieve a goal. The key
requirement is to be novel, “something that has never been made before.”4
Inventions usually come in the form of a device or a method that solves a specific
problem or performs a task in a new and significantly improved way. An invention
may be enhancing a known solution by adding new elements, or it may be entirely
new. Inventions frequently refer to purely technological or scientific subjects, but
they also happen in other expressions of human activity—such as in social and
cultural spheres. Thus, they may happen independently of production and commer-
cialization plans—the inventor may be solving a problem, without having specific
commercial goals, or a strategy to exploit it and monetize it.

1.3 Innovation as an Outcome

Innovation is more than invention: most of the definitions of innovation include a

condition on execution or implementation—they consider as innovation a realized
idea launched to the market and exposed to real users. For instance, according to the
following definition (OECD 2016):

An innovation is the implementation of a new or significantly changed product or process. A

product is a good or a service. Process includes production or delivery, organization, or
marketing processes.

According to the same source:

A common feature of an innovation is that it must have been implemented. A new or

improved product is implemented when it is introduced on the market. New processes,
marketing methods or organizational methods are implemented when they are brought into
actual use in the firm’s operations.

Following this definition, the product or service must be implemented and

available to potential users in order to qualify as innovation. Other popular
definitions include criteria such as success, wide adoption in the market, and proven

4
https://dictionary.cambridge.org/dictionary/english/invention
1.3 Innovation as an Outcome 7

impact. For example, according to the UK Department of Trade and Industry (DTI
2007), innovation is “the successful exploitation of new ideas.”
These definitions work well when approaching innovation from a macro-
perspective, for example, when measuring the level of innovation in a market,
industry, or geography; they consider primarily the end result, the outcome of a
long process of development and commercialization—they look for novelty that has
been implemented and delivered to users, with proven adoption in the market. Such
macro-views bound innovation to impact or success.
At the micro-level, when looking from within the corporation, a more flexible
definition is needed—one that can be used to track innovation as it happens. In a
typical business environment, there are multiple parallel projects and initiatives, with
various levels of novelty and business potential. Given that the journey from an idea
to market is long, the company should be able to monitor, quantify, and analyze the
innovation potential of each project. It should be able to spot and measure
innovation—by evaluating the entire opportunity pipeline and the innovation port-
folio—based on the novelty, feasibility, and expected impact of the contained
projects. In this scenario, when zooming into the development process of a given
organization, the class of definitions presented above will not work in identifying
and measuring innovation—as they prerequisite implementation and impact.
Consider, for example, a product concept which is at a mature state, has verified
technical novelty, and has successfully passed rigorous user testing, indicating
that—in all probability—it solves a major problem for a critical mass of users, in
a better and economically viable way. According to the classic definitions, it cannot
be measured as an innovation yet—as it has not reached the market and it is not fully
implemented—it does not meet the criteria of adoption and exploitation. Even when
the product is built, the condition of implementation, as used in the definition above,
is not satisfied until the product is released to the market. However, in a corporate
context, this is an instance of genuinely innovative activity and intermediate
innovation output. In this example, the product should be seen as a validated
innovation opportunity that, if built and launched properly, may reach the level of
adoption to qualify as “classic” innovation. But even if this product finally fails, this
should still be reported—within the corporation—as an innovation initiative that had
partial-only success—a concept that converted up to a specific stage in the
innovation funnel.
Hence, to assess the level of innovation of an organization from within, a more
flexible definition is needed—one that can flag the innovation potential of less-
mature solutions, before they reach the market. The definition should be independent
of the result—as success in the market depends on various factors, some of which
may not be directly related to the company’s ability to innovate or ability to execute.
8 1 Innovation (Re) Defined

1.4 Innovation as an Opportunity

Typically, innovative organizations maintain portfolios consisting of multiple

promising concepts—which may be novel and high potential but not yet built or
released in the market. Some of these concepts may be tactical, while others may be
part of ambitious programs tackling big problems or unarticulated user needs; they
may be in a prototyping phase, waiting for a decision or queued up for implementa-
tion, and may or may not reach the market. In the context of the innovation mode, we
call these novel and high-potential concepts innovation opportunities, defined as:

A feasible, well-structured solution to a defined problem, with some novel aspects that are
validated as highly probable value-drivers for a critical mass of users.

This definition is more flexible in terms of maturity, novelty, and success since it
allows a less-mature solution to also qualify as an innovation within the organiza-
tion. The term solution is used with its broader meaning—it refers to a defined,
validated proposition addressing a well-articulated problem. The latter should come
as a structured problem presentation, ideally articulated as a problem statement5—
which also helps in setting high-level success criteria. To qualify as an innovation
opportunity, the solution must have the potential for a significant improvement
toward the ideal situation described in the problem statement. It may be pointing
to a new product, a feature, a process, or a service, and it may take various forms, for
example, a physical or digital product or an online experience.
According to this definition, to be measured as innovation, the solution must also
be feasible, meaning that it can be developed and offered in a way that creates value
for both its users and the corporation. Additionally, the solution needs to have at least
some novel aspects that, based on validation, are expected to be significant drivers of
value. It does not have to be an entirely new concept: a proposal to upgrade a known
and conventional product by adding a set of novel, high-potential features may also
be considered as an innovation opportunity—provided that these novel features are
identified as the primary value multipliers—the source of benefit for a critical mass
of users. The definition does not assume success: the term highly probable
underlines that there is still a level of uncertainty involved and denotes that a precise
process has been applied in validating the solution. Failure is always a possible
outcome, whether the solution is in development or when exposed to the market. In
an expanded form, the above definition would read like:

An innovation opportunity is a somehow novel solution that is well-defined and estimated to

be technically feasible and economically viable. It addresses a defined problem by
leveraging novel aspects that have been validated as significant value-drivers for the
end-users and stakeholders.

5
https://en.wikipedia.org/wiki/Problem_statement
1.5 Innovation as a Function of the Organization 9

These relaxed definitions enable different views of innovation—from within the

corporation. Ideas, concepts, and proposed solutions are validated early enough in
the process—they are scored by a team of experts against the core components of
innovation—as contextualized and weighted by the corporation. This consistent,
internal view of innovation allows the leadership to better understand how the
company is innovating and, as a result, to better orchestrate the innovation process.

1.5 Innovation as a Function of the Organization

The innovation function, in a corporate environment, is what enables the organiza-

tion to innovate—to create innovation opportunities and, ultimately, innovation in
the classic sense. It is the general capability and readiness to react fast and wisely on
signals and emerging patterns from the global economic environment. We define the
innovation function in the following:

The innovation function is an always-on system of procedural, cultural and technical

activities, innovation enablers, and resources, aiming to maximize the likelihood of produc-
ing successful innovation opportunities.

The innovation function may be thought of as a system that receives signals—

such as unmet customer needs, market trends—and triggers the right innovation
processes, which allow people to react by generating ideas and proposals.
Specialized innovation teams, also part of the system, process ideas, spot
opportunities, and eventually drive specific ones to market. Beyond innovation
opportunities, the system outputs knowledge and innovation assets.
The enablers mentioned in the definition refer to individual capabilities, systems,
or services that support and accelerate the innovation processes. For example, the
ability to capture, manage, and evaluate ideas and the framework for rapid
prototyping. Enablers also refer to a range of services that support practical aspects
of innovation, such as the setup and facilitation of innovation events, and the
provisioning of resources. They may take the form of special teams that operate
innovation systems, handle the logistics for ad hoc or recurring events, create
branded innovation content, or provide innovation support, training, and mentorship.
The resources refer to anything that is essential in practical innovation
initiatives—from raw materials, equipment, tools, and hi-tech devices to communi-
cation systems and physical space. This also implies an effective procurement
process to cover the special requirements of innovation projects, fast. The innovation
function of an organization requires a framework providing the right capabilities,
process, and resources—this is covered in Chap. 4.
10 1 Innovation (Re) Defined

1.6 The Innovative Organization

The obvious way to define the innovative organization is by referencing its ability to
deliver innovation to the market. However, this approach depends on the measurable
impact in the market and the adoption of innovation. As described previously, given
all the types and flavors of innovation and the different views on novelty, the
criterion of realized innovation is rather limiting.
To illustrate that, consider a company that operates for years, following all the
innovation principles and practices—it has achieved a great culture, and it has all the
enablers in place—but with no successful market-facing innovation results yet. How
innovative is this company? Similarly, a company may be innovating following its
own style and depth—for example, it may be adopting the latest inventions and
novel technologies from open innovation networks and embedding them in its own
products, services, or production methods. There are organizations that are not
innovating in a systematic way, but still, they occasionally manage to create
innovation opportunities and drive them to the market. In all these cases, companies
are innovative in some way, and to a certain extent. The key question is what
constitutes an innovative organization? The following proposes a generic definition
that also takes into consideration the intermediate innovation artifacts of the
company:

An organization is innovative when it consistently demonstrates an increased ability to

generate validated innovation opportunities in alignment with its purpose.

According to this definition, an organization may be considered innovative, even

if innovation is in progress—with no realized market impact or adoption yet. By
referencing the interim outputs of the innovation process—less-mature artifacts in
the form of innovation opportunities—this definition allows companies that innovate
in different ways—at a smaller scale, at the process level, etc. to also qualify as
innovative. It enables companies to quantify how innovative they are, by identifying
and measuring the volume of innovation opportunities generated over time com-
pared to regular projects and innovation investments.
In addition, companies may perform regular self-assessment of their
innovativeness, using a suitable questionnaire that measures aspects of culture,
technology, process readiness, and their perceived ability to innovate. These indi-
vidual metrics are then fed into a scorecard that weighs the partial inputs according to
their importance for the organization, leading to a single “level of innovativeness.”

1.7 Classification of Innovation

Classifying innovation is not always straightforward since it depends on the defini-

tion, the context, and the point of view. However, it is crucial for leaders to
understand the basic typology, as it helps to define the innovation strategy and
articulate the innovation agenda. Also, contextualizing the different types of
1.7 Classification of Innovation 11

innovation—understanding and reflecting how they serve the purpose of the com-
pany—helps to better set the focus and balance divergent innovation strategies
through portfolios of initiatives.
Classification of innovation can be done based on its target—what the innovation
aims to improve or its intensity—how smooth and continuous innovation is. In many
cases, it is classified based on its openness or the maturity of the efforts or the state of
the target market. There is a plethora of variations and combinations of typologies,
frequently leading to confusion and limited understanding of the underlying
concepts. The following discusses a structured approach in classifying innovation.

1.7.1 Based on the Target: The Object of Innovation

Innovation introduces new ways to improve something. Thus, it can be classified

based on the form of its primary target—the nature of the object to be improved.
According to the OECD,6 there are four main types of innovation, namely product,
process, marketing, and organizational—as described in the following.

Product Innovation In this type, the innovation efforts result in a new product—
good or service—or the improvement of an existing one by introducing significant
and novel enhancements. A product in this context can be anything that may be
offered to the market to satisfy a specific customer need—it can be a physical object,
a digital product such as an application or a web experience.
When targeting new products, this type of innovation has typically a long
lifecycle since there are multiple stages involved in the process—from conceptuali-
zation to prototyping, experimentation, etc. and it may require significant
investments in production lines, development teams, research activities, and market-
ing plans.

Marketing Innovation This type of innovation refers to the ways a product is

being offered to the market. According to the OECD,7 “A marketing innovation is
the implementation of a new marketing method involving significant changes in
product design or packaging, product placement, product promotion or pricing.” At
this level, innovation may come as novel ways of communicating and persuading
potential users to engage with products or services. For example, it could take the
form of a new interactive campaign, a cross-channel promotion experience or novel
digital means of exploring the features of a product. The purpose of marketing
innovation is to present the company’s commercial offerings in a better way and
thus assist in opening up new markets, better positioning products and services, and
driving sales and growth. Based on the same definition, to be considered as market-
ing innovation, such an activity must be also new to the company—never applied

6
https://www.oecd.org/site/innovationstrategy/defininginnovation.htm
7
https://stats.oecd.org/glossary/detail.asp?ID¼6871
12 1 Innovation (Re) Defined

before; it must be “part of a new marketing concept or strategy that represents a

significant departure from the firm’s existing marketing methods.” Marketing
innovation usually requires smaller investments and effort. The implementation
time is typically short, and it may or may not require technical implementation.

Organizational Innovation This type of innovation targets the organization itself.

In this sense, it is a self-improvement process introducing changes in the way the
company operates, communicates, and decides. This type may refer to new means of
organizing the work, executing and measuring progress, or new patterns of collabo-
ration and contribution. It may come in the form of more efficient systems, practices,
or methods. For example, it could be a new process for sharing information and
gathering feedback from people in the organization, or a connected building diffus-
ing knowledge and information on plans, events, and the innovation agenda of the
organization via connected screens and interactive, personalized experiences.

Process Innovation Innovation at the process level takes the form of improvements
of methods, techniques, and systems—it refers to “new or significantly improved
production or delivery methods for the provisioning of services and goods.”8 Any
new and non-obvious process or step that improves outputs by better handling the
inputs can be considered process innovation. The improvements need to be novel, at
least internally, within the boundaries of the organization.
Typically, such innovations impact the design and production methods, the
distribution or delivery of products, the supply chain operations, and management
of stock and organizational resources. For example, a company may introduce new
operational procedures for a production plant or new systems simplifying the
assembly line in order to improve its throughput, raise the levels of quality, or
reduce costs. Normally, this type of innovation is not directly seen by customers—
it helps in delivering better products and experiences overall, but it is not necessarily
visible in instances of the product. Process innovation often comes as expensive,
sophisticated technological solutions combining software, hardware, or machinery.
In certain cases, though, it can be relatively inexpensive, for example, a new, more
efficient way to authenticate employees and grant them access to a smart building by
using existing equipment and already available data.
The rise of machine learning and IoT introduces a massive opportunity for
innovation of this type as the available data and algorithms allow radically new
ways in designing processes. For instance, an industrial production line may be
optimized by enhancing its telemetry and introducing real-time data processing—
allowing production managers to make optimal choices. Beyond optimization, the
production line may be altered and enhanced by incorporating “cognitive abilities”,
for example, by adding computer vision algorithms that check the attributes of the
products being produced. In this hypothetical scenario, the production line becomes,
in a sense, “self-aware” of its own performance: through real-time insights from a

8
https://stats.oecd.org/glossary/detail.asp?ID¼6870
1.7 Classification of Innovation 13

computer vision algorithm, it can detect deviations from normality—in terms of

quality of the in-process products, and act accordingly—for example, flag a prob-
lematic product, re-route it for a fix, or notify the right team to intervene. In the same
example, a new process may introduce the notion of self-check; that is, the produc-
tion system automatically compares current performance metrics against its own
history and detects or predicts forthcoming needs for maintenance or triggers
troubleshooting for issues before they severely impact the process.

Business Model Innovation Simply put, a business model describes the logic that
an organization uses to make profits or achieve success; it provides a holistic view by
summarizing the end-to-end mechanism that creates and distributes value to
customers. A business model comprises all the pieces that allow the company to
pursue an opportunity, a specific line of service, or its overall purpose. More
specifically, it references the products or other offerings, the value proposition,
along with the involved cost structures, the pricing, and monetization models; it
defines how partner networks and distribution channels play a role in the process.
Introducing new “logic” to any of these components or the whole model
constitutes business model innovation. Usually, this type of innovation requires no
new product or technology—it is defined on top of existing products and often a
customer base.

1.7.2 Based on the Pace, Intensity, or Continuity

Radical Innovation This form of innovation brings a major change in something

established—usually as a breakthrough idea or technology. In some cases, it
replaces existing solutions or technologies entirely. Typically, it is the result of
long-term, expensive, and high-risk investments at the technical and scientific layers.
In many cases, it may also trigger marketing and business model innovations.
Radical innovation is what typically attracts media attention—it is what consumers
and the market perceive as innovation.

Incremental Innovation In this form, innovation happens at a smaller scale and,

frequently, probably on top of current technologies or products. It can be thought of
as a “continuous” process of improving an existing offering—either by releasing
enhanced versions of known features or by adding new ones. It is more conservative,
less risky, but also less promising in terms of impact. Although this does not usually
drive rapid results, it increases the likelihood that the product remains competitive.
Unless the competition is faster or manages to successfully release a radical
innovation addressing the same needs and market segments, incremental innovation
should be sufficient to maintain proven products and technologies at the state of the
art. In a digital context, incremental innovation can be fully embedded in the product
development process: in parallel to scheduled development work, a product team
maintains a backlog of novel ideas which, given the fast iterations of the agile
approach, can be prototyped and tested or even exposed as preview features to a
14 1 Innovation (Re) Defined

small subset of the user base—all at fast pace. This way, the team gets insights about
their expected performance, makes informed decisions about further development,
and keeps improving the product with smaller, frequent doses of innovation.

Disruptive Innovation Disruptive innovations, as Christensen describes, are not

breakthrough technologies that improve existing products, but instead, innovations
that make products and services more affordable and accessible, thus available to a
larger population.9 The disruption happens when a product or service enters at the
bottom of a market as an inexpensive and more accessible option and then moves
fast in gaining market and eventually displacing established competitors.”10 Disrup-
tive innovations are usually driven not by established, successful companies but by
outsiders such as startups. In this theory, market leaders do not respond to disruptive
innovations when they first arise, because they are not profitable enough and because
their development can take scarce resources away from sustaining innovations.

1.7.3 Based on the Style and Approach

Corporate innovation may also be characterized by its style—the approach taken by

the organization, the level of openness, and how visible and accessible it is to people
in the organization.

The Centralized Approach Expensive innovation programs may take the form of
specialized technology labs and research and development departments. This defines
a centralized innovation model, according to which the agenda and outputs of
innovation are controlled by a single entity, and the rest of the organization has
limited participation—practically acting as first-level “consumers” of the inventions
and knowledge produced by the labs.

The Decentralized Approach Modern views on corporate innovation advocate for

an open, decentralized model where artifacts, knowledge, and resources are available
to all. In such a setup, innovation can originate from any team, and the knowledge
produced is diffused across the organization. Of course, in specific industrial or
scientific environments, the need for specialized laboratories or research facilities
may still be the right approach—although it may coexist with higher-level
innovation programs that connect them with the rest of the organization.

9
https://www.christenseninstitute.org/disruptive-innovations/
10
https://en.wikipedia.org/wiki/Disruptive_innovation
1.7 Classification of Innovation 15

1.7.4 A Special Case: Open Innovation

In our interconnected reality, it is extremely difficult to think of a problem or a

solution that has not been conceived elsewhere in the world. Big problems and
challenges—as sources of ideas and stimulus for innovation—are uniformly
distributed via our digital networks to billions of connected users: the world is
innovating on the same agenda, in a synchronized way. Clusters of individuals and
business entities across the globe are possibly solving variations of the same
problem, independently from each other (and thus, from a macro-perspective,
inefficiently). The “old way” is to protect and compete; the modern approach is to
share and partner up. Open innovation allows economic entities to connect and
selectively exchange knowledge, form partnerships, and speed up the innovation
process in ways that create benefit for all.
Open innovation is a “new” paradigm on how companies utilize internal and
external knowledge as part of their innovation process. It is formally defined as “a
distributed innovation process based on purposively managed knowledge flows
across organizational boundaries, using pecuniary and non-pecuniary mechanisms
in line with the organization’s business model” (Chesbrough and Bogers 2014). It
allows organizations to participate in a rapidly growing, world-scale system of
knowledge and technology creation.
This broader view on innovation acknowledges the fact that it may be too difficult
and expensive to innovate in isolation—without leveraging ideas and knowledge
produced beyond the boundaries of the organization. In contrast to the mode of
secrecy and protection of knowledge, open innovation proposes an extended knowl-
edge ecosystem consisting of companies, user communities, research centers, and
hubs. Its members both discover and share ideas, knowledge, and inventions. In
many cases, companies crowdsource problems—asking their partners, customers, or
even the public domain for novel ways to tackle them—a process that may drive
remarkable ideas and insights and other positive effects. Open innovation is not only
for corporations—smaller entities, including startup companies, can join to contrib-
ute and benefit from this world-scale knowledge fabric. Public sector entities and
non-profit organizations may also play a significant role.
Very often, companies have rich patent portfolios, with only a tiny fraction of
them utilized. Or, they may be protecting trade secrets—that are no longer of
significant commercial interest. In the open innovation scenario, these could become
part of the outflow toward the ecosystem. For example, a company may consider
sharing selected non-commercialized inventions that might be valuable for other
members. On the other hand, the company may explore and eventually leverage
ideas and knowledge produced by others—through patents acquisition, licensing, or
commercial agreements.
Beyond the exchange of knowledge, companies need to open up in exploring new
models of partnerships in the form of cocreation and exploitation of knowledge and
16 1 Innovation (Re) Defined

inventions. Open Innovation 2.011 accelerates this change by introducing a new

paradigm of collaboration, with the aim to “drive structural changes far beyond the
scope of what anyone organization or person could do alone.”12
This knowledge exchange with the ecosystem needs a method and the right
strategy that would enable the company to stay in sync and discover, evaluate, and
possibly internalize third-party inventions, ideas, and resources. This strategy also
defines how to give back to the “innovation partners,” by sharing selected pieces of
knowledge—those internally developed ideas, research findings, inventions, or
technologies that are not planned for commercialization. The connection with the
ecosystem must be carefully designed to minimize the risk of losing competitive
advantages by unintentionally disclosing aspects and ideas associated with confi-
dential initiatives or protected knowledge.

1.7.5 Social Innovation

We may also differentiate innovation based on its ultimate goal. For example, in
contrast to business innovation, which focuses on driving business success in terms
of profits and market share, social innovation prioritizes impact and value at the
societal level—it aims to introduce improvements in working models, education,
access to health services, and community development. It may be driven by
non-profits, activism, volunteers, or self-organizing communities.

1.7.6 Selecting the Right Type of Innovation

The right approach to innovation—the style, type, and pace—should be dictated by

the overall strategy of the company: it is the long-term goals, growth plans, and the
innovation agenda that point to the appropriate balance between innovation types
and modes. The strategy can be translated into a roadmap that tackles named
problems with different types of innovation, running in parallel, with varying
lifecycles. For example, a company may be investing in radical innovation initiatives
while accelerating its incremental innovation capacity to protect its market share and
keep current product offerings competitive and profitable. Innovation portfolios
allow companies to combine different styles and innovation objectives.

11
https://webfoundation.org/2013/06/announcing-the-global-open-data-initiative-godi/
12
https://ec.europa.eu/digital-single-market/en/open-innovation-20
1.8 Innovation in the Era of AI 17

1.8 Innovation in the Era of AI

Digital transformation has already happened—for a big part of our world and is
accelerating for the rest. The global digital population as of January 2020 is
estimated to be 4.5 billion users,13 while the number of connected devices is
expected to reach 29 billion by 202214 and 75 billion by 2025.15 The entire world
is getting connected, forming a massive network of human and artificial intelligence.
People already have access to a world-scale digital fabric, an immense collection of
resources as the building blocks for new solutions, services, and products.
Humanity’s accumulated knowledge and ideas are available to people and machines
through simple APIs and search engines. Resources such as software libraries and
frameworks, machine learning models, data, and creative content can be used for
free under certain terms such as the MIT license or Creative Commons.16
The process of innovation is becoming faster and more efficient. With a proper
setup, a company can shorten and streamline the cycles from an idea to an informed
decision. Technology empowers the end-to-end innovation process—from ideas to
rapid prototyping, validation of concepts through digital channels, content discov-
ery, and experimentation. For instance, a “crazy” idea regarding a connected physi-
cal product that can identify the current user via facial recognition and serve a
personalized experience could be quickly tested by creating a digital model of the
object and then materializing it through a 3D printer. The prototype would become
functional by integrating a camera and inexpensive computer components that allow
it to connect and consume third-party facial recognition services. This would provide
a realistic experience that can be exposed to selected users for testing and feed-
back—all at a relatively low cost. Similarly, in the purely digital context of an online
product, A/B testing a new idea that aims to improve an existing experience can give
statistically significant results in no time. Leveraging feedback from a distributed
group of experts who interact with a digital prototype can be done in a matter of
minutes.
At the same time, this significant improvement in the general ability to innovate
raises the expectations from users, customers, and shareholders: innovation is now
“expected” to be present in products, experiences, and strategic plans, which creates
additional pressure for companies to actually innovate.

1.8.1 How Digital Technology Accelerates Innovation

The impact of digital technologies, in terms of connectivity, access to information,

and intelligent automation, creates tremendous opportunities for both incremental

13
https://www.statista.com/statistics/617136/digital-population-worldwide/
14
https://www.ericsson.com/en/mobility-report/internet-of-things-forecast
15
https://www.statista.com/statistics/471264/iot-number-of-connected-devices-worldwide/
16
https://creativecommons.org/
18 1 Innovation (Re) Defined

and radical innovations. Most importantly, it impacts the general ability to inno-
vate—in at least the following ways.

Access to Technology: Reusability, Openness, Availability Technology is

becoming not only extremely powerful but also generally available. Technologies
that once could only be found in expensive research labs are now open to the public.
Advanced artificial intelligence models are offered as services, ready to be integrated
into simple software applications—for instance, facial recognition or content under-
standing services. Any individual with basic software development skills and an
Internet connection can leverage technologies which, until very recently, were seen
as science fiction.
Reusability and openness empower innovation by increasing the bandwidth to
tackle unsolved, challenging problems. For example, by reusing components, data,
models, and knowledge, a development team can easily cover the known, conven-
tional aspects of a concept. Therefore, it gains in terms of capacity and focus—the
team can become creative on what matters the most: the new, unsolved parts. More
specifically, when prototyping a product, developers can quickly plug in
standardized components and services to inexpensively build the features that,
although important for the overall experience, are generally known and solved.
This way, development teams allocate resources on the features that truly need a
novel approach.
With the rise of APIs as the means for standard communication interfaces,
systems and products are now more open, exposing parts of their functionality,
and thus contributing to the formation of a massive collection of “building blocks.”
These make the path from an idea to prototype and a live service faster, more
flexible, and smoother. For instance, a developer building a modern AI-powered
mobile app can save time by integrating various third-party services that provide
data, content, and perform cognitive functions in real time. The developer preserves
valuable resources, in order to bring innovation at a different level—by studying the
users, designing and building a great, novel user experience.
The process of developing and operating products is also faster. Companies have
moved from maintaining on-premises servers to virtual ones, then to cloud services,
and now to serverless architectures. The cloud paradigm enables faster implementa-
tion and efficient hosting of complex solutions. At the same time, it addresses
important aspects of performance, scalability, and security. In general, modern
software engineering tools, practices, and online platforms have shortened the
application development lifecycles.

Access to Global Talent Digital technologies enable easy formation and effective
management of remote teams. Talent can be discovered across geographies, and it is
now feasible to have virtual, distributed teams that work together in very productive
and creative ways. These flexible models may involve full-time employees that
happen to work remotely, or contractors, partners, and vendors serving just-in-time
needs through flexible short-term assignments. In some cases, such remote teams can
be community-driven—in an open-source context. This defines a global pool of
1.8 Innovation in the Era of AI 19

talent available in dynamic working models, through simple processes, via online
platforms—a significant achievement of our times, powered by digital technologies,
and the subsequent cultural change.
Access to this global pool of talent benefits innovation in many ways. For the first
time in history, having a good idea opens up so many great options: an individual can
literally ask the world for help, build a remote team to cocreate, or set up an open-
source project and use the power of communities to drive the idea to life. Teams can
be formed online and operate remotely—successful products can be built without
teammates ever meeting in person.

Access to Knowledge, Insights, and Stimulus Thanks to our digital world, people
have access to a wealth of information and knowledge. If processed properly, this
stream of content can be extremely beneficial in an innovation context: it empowers
teams to establish a strong link with the market and obtain key insights in a timely
fashion. In this sense, digital technologies help companies to better understand their
economic environment and empower them to discover unmet or even unimagined
needs for users and businesses.
For example, a product manager may receive notification due to reputation risk in
social media—triggered by growing complaints about a new feature or a perfor-
mance drop following a product update, or a new product release announcement
from a competitor, or a relevant patent application which was just published.
Additionally, with the rise of big data and the evolution of data mining
capabilities, there is a new source of innovation: data discoveries, in the form of
insights, patterns, and interesting deviations from normality, which are non-obvious
and new. As curious minds try to interpret or explain unexpected patterns in
otherwise well-understood data sets, they raise interesting and tough questions,
which in turn may lead to great ideas. Furthermore, new ways to visualize insights
in an interactive fashion power a range of novel data-exploration experiences, which
in turn fuel the creative process. This is further discussed in Chap. 8—Data-Driven
Brainstorming.

1.8.2 The Impact of Open Source

Digital technologies have already introduced a massive change in the ways humans
work and collaborate. Fast connectivity, along with smart collaboration tools and
online platforms, allows people to work together effectively across time zones. And
this happens not only among colleagues employed by a company but also among
strangers who form active communities based on shared interests and common
goals. The digital revolution allowed the formation of different philosophies regard-
ing the exchange of services, knowledge, and ideas: people join online communities
and contribute voluntarily based on values and principles that go far beyond
monetary objectives. This philosophy is frequently encapsulated in terms like
mass or open collaboration and in a software context, as free open source.
Another random document with
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relaxed the rigid limbs. The next day the rigidity continued until
complete etherization was effected. In fact, when the breathing was
loudly stertorous and the conjunctiva insensible to touch, the rigidity
was complete, and it was not until a large amount of ether had been
inhaled that the limbs relaxed. While under the effects of the ether a
vaginal examination was made, and the uterus found normal in
position and size. No evidences of self-abuse were found, nor had
there been any reason for suspecting this. She continued in the
condition described for many days. She was filthy in her habits, and
would not use the commode, although she was made to sit on it for
hours. She would have a stool on the floor or in bed immediately
after rising from the commode. She seemed imbecile, and scarcely
spoke, or, if she did, would say she was dead or was a baby. She
would eat nothing voluntarily: food was put into her mouth, and she
would swallow it, but made no effort to close the lips herself. She
was fed in this way for four or five weeks. If taken up to be dressed,
she would make the procedure as difficult as possible, and when
dressed would not let her clothing remain buttoned, so that her
clothes had to be sewed on her.

After about ten weeks a slight improvement showed itself, first in her
taking food voluntarily, then in speaking. By degrees she became
reasonable, and in about four months from the time she was first
seen was perfectly well. The medication used was very slight, but
she was thoroughly fed, took bromide of sodium and ergot for a time,
and occasionally a dose of paraldehyde to produce sleep. She had
two efficient nurses, who carefully carried out all directions, and who
never yielded a point, but tried to be always as kind as firm. This
case is instructive, not only because of its phenomena, but also
because of the method of feeding and managing the patient and the
result of treatment.

At a meeting of the Philadelphia Neurological Society held February

22, 1886, I exhibited, at the request of Dr. C. P. Henry, of the Insane
Department of the Philadelphia Hospital, a case presenting
cataleptoid symptoms, the phenomena of automatism at command,
and of imitation automatism.
This patient had been recently admitted to the hospital, and no
previous history had been obtained. He was a middle-aged man, not
unintelligent-looking, and in fair physical condition. His condition and
his symptoms had remained practically the same during the short
time that had elapsed since admission. He remained constantly
speechless, almost continually in one position; would not open his
eyes, or at least not widely; would not take food unless forced; and
his countenance presented a placid but not stupid or melancholy
appearance. He had on several occasions assumed dramatic
positions, posing and gesticulating. It had been discovered by Henry
that the patient's limbs would remain where they were placed, and
that he would obey orders automatically. The case had been
regarded as probably one of katatonia, but in the absence of
previous history it was not known whether or not he had passed
through the cycle of mania, melancholia, etc. which constitutes this
fully-developed disease. He had had since admission attacks of
some severity, probably, from description, hystero-epileptic in
character.

In exhibiting the patient I first placed his arms and legs and body and
head in various positions, where they remained until he was
commanded to place them in other positions. His mouth was
opened, one eye was opened and the other was shut, and he so
remained until ordered to close his mouth and eyes. In most of these
experiments the acts performed were accompanied by remarks that
the patient would do thus and so as he was directed.

Various experiments to show automatism at command were

performed. I remarked, for instance, that the gentleman was a good
violin-player, when he immediately proceeded to imitate a violin-
player. In a similar way he took a lead-pencil which was handed to
him and performed upon it as if it were a flute. He danced when it
was asserted that he was an excellent dancer; placed his arms in a
sparring position and struck out and countered on telling him that he
was a prize-fighter; went through many of the movements of drilling
as a soldier, such as attention, facing, marking time, and marching.
He was told that he was a preacher and must preach, and
immediately began to gesticulate very energetically, as if delivering
an earnest exhortation. He posed and performed histrionically when
told that he was an actor. He was given a glass of water and told that
it was good wine, but refused to drink it, motioning it away from him.
He was then told that it was very good tea, when he tasted it,
evincing signs of pleasure. During all these performances he could
not be induced to speak; his eyes remained closed, or at least the
eyelids drooped so that they were almost entirely closed. He showed
a few phenomena of imitation, as keeping time and marching to the
sound of the feet of the operator.

In the nervous wards of the Philadelphia Hospital there is now an

interesting case of melancholia with catalepsy and the phenomena
of automatism at command—a man aged twenty-five, white, single,
who for thirteen years had worked in a type-foundry. Three years
before coming to the hospital he had an attack of acute lead-
poisoning with wrist-drop. Two years later he had an attack of mental
excitement with other evidences of insanity. He had hallucinations of
sight and hearing, and thought that he heard voices accusing his
sister of immorality. He at times accused this sister of trying to
poison him. He believed that his fellow-workmen were trying to have
him discharged. This condition lasted for six weeks, when he
became gloomy and stuporous, and would make no effort to do
anything for himself. His friends had to feed him. When first admitted
to the nervous wards he sat in the same position all day long, with
his head almost touching his knees, his arms fully extended by his
sides. He would not help himself in any way. His eyes were always
open, and he never winked. He never slept any during the day, but
was perfectly oblivious to all surroundings. He did not speak or move
out of any position in which he was placed. He could be placed in all
sorts of uncomfortable positions, and would remain in them. After
treatment with strong electrical currents and forced exercise he
brightened considerably, and would walk, after being started, without
urging. When treatment was discontinued, he relapsed into his
former state. Frequent experiments have been performed with this
man. Placing his limbs in any position, they will remain if a command
is given to retain them. He marches, makes movements as if boxing,
etc. at command.

The phenomena shown by both of these patients are those which

have for many years been known and described under various
names. I well remember when a boy attending a series of exhibitions
given by two travelling apostles of animal magnetism, in which many
similar phenomena were shown by individuals, selected apparently
at haphazard from a promiscuous audience, these persons having
first undergone a process of magnetizing or mesmerizing. In
experiments of Heidenhain of Breslau upon hypnotized individuals
many similar phenomena were investigated, and described and
discussed by this physiologist under the names of automatism at
command and imitation automatism. The hypnotized subjects, for
instance, were made to drink ink, supposing it to be wine, to eat
potatoes for pears, to thrust the hand into burning lights, etc. They
also imitated movements possible for them to see or to gain
knowledge of by means of hearing or in any other way. They
behaved like imitating automatons, who repeated movements linked
with unconscious impressions of sight or hearing or with other
sensory impressions. It was noted in the experiments of Heidenhain
that the subjects improved with repetition. The manifestations of my
patients, although not simulated, improved somewhat by practice.
Charcot, Richer, and their confrères have made similar observations
on hysterical and hypnotized patients, which they discuss under the
name of suggestion. Hammond26 suggested the term
suggignoskism, from a Greek word which means to agree with
another person's mind, as a proper descriptive designation for these
phenomena. In referring to persons said to be in one of the states of
hypnosis, he says that he does not believe that the terms hypnotism
and hypnosis are correct, as, according to his view, the hypnotic
state is not a condition of artificial somnambulism; the subject, he
believes, is in a condition where the mind is capable of being
affected by another person through words or other means of
suggesting anything. In the clinical lecture during which these
opinions were expressed he is reported to have performed on four
hypnotized young men experiments similar to those which were
exhibited by my insane patients. His subjects, however, were not
insane. A bottle was transformed by suggestion into a young lady;
sulphur was transmuted into cologne; one of the subjects was bent
into all sorts of shapes by a magnet; another was first turned into
Col. Ingersoll and then into an orthodox clergyman, etc. In reading
such reports, and in witnessing public exhibitions of the kind here
alluded to, one often cannot help believing that collusion and
simulation enter. Without doubt, this is sometimes the case,
particularly in public exhibitions for a price; but what has been
observed in the mentally afflicted, what has been shown again and
again by honest and capable investigators of hypnotism, prove,
however, not only the possibility, but the certainty, of the
genuineness of these phenomena in some cases.
26 Med. and Surg. Reporter, vol. xlv., Dec. 10, 1881.

Catalepsy and this automatism at command are sometimes

confused, or they may both be present in the same case; indeed,
they are probably merely gradations of the same condition, although
it is well to be able to differentiate them for the purposes of more
careful and accurate investigation. In automatism at command the
individual does what he is directed as long as he remains in this
peculiar mental condition. In experimenting upon him, his arms or
legs, his trunk or head, may be put in various positions, and if
commanded to retain them in these positions he will do so, or he will,
at command, put them in various positions, there to stay until a new
order is given. Imitation automatism occurs also in such cases;
patients will imitate what they see or hear. These cases differ only
from those of genuine catalepsy in that they do not seem to present
true waxen flexibility. The phenomena presented are those which
result from control over an easily-moulded will, rather than
phenomena due to the fact that the will is entirely in abeyance.

PATHOLOGY—Attempts to explain the nature of catalepsy leave one in

a very uncertain and irritable frame of mind. Thus, we are told very
lucidly that most authors are inclined to the opinion that the
cataleptic rigidity is only an increase of the normal tonus of the
voluntary muscles occurring occasionally in the attacks. What
appears to be present in all genuine cases of catalepsy is some
absence or abeyance of volition or some concentration and
circumscription of cerebral activity. The study of the phenomena of
catalepsy during hypnosis throws some light upon the nature of
catalepsy. Heidenhain's theory of hypnotism is that in the state of
hypnosis, whether with or without cataleptic manifestations, we have
inhibition of the activity of the ganglion-cells of the cerebral cortex.
Herein is the explanation of many cataleptic phenomena even in
complicated cases. In hysteria and in catalepsy the patient,
dominated by an idea or depressed in the volitional sphere by
emotional or exhausting causes, no longer uses to their full value the
inhibitory centres. When organic disease complicates catalepsy, it
probably acts to inhibit volition by sending out irritative impulses from
the seat of lesion.

DURATION.—Usually, attacks of catalepsy recur over a number of

years; but even when this is the case the seizures are not as
frequent, as a rule, as those of hystero-epileptic paroxysms.
Uncomplicated cases of catalepsy, or those cases which occur in the
course of hystero-epilepsy, usually preserve good general health.

Of the duration of attacks of catalepsy it need only be said that they

may last from a few seconds or minutes to hours, days, weeks, or
even months. The liability to the recurrence of cataleptic attacks may
last for years, and then disappear.

DIAGNOSIS.—In the first place, the functional nervous disorder

described as catalepsy must be separated from catalepsy which
occurs as a symptom in certain organic diseases. It is also
necessary to be able to determine that a patient is or is not a true
katatonic.

It must not be forgotten that genuine catalepsy is very rare. Mitchell

at a recent meeting of the Philadelphia Neurological Society said that
in his lifetime he had seen but two cases of genuine catalepsy—one
for but a few moments before the condition passed off. The other
was most extraordinary. Many years ago he saw a young lady from
the West, and was told not to mention a particular subject in her
presence or very serious results would ensue. He did mention this
subject, rather with the desire to see what the result would be. She
at once said, “You will see that I am about to die.” The breath began
to fail, and grow less and less. The heart beat less rapidly, and finally
he could not distinguish the radial pulse, but he could at all times
detect the cardiac pulsation with the ear. There was at last no visible
breathing, although a little was shown by the mirror. She passed into
a condition of true catalepsy, and to his great alarm remained in this
state a number of days, something short of a week. Throughout the
whole of this time she could not take food by the mouth. Things put
in the mouth remained there until she suddenly choked and threw
them out. She apparently swallowed very little. She had to be
nourished by rectal alimentation. She was so remarkably cataleptic
that if the pelvis were raised, so that the head and heels remained in
contact with the bed, she would retain this position of opisthotonos
for some time. He saw her remain supported on the hands and toes,
with feet separated some distance, with the face downward, for
upward of half an hour. She remained as rigid as though made of
metal. On one occasion while she was lying on her back he raised
the arm and disposed of the fingers in various ways. As long as he
watched the fingers they remained in the position in which they had
been placed. At the close of half an hour the hand began to descend
by an excessively slow movement, and finally it suddenly gave way
and fell. Not long after this she began to come out of the condition,
and quite rapidly passed into hysterical convulsions, out of which she
came apparently well. He was not inclined to repeat the experiment.

Catalepsy is to be diagnosticated from epilepsy. It is not likely that a

grave epileptic seizure of the ordinary type will be mistaken by an
observer of even slight experience for a cataleptic attack. It is some
of the aberrant or unusual types of epilepsy that are most closely
allied to or simulate catalepsy. Cataleptic or cataleptoid conditions
undoubtedly occur regularly or irregularly in the course of a case of
epilepsy, but I do believe that it is true, as some observers contend,
that between catalepsy and some types of true epilepsy no real
distinction can be made. Hazard,27 in commenting on a case
reported by Streets,28 holds that no difference can be made between
the attacks detailed and those forms of epilepsy described as petit
mal.
27 St. Louis Clin. Rec., iii. 1876, p. 125.

28 “Case of Natural Catalepsy,” by Thomas H. Streets. M.D., Passed Assistant

Surgeon U. S. N., in the American Journal of Medical Sciences for July, 1876.

The case was that of a sailor aged forty-two years, of previous good
health. The attacks to be described followed a boiler explosion, by
which he was projected with great force into the water, but from
which he received no contusion nor other appreciable injury. There
was no history of any nervous trouble in his family. It was the
patient's duty to heave the lead. The officer noticed that he was
neglecting his business, and spoke to him in consequence, but he
paid no attention to what was said to him. “He was in the attitude he
had assumed in the act of heaving the lead, the left foot planted in
advance, the body leaning slightly forward, the right arm extended,
and the line held in the left hand. The fingers were partially flexed,
and the sounding-line was paying out through them in this half-
closed condition. The eyes were not set and staring, as is the case in
epilepsy, but they were moving about in a kind of wandering gaze, as
in one lost in thought with the mind away off. The whole duration of
the trance was about five minutes.”

Dickson29 reports a very striking case, and in commenting on it holds

to the same views. The patient had apparently suffered from some
forms of mania with delusions. She was found at times sitting or
standing with her body and limbs as rigid as if in rigor mortis, and her
face blanched. These spells were preceded by maniacal excitement
and followed by violence. On being questioned about the attacks,
she said that chloroform had been given her. Numerous experiments
were performed with her. Her arms and hands were placed in
various positions, in all of which they remained; but it was necessary
to hold them for a few moments in order to allow the muscles to
become set. She was anæsthetic. After recovering she said that she
remembered being on the bed, but did not know how she came
there; also, that she had been pricked with a pin, and that her fit had
been spoken of as cataleptic. Her mind became more and more
affected after each attack, and she finally became more or less
imbecile. From the facts observed with reference to this case,
Dickson thinks that we may fairly conclude that the mental
disturbance in either epilepsy or catalepsy is identical, and results
from the same cause—viz. the anæmia and consequent malnutrition
of the cerebral lobes; while its termination, dementia, is likely to be
the same in either case; also, that catalepsy, instead of being a
special and distinct form of nervous disorder, is to be considered as
a specific form of epilepsy, and to be regarded as epilepsy, in the
same manner as le petit mal is considered epilepsy, and a result of
the same proximate cause; the difference in the muscular
manifestation bearing comparison with any other specific form of
epilepsy, and occurring in consequence of one or other particular
cerebral centre becoming more or less affected.
29 “On the Nature of the Condition known as Catalepsy.” by J. Thompson Dickson,
M.A., M.B. (Cantab., etc.), British Med. Journ., vol. ii., Dec. 25, 1869.

I do not believe that this ground is well taken. The conditions present
in petit mal are sometimes somewhat similar to, but not identical
with, those of genuine catalepsy. In the first place, the loss of
consciousness, although more complete and more absolute—or
rather, strictly speaking, more profound—than in genuine catalepsy,
is of much briefer duration. The vertigo or vertiginous phenomena
which always accompany genuine petit mal are rarely if ever present
in catalepsy. To say that the mental disturbance in catalepsy and in
epilepsy is identical is to admit an imperfect acquaintanceship with
both disorders. The mental state during the attack of either disorder
it is only possible to study by general inspection or by certain test-
experiments.

Tetanus is not likely, of course, to be mistaken for catalepsy, but

there is a possibility of such an occurrence. The differential diagnosis
already given between hystero-epilepsy and tetanus will, however,
furnish sufficient points of separation between catalepsy and
tetanus.

Catalepsy has been supposed to be apoplexy, or apoplexy

catalepsy. The former mistake is, of course, more likely to be made
than the latter. A careful study of a few points should, however, be
sufficient for the purposes of clear differentiation. The points of
distinction given when discussing the diagnosis of hysterical and
organic palsies of cerebral origin will here apply. In true apoplexy
certain peculiar changes in pulse, respiration, and temperature can
always be expected, and these differ from those noted in catalepsy.
The stertorous breathing, the one-sided helplessness, the usually
flushed face, the conjugate deviation of the eyes and head, the loss
of control over bowels and bladder, are among the phenomena
which can be looked for in most cases of apoplexy, and are not
present in catalepsy.

It is hardly probable that a cataleptic will often be supposed to be

drunk, or a man intoxicated to be a cataleptic; but cases are on
record in which doubts have arisen as to whether an individual was
dead drunk or in a cataleptic stupor. The labored breathing, the
fumes of alcohol, the absence of waxen flexibility, the possibility of
being half aroused by strong stimuli, will serve to make the diagnosis
from catalepsy. The stupor, the anæsthesia, the partial loss of
consciousness, the want of resistance shown by the individual
deeply intoxicated, are the reasons why occasionally this mistake
may be made.

Catalepsy is simulated not infrequently by hysterical patients.

Charcot and Richer30 give certain tests to which they put their
cataleptic subjects with the view of determining as to the reality or
simulation of the cataleptic state. They say that it is not exactly true
that if in a cataleptic subject the arm is extended horizontally it will
maintain its position during a time sufficiently long to preclude all
supposition of simulation. “At the end of from ten to fifteen minutes
the member begins to descend, and at the end of from twenty to
twenty-five minutes at the most it resumes the vertical position.”
These also are the limits of endurance to which a vigorous man
endeavoring to preserve the same position will attain. They have
therefore resorted to certain experimental tests. The extremity of the
extended limb is attached to a tambour which registers the smallest
oscillations of the member, while at the same time a pneumograph
applied to the chest gives the curve of respiratory movements. In the
case of the cataleptic the lever traces a straight and perfectly regular
line. In the case of the simulator the tracings at first resemble those
of the cataleptic, but in a few minutes the straight line changes into a
line sharply broken, characterized by instants of large oscillations
arranged in series. The pneumograph in the case of the cataleptic
shows that the respirations are frequent and superficial, the end of
the tracings resembling the beginning. In the case of the simulator, in
the beginning the respiration is regular and normal, but later there
may be observed irregularity in the rhythm and amplitude of the
respiratory movements—deep and rapid depressions, indicative of
the disturbance of respiration that accompanies the phenomena of
effort. “In short, the cataleptic gives no evidence of fatigue; the
muscles yield, but without effort, and without the concurrence of the
volition. The simulator, on the contrary, committed to this double test,
finds himself captured from two sides at the same moment.”
30 Journal of Nervous and Mental Diseases, vol. x., No. 1, January, 1883.

Chambers31 says that no malingerer could successfully feign the

peculiar wax-like yielding resistance of a cataleptic muscle. He
speaks of using an expedient like that of Mark's. Observing that
really cataleptic limbs finally, though slowly, yield to the force of
gravity and fall by their own weight, he attached a heavy body to the
extended hand of a suspected impostor, who by an effort of will bore
it up without moving. The intention of the experiment was explained,
and she confessed her fraud. This rough test, although apparently
different, is in reality similar to that of Charcot and Richer. In both
proof of willed effort is shown.
31 Reynolds's System of Medicine, vol. ii., No. 108.
It must not be forgotten that in catalepsy, as has been already noted
in hysteria, real and simulated phenomena may commingle in the
same case; also, that upon a slight foundation of genuine conditions
a large superstructure of simulated or half-simulated phenomena
may be reared.

PROGNOSIS.—The prognosis of catalepsy is on the whole favorable. It

must be admitted, however, that owing to the presence of neurotic or
neuropathic constitution a tendency to relapse is present. Hystero-
catalepsy tends to recover with about the same frequency as any of
the other forms of grave hysteria. Those cases which can be traced
to some special reflex or infectious cause, as worms, adherent
prepuce, fecal accumulations, scars, malaria, etc., give relatively a
more favorable prognosis. Cases complicated with phthisis,
marasmus, cancer, insanity, etc. are of course relatively unfavorable.

TREATMENT.—The treatment of the cataleptic seizure is not always

satisfactory, a remedy that will succeed in one case failing in
another. Niemeyer says that in case of a cataleptic fit he should not
hesitate to resort to affusion of cold water or to apply a strong
electrical current, and, unless the respiration and pulse should seem
too feeble, to give an emetic. The cold douche to the head or spine
will sometimes be efficacious. In conditions of great rigidity and
coldness of surface Handfield Jones recommends a warm bath, or,
still better, wet packing. Chambers quotes the account of a French
patient who without success was thrown naked into cold water to
surprise him, after having been puked, purged, blistered, leeched,
and bled. This treatment is not to be recommended unless in cases
of certain simulation, and even here it is of doubtful propriety and
utility. If electricity is used, it should be by one who thoroughly
understands the agent. A galvanic current of from fifteen to thirty
cells has been applied to the head with instantaneous success in
hystero-epileptic and hystero-cataleptic seizures. A strong, rapidly-
interrupted faradic current, or a galvanic current to the spine and
extremities, sometimes succeeds and sometimes fails. Rosenthal
reports that Calvi succeeded in relieving cataleptic stiffness in one
case by an injection of tartar emetic into the brachial vein—a
procedure, however, not to be recommended for general use.
Inhalations of a few drops of nitrate of amyl is a remedy that should
not be passed by without a trial; it is of great efficacy in the
hysteroidal varieties. Inhalation of ammonia may also be tried. A
hypodermic injection of three minims of a 1 per cent. solution of
nitroglycerin, as recommended for severe hystero-epileptic seizures,
would doubtless be equally efficient in catalepsy.

Music has been used to control hysterical, hystero-epileptic, and

cataleptic seizures. The French cases reported have all been of the
convulsive types without loss of consciousness and those varieties in
which the special sensibility sometimes persists, as in hystero-
catalepsy, lethargy, and somnambulism. Music has been used as
medicine from the times of Pythagoras to the present, although it can
hardly be claimed to have attained a position of much prominence as
a therapeutic agent.

In one case a vigorous application of fomentations of turpentine to

the abdomen was promptly efficacious in bringing a female patient
out of a cataleptic seizure.

Meigs, whose case of catalepsy produced by opium has been

reported under Etiology, suggests that purgative medicines, used
freely in the treatment of his case, might be advantageously resorted
to in any case of catalepsy.

Powerful tonics, such as quinine, iron, salts of zinc and silver, should
be used in connection with nutrients, such as cod-liver oil,
peptonized beef preparations, milk, and cream, to build up cataleptic
cases in the intervals between the attacks.
 ECSTASY.

BY CHARLES K. MILLS, M.D.

DEFINITION.—Ecstasy is a derangement of the nervous system

characterized by an exalted visionary state, absence of volition,
insensibility to surroundings, a radiant expression, and immobility in
statuesque positions. The term ecstasy is derived from two Greek
words, ἐκ and στάσις, which means to be out of one's senses or to
be beside one's self. Commonly, ecstasy and catalepsy, or ecstasy
and hystero-epilepsy, or all three of these disorders, alternate,
coexist, or occur at intervals in the same individual. Occasionally,
however, the ecstatic seizure is the only disorder which attracts
attention. Usually, in ecstasy the concentration of mind and the
visionary appearance have reference to religious or spiritual objects.

SYNONYMS.—Trance is sometimes used as synonymous with ecstasy.

While, however, ecstasy is a trance-like condition, conditions of
trance occur which are not forms of ecstasy. Other synonyms are
Carus-extasis, Catochus, Catalepsia spuria.

HISTORY AND LITERATURE.—Accounts of cases of ecstasy abound in

both ancient and modern medical and religious literature. The
epidemics of the Middle Ages, the days of the New England
witchcraft, the revivals in England and America, have afforded many
striking illustrations. Not a few special cases of ecstasy have
become historical. Elizabeth of Hungary and Joan of Arc were both
cataleptics and ecstatics. Saint Gertrude, Saint Bridget, Saint
Theresa, Saint Catharine, and many other saintly individuals of
minor importance have owed their canonization and their fame to the
facility with which they could pass into states of ecstasy, catalepsy,
or hystero-epilepsy.

Gibbon1 has well described the occurrence of ecstasy in the monks

of the Oriental Church in the following passage: “The fakirs of India
and the monks of the Oriental Church were alike persuaded that in
total abstraction of the faculties of the mind and body the purer spirit
may ascend to the enjoyment and vision of the Deity. The opinions
and practices of the monasteries of Mount Athos will be best
represented in the words of an abbot who flourished in the eleventh
century. ‘When thou art alone in thy cell,’ says the ascetic teacher,
‘shut thy door and seat thyself in a corner; raise thy mind above all
things vain and transitory; recline thy beard and thy chin on thy
breast; turn thine eyes and thy thoughts toward the middle of thy
belly, the region of the navel; and search the place of the heart, the
seat of the soul. At first all will be dark and comfortless; but if you
persevere day and night you will feel an ineffable joy; and no sooner
has the soul discovered the place of the heart than it is involved in a
mystic and ethereal light.’ This light, the production of a distempered
fancy, the creature of an empty stomach and an empty brain, was
adored by the Quietists as the pure and perfect essence of God
himself; and as long as the folly was confined to Mount Athos the
simple solitaries were not inquisitive how the divine essence could
be a material substance, or how an immaterial substance could be
perceived by the eyes of the body. But in the reign of the younger
Andronicus the monasteries were visited by Barlaam, a Calabrian
monk, who was equally skilled in philosophy and theology, who
possessed the languages of the Greeks and Latins, and whose
versatile genius could maintain their opposite creeds according to
the interest of the moment. The indiscretion of an ascetic revealed to
the curious traveller the secrets of mental prayer, and Barlaam
embraced the opportunity of ridiculing the Quietists, who placed the
soul in the navel—of accusing the monks of Mount Athos of heresy
and blasphemy.”
1 Decline and Fall of the Roman Empire, by Edward Gibbon, Esq., in 8 vols., vol. viii.
p. 64, London, 1838.
Some of Swedenborg's supernatural visions were, so far as can be
judged, simply accounts of attacks of ecstasy; and of like character
were the visions of John Engelbrecht as related by Arnold.2
2 Observations, etc., London, 1806.

In a very curious American book3 published in 1815 a history is given

of the wonderful performances of a woman named Rachel Baker,
who was undoubtedly in the habit of passing into conditions of
religious ecstasy, during which were present many of the
phenomena which occur in ecstatics, Catholic or Protestant, religious
or otherwise. When seventeen years old she witnessed the baptism
of a young lady, which impressed her strongly and caused her to
become much dejected and affected about her religious state. She
began to have evening reveries or night talks which soon attracted
attention. She united with the Presbyterian Church. These reveries
after a while expanded into evening exercises which began with
prayer, after which she exhorted and made a closing prayer. She
removed from Marcellus to Scipio, New York, in 1813, and shortly
afterward, in the same year, she went to New York City for medical
advice. While there she gave many opportunities to witness her
powers when in what her editors quaintly call her somnial
paroxysms. Her discourses were good illustrations of what is
sometimes termed trance-preaching.
3 Devotional Somnium; or, A Collection of Prayers and Exhortations Uttered by Miss
Rachel Baker, by Several Medical Gentlemen, New York, 1815.

One of the most interesting parts of this curious book is a

dissertation by Samuel L. Mitchill, M.D., on the function of somnium.
He says there are three states of animal existence—wakefulness,
sleep, and vision or dream. The definition of somnium, which he
quotes from Cicero, is a very fair one to be applied to some of the
conditions which we now speak of under such heads as lethargy,
trance, ecstasy, etc. “By somnium,” he says, “may be understood the
performance of certain mental and bodily actions, which are usually
voluntary, without the direction or government of the will or without
the recollection afterward that such volition existed.” He divides
somnium into symptomatic and idiopathic. The symptomatic
somnium occurs from indigestion, the nightmare, from affusions of
water into the chest, from a feverish state of the body, from debility
with fasting, from fresh and vivid occurrences, etc. The idiopathic
somnium is divided into somnium from abstraction, somnium with
partial or universal lunacy, with walking, with talking, with invention,
with mistaken impressions of sight and of hearing, with singing, with
ability to pray and preach or to address the Supreme Being and
human auditors in an instructive and eloquent manner, without any
recollection of having been so employed, and with utter
incompetency to perform such exercises of devotion and instruction
when awake. To the last of these affections he refers the case of
Rachel Baker, whose devotional somnium he describes.

A number of other curious cases are recorded in this book: that of

Job Cooper, a weaver who flourished in Pennsylvania about the year
1774; that of the Rev. Dr. Tennent, who came near having a funeral
in one of his states of trance, who has related his own views,
apprehensions, and observations while in a state of suspended
animation. He saw hosts of happy beings; he heard songs and
hallelujahs; he felt joy unutterable and full of glory: he was, in short,
in a state of ecstatic trance. Goldsmith's history of Cyrillo
Padovando, a noted sleep-walker, who was a very moral man while
awake, but when sleep-walking a first-class thief, robber, and
plunderer of the dead, is also given.

One of the most remarkable instances of ecstasy is that of the girl

Bernadette Soubirons, whose wonderful visions led to the
establishment of the now famous shrine of Our Lady of Lourdes in
the south of France. It is related of this young girl by her historian
Lasserre4 that when about to cross the Gave, a mountain-stream of
the Pyrenees, she suddenly saw in a niche of a rock a female figure
of incomparable splendor, which she described as a real woman with
an aureola about her head and her whole body of surprising
brightness. The child afterward described in detail the vision she had
seen. Later, on a number of occasions at the same spot, she saw the
same vision, described as appearing transfigured. The child believed
that she saw the Immaculate Virgin. The Virgin told her that she
wished a church to be built on the spot. The place has since become
a shrine for Catholics of all nations.
4 Our Lady of Lourdes, by Henri Lasserre, translated from the French, 7th ed., New
York, 1875.

Meredith Clymer5 has written an elaborate communication on

ecstasy. Ambrose Paré, quoted by Clymer, defines ecstasy as a
reverie with rapture of the mind, as if the soul was parted from the
body. Briquet describes it as a state of cerebral exaltation carried to
such a degree that the attention, concentrated on a single object,
produces the temporary abolishment of the other senses and of
voluntary movements.
5 “Notes on Ecstasy and other Dramatic Disorders of the Nervous System,” Journal of
Psychological Medicine, vol. iv., No. 4, October 1870.

ETIOLOGY.—Under the predisposing causes of ecstasy may be

comprised almost all of those described under hysteria. The
predisposition to the development of ecstasy will be governed in
great measure by peculiarities of religious education and of domestic
and social environment.

Extreme religious feeling is undoubtedly among the most frequent of

the exciting causes of ecstasy. The accidents and incidents of love
have also had a place. Sexual excitement is sometimes associated
with the production of ecstasy. “In pre-Christian times,” says
Chambers, “when, in default of revelation, men worshipped their
incarnate passions, we have from the pen of Sappho a description of
a purely erotic ecstasy which can never be produced again.” Fear or
fright has been known to throw a predisposed individual into an
attack of ecstasy. Severe threats have occasionally had the same
influence.

SYMPTOMATOLOGY.—In considering the symptomatology of ecstasy it

will only be necessary to call attention to the ecstatic attack. The
accompanying phenomena are those of hysteria, hystero-epilepsy,
etc., already fully described. I cannot do better than quote from
Lasserre the account of one of the ecstatic seizures of Bernadette
Soubirons. Although given in turgid language and from the religious
point of view, the description is a good one of the objective
phenomena of ecstasy:

“A few moments afterward you might have seen her brow light
up and become radiant. The blood, however, did not mantle her
visage; on the contrary, she grew slightly pale, as if Nature
somewhat succumbed in the presence of the apparition which
manifested itself to her. All her features assumed a lofty and still
more lofty expression, and entered, as it were, a superior
region, a country of glory, significant of sentiments and things
which are not found below. Her mouth, half open, was gasping
with admiration and seemed to aspire to heaven. Her eyes, fixed
and blissful, contemplated an invisible beauty, which no one
else perceived, but whose presence was felt by all, seen by all,
so to say, by reverberation on the countenance of the child. This
poor little peasant-girl, so ordinary in her habitual state, seemed
to have ceased to belong to this earth.

“It was the Angel of Innocence, leaving the world for a moment
behind and falling in adoration at the moment the eternal gates
are opened and the first view of paradise flashes on the sight.

“All those who have seen Bernadette in this state of ecstasy

speak of the sight as of something entirely unparalleled on
earth. The impression made upon them is as strong now, after
the lapse of ten years, as on the first day.

“What is also remarkable, although her attention was entirely

absorbed by the contemplation of the Virgin full of grace, she
was, to a certain degree, conscious of what was passing around
her.

“At a certain moment her taper went out; she stretched out her
hand that the person nearest to her might relight it.
 “Some one having wished to touch the wild rose with a stick,
she eagerly made him a sign to desist, and an expression of
fear passed over her countenance. ‘I was afraid,’ she said
afterward with simplicity, ‘that he might have touched the Lady
and done her harm.’”

Side by side with this description by the devout Lasserre of the

appearance presented by Bernadette when in a state of ecstasy, I
will quote the often-recorded account which Saint Theresa has given
in her Memoirs of her subjective condition while in a similar state:

“There is a sort of sleep of the faculties of the soul,

understanding, memory, and will, during which one is, as it
were, unconscious of their working. A sort of voluptuousness is
experienced, akin to what might be felt by a dying person happy
to expire on the bosom of God. The mind takes no heed of what
is doing; it knows not whether one is speaking or is silent or
weeping; it is a sweet delusion, a celestial frenzy, in which one
is taught true wisdom in a way which fills us with inconceivable
joy. We feel as about to faint or as just fallen into a swoon; we
can hardly breathe; and bodily strength is so feeble that it
requires a great effort to raise even the hands. The eyes are
shut, or if they remain open they see nothing; we could not read
if we would, for, though we know that they are letters, we can
neither tell them apart nor put them together, for the mind does
not act. If any one in this state is spoken to, he does not hear;
he tries in vain to speak, but he is unable to form or utter a
single word. Though all external forces abandon you, those of
the soul increase, so as to enable you the better to possess the
glory you are enjoying.”

Occasionally striking illustrations of ecstasy are to be found among

hysterical and hystero-epileptic patients in whom religious faith has
no place. In these cases usually other special phases of grave
hysteria are present. In some of the descriptions given by Charcot
and Richer of hystero-epileptics in the stage of emotional attitudes or
statuesque positions the patients are, for a time at least, in an