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Author's reply

Published online by Cambridge University Press:  02 January 2018

R. Harland
Affiliation:
Division of Psychological Medicine, Institute of Psychiatry, London, UK. E-mail: [email protected]
C. Morgan
Affiliation:
Division of Psychological Medicine, Institute of Psychiatry, London, UK. E-mail: [email protected]
G. Hutchinson
Affiliation:
The University of the West Indies, Department of Psychiatry, Mount Hope, Trinidad
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Abstract

Type
Columns
Copyright
Copyright © 2005 The Royal College of Psychiatrists 

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. Reference CuttingCutting, 1997; Reference Sass, Hunter Jenkins and BarrettSass, 2004; Reference StanghelliniStanghellini, 2004).

To precis Dan Zahavi (Reference Zahavi, Kircher and David2003: 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.

Footnotes

EDITED BY KHALIDA ISMAIL

References

Cutting, J. (1997) Principles of Psychopathology. Oxford: Oxford University Press.CrossRefGoogle Scholar
Sass, L. (2004) ‘Negative symptoms’, common sense and cultural disembedding in the modern age. In Schizophrenia, Culture, and Subjectivity (eds Hunter Jenkins, J. & Barrett, R. J.), pp. 303328. New York: Cambridge University Press.Google Scholar
Stanghellini, G. (2004) Disembodied Spirits and Deanimated Bodies. Oxford: Oxford University Press.CrossRefGoogle Scholar
Zahavi, D. (2003) Phenomenology of the self. In The Self in Neuroscience and Psychiatry (eds Kircher, T. & David, A.), pp. 5675. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
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