384 384..386 References 1 Mulder R, Newton-Howes G, Coid JW. The futility of risk prediction in psychiatry. Br J Psychiatry 2016; 209: 271–2. 2 Chan MKY, Bhatti H, Meader N, Stockton S, Evans J, O’Connor RC, et al. Predicting suicide following self-harm: systematic review of risk factors and risk scales. Br J Psychiatry 2016; 209: 277–83. 3 Quinlivan L, Cooper J, Meehan D, Longson D, Potokar J, Hulme T et al. Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study. Br J Psychiatry 2017; 210: 429–36. 4 Carter G, Milner A, McGill K, Pirkis J, Kapur N, Spittal MJ. Predicting suicidal behaviours using clinical instruments: systematic review and meta-analysis of positive predictive values for risk scales. Br J Psychiatry 2017; 210: 387–95. 5 Sackett DL, Haynes RB. The architecture of diagnostic research. BMJ 2002; 324: 539–41. 6 National Institute of Health and Care Excellence. Self-Harm. The NICE Guideline on Longer-term management. National Clinical Guideline Number 133. British Psychological Society & Royal College of Psychiatrists, 2011. 7 Bolton JM, Gunnell D, Turecki G. Suicide risk assessment and intervention in people with mental illness. BMJ 2015; 351: h4978. 8 Horrocks J, Hughes J, Martin C, House A, Owens D. Patient Experiences of Hospital Care Following Self-harm – A Qualitative Study. University of Leeds, 2005. 9 Taylor TL, Hawton K, Fortune S, Kapur N. Attitudes towards clinical services among people who self-harm: systematic review. Br J Psychiatry 2009; 194: 104–10. 10 Palmer L, Blackwell H, Strevens P. Service Users’ Experiences of Emergency Services Following Self-Harm: A National Survey of 509 Patients. CCQI, Royal College of Psychiatrists, 2007. 11 Owens C, Hansford L, Sharkey S, Ford T. Needs and fears of young people presenting at accident and emergency department following an act of self-harm: secondary analysis of qualitative data. Br J Psychiatry 2016; 208: 286–91. 12 Hunter C, Chantler K, Kapur N, Cooper J. Service user perspectives on psychosocial assessment following self-harm and its impact on further help-seeking: a qualitative study. J Affect Disord 2013; 145: 315–23. 13 Cooper J, Steeg S, Bennewith O, Lowe M, Gunnell D, House A, et al. Are hospital services for self-harm getting better? An observational study examining management, service provision and temporal trends in England. BMJ Open 2013; 3: e003444. 386 Owens & Kelley The Counterfeiters by André Gide Alistair Stewart Sexuality (homo and hetero), youth and age, seduction, corruption, religion, respectability and hypocrisy, uncertain parentage, masturbation, innocence and cynicism, adultery, mental illness, art, appearance and reality, suicide, partying and self-discovery – André Gide packed all this into The Counterfeiters, his novel of 1925, set among the Parisian bourgeoisie of the early 20th century. One innocent caught up in this tangled and dangerous web is a vulnerable, troubled and lovable boy of 13 called Boris. His mother is a highly strung travelling singer; his father the man with whom she eloped, but who is now dead; he is pined for by a grandfather, an ailing, unhappy man who has never seen him. Boris has been entrusted to the care of a Polish psychoanalyst, Mme Sophroniska, who is trying to release him from a state of regressed and erratic behaviour accompanied by a private language. She in turn describes her daughter Bronja, with whom Boris has formed an intense bond, as his ‘real doctor’. The character of Sophroniska is based on the Polish psychoanalyst Eugenia Sokolnicka, pupil of Jung and analysand of Freud in Vienna, and then, more successfully, of Ferenczi in Budapest. A complex personality, she became a key figure in the introduction of Freud’s methods into France and a pioneer of child psychoanalysis. She was known to André Gide and treated him, although he only attended for six sessions; possibly he was only seeking material for his writings. He certainly drew for Boris’s story on some superficial details of Sokolnicka’s account, published in 1920, of her analysis of a 10-year-old boy with an obsessional neurosis. And although the cases of the real and the fictional child are quite different, there are clear echoes in Sophroniska’s approach of Sokolnicka’s careful, undogmatic and practical method, and her emphasis on the importance of basic sex education, as reflected in her paper, which incidentally is not difficult to find. Sophroniska is described by Edouard, a somewhat ambiguous and morally complacent author, who meets her and Boris and Bronja at a resort in the Swiss Alps. She gently teases him about his artistic pretensions, and explains her own procedure as follows: ‘My role is to allow things to emerge, and above all not to suggest anything. This requires extraordinary patience’. Her elucidation and formulation of Boris’s troubles, her treatment of him, and what subsequently happens to Boris and Bronja, form an important strand in the novel and are central to its denouement. The title alludes to a case of circulating forged money, but also clearly has a wider resonance. As often in life, young people suffer because of the selfish, hypocritical or thoughtless behaviour of their elders; certain more cynical and malevolent individuals induce impressionable children and adolescents to do their dirty work, while keeping their own hands clean. At the same time Gide is unsentimental about how cruel children can be. It is one thing to cure a child of a neurosis, quite another to protect them from the dangers of the outside world. The British Journal of Psychiatry (2017) 210, 386. doi: 10.1192/bjp.bp.117.198143 psychiatry in literature Downloaded from https://www.cambridge.org/core. 06 Apr 2021 at 01:36:04, subject to the Cambridge Core terms of use. https://www.cambridge.org/core