Loosening the Gordian Knot Psychotherapy with the difficult patient


The Royal Australian & New Zealand College of Psychiatrists

Section of Psychotherapy
2 O11 C o n f e r e n c e


Loosening the Gordian Knot: Psychotherapy with the difficult patient



Melbourne. 22-24 July, 2011

Sebel Albert Park Hotel

Announcement & Call for Abstracts

Closing date for receipt of abstracts:

Thursday 31 March, 2011

Glen O. Gabbard, M.D., is Professor of Psychiatry and Brown Foundation Chair of Psychoanalysis at Baylor College of Medicine in Houston, Texas. He is also training  and supervising analyst at the Houston /Galveston Psychoanalytic Institute. From 2001 to 2007, he was Joint Editor-in-Chief of the International Journal of Psychoanalysis, the first non-British Editor. He has also served as Associate Editor of American Journal of Psychiatry. He has authored or edited 26 books, including  Psychodynamic Psychiatry in Clinical Practice, which has been translated into 10 languages, Long-Term Psychodynamic Psychotherapy: a Basic Text, Gabbard’s Treatments of Psychiatric Disorders: 4th Edition, Psychiatry and the Cinema, and The Psychology of The Sopranos. He has also published over 320 scientific papers and book chapters. He has received numerous awards including the American Psychiatric Association /National Institute of Mental Health Vestermark Award as outstanding psychiatric educator in 2010.

The Phrygians lacked a king. An oracle decreed that the next man to enter the city driving an ox-cart would be king. And so it came to pass that the peasant farmer, Gordias, was declared king. His son in celebration, tied the ox-cart with an intricate knot, affixing it in the palace of the former kings of Phrygia at Gordium, in the 4th century BCE.  Phrygia went into decline. When the conquering Alexander the Great failed to untie the knot, he imperiously sliced it in half in a bold stroke, the so-called “Alexandrian Solution”.

The Gordian Knot is used as a metaphor for an intractable problem solved by a bold stroke (cutting the Gordian Knot). To apply the metaphor of what doctors do, the “Alexandrian Solution” lends itself best to the surgeon’s approach. It can be seductive for both psychiatrist and patient to imagine that there is indeed an “Alexandrian Solution” for the patient’s predicament. But as psychiatrists who practice psychotherapy, our work inclines to slow but persistent unloosening of the Gordian Knot, to allow fluidity and flexibility into an otherwise rigid and uncompromising system that constrains the difficult patient. In this case, the psychotherapist is more akin to Shakespeare’s Henry V:


Turn him to any cause of policy,
The Gordian Knot of it he will unloose,
Familiar as his garter



(Henry V, Act 1, Scene 1, 45-47)

The theme of our conference is psychotherapy with the difficult patient. At best we may hope to loosen the Gordian knot of psychopathology, rather than succeed in untying it. The degree of “unloosening” possible is not guaranteed, but independently varies amongst patients and therapists. It is the job of both patient and therapist to mourn successfully their limitations and learn to accept that which is not amenable to change. This serves as an echo of Freud’s words, enshrining his belief that there is no cure for common unhappiness: “... much will be gained if we succeed in transforming your hysterical misery into common unhappiness ... you will be better armed against that unhappiness.”
(Studies in Hysteria)



Paul Foulkes (Convenor),
Ilana Nayman (Chair)




If you are not a member of the RANZCP Section of Psychotherapy or a psychiatry trainee, and wish to be included in
the mailing list to receive the advance program and registration brochure, please email us at:
info@conorg.com.au (including “Psychotherapy” in the subject line and your postal address in the body of the email) or complete the following and return to:
Psychotherapy Conference
c/- The Conference Organiser
146 Leicester Street
Carlton Victoria 3053
Fax: (03) 9349 2230
Int: +61 3 9349 2230







Post Code: 


Regarded by many as the cultural capital of Australia, Melbourne is a beautiful setting for our conference. A friendly, multicultural city located on the banks of the Yarra River, Melbourne offers excellent shopping, world class cultural events, and spectacular food and wine from over 3,000 restaurants. You’ll find endless rows of cafes and boutiques along the riverside at Southgate, in the lanes and streets of the city centre and adjoining bohemian neighbourhoods like Carlton, Fitzroy, St Kilda and South Yarra. Outside Melbourne, you’ll find a host of regional attractions, from the Fairy Penguins to the spectacular Great Ocean Road.




For more information about Melbourne, go to:





Conference Venue



The Sebel Albert Park Hotel. 65 Queens Road, Melbourne.
Overlooking tranquil Albert Park Lake and golf course, The Sebel Albert Park is ideally situated just a short tram ride away from Melbourne’s CBD, Crown Entertainment Complex, St Kilda Esplanade, South Yarra /Chapel Street shopping precinct, and Port Phillip Bay.

Social Program
The social program will include a late afternoon reception on the Friday, and a dinner on the Saturday.


Program Format
Dr Gabbard will conduct a three hour optional workshop on the Friday morning on “The Impossible Patient”. Formal presentations are planned for Friday afternoon, Saturday morning and afternoon, and Sunday morning, and will include two keynote addresses by Dr Gabbard.



Participants in the RANZCP CPD Program may claim credits for CPD activities that are in accordance with his/her CPD Plan and that are in line with the principles and obligations of the RANZCP CPD Program. Evidence of attendance should be retained for use in the case of an Audit of Claim.








First and final Call for Abstracts

Loosening the Gordian Knot:

Psychotherapy with the difficult patient

Closing date for receipt of abstracts: Thursday 31 March, 2011

The Organising Committee invites all potential contributors to submit abstracts

for papers relating to the conference theme (30 minutes including discussion).

Please note that the acceptance of papers is contingent on registration

for the conference.

Please ensure that you comply with the following and forward no later than

31 March, 2011.

The abstract must be:

• Typed in Microsoft Word

• No more than 300 words

• Submitted by email as an attachment or by post on a CD

(faxes will not be accepted)

Abstracts should include:

• Name of conference (“RANZCP Psychotherapy Conference”)

• Title of presentation

• Author/s name(s), with name of presenting author underlined

• Authors’ affiliations

• Main author’s address and contact details

(postal and email addresses, phone and mobile numbers)

Please email abstracts to: info@conorg.com.au

or post on a CD to: Psychotherapy Conference

c/- The Conference Organiser

146 Leicester Street

Carlton, Victoria 3053


For further details regarding the

meeting, please contact:

The Conference Organiser

146 Leicester Street

Carlton, Victoria 3053


Telephone: (+61) (03) 9349 2220

Email: info@conorg.com.au


At the time of printing, all information contained in this brochure is correct; however, the

organising committee, its sponsors and its agents cannot be held responsible for any changes

to the final structure or content of the programs, or any other general or specific information

published in this brochure.