Author's reply

In suggesting that the environment acts to produce biologically based phenotypes depending on genetic propensity, through ‘intra-organismic’ processes, this letter points to one mantra of modern psychiatry. But in looking for how our editorial contributes to the incremental nature of this important science it misunderstands our intent.

By ‘a new model’ we are describing an alternative way of seeing the problem, as opposed to the box and line model we have become more familiar with when considering a novel testable hypothesis. Phenomenology, conceived by Husserl, developed through Heidegger, Ricoeur and others, is notoriously difficult. On these terms there may be those who feel that what we have attempted is misconceived. However, it is a tradition that influenced many of the early scientific thinkers in our field, including Jaspers, Schneider, Minkowski and Lewis, and it continues to influence today (e.g. Cutting, 1997; Sass, 2004; Stanghellini, 2004).

To precis Dan Zahavi (2003: p. 59) we cannot ask what it is like to be a bar of soap or a rock. However, we can ask what it is like to be a mouse, a human or, indeed, to experience schizophrenia. This ‘what it is like’ has an internal structure that phenomenology attempts to capture. Likewise, in our editorial we suggest that migration can provoke changes in ‘what it is like to be’ on a similar level and that the field of anthropology (which draws on phenomenology) offers insights here. We then link these changes to the increased rates of psychotic illness in some groups and suggest that this fits well with the current psychiatric thesis that the brain is the product of its own historical trajectory.

We remain open to whether biological or environmental correlates with identified phenomenological structures can meaningfully be found. But a reinvigoration of phenomenology is perhaps just what psychiatry needs at this time. We would do well to bring to mind that despite our best efforts we have yet to find aetiological factors in environmental or biological terms that take us beyond the group effect to the individual.

Above all the purpose of writing the editorial was to stimulate debate.