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The author deals with the relation between the dynamisms implicit to the identity of the physician in Western culture (the old family doctor, the lineal heir of the Hippocratic tradition) and the individual dynamisms of the analyst. 'Our cultural image of the physician is shaped by the unchanging imperatives of the sick, epitomized from the past in the oath of Hippocrates and in the present by the stereotype of the "old family doctor".' The compassion and self-sacrifice
inherent in these idealized images imply 'extreme renunciation of instinctual gratification, except in the altered form of service for others'.
The myths and legends of Aesculapius contain the dynamic themes pertinent 'to the renunciations of the Hippocratic oath. The major themes include avoidance of open Oedipal identification and rivalry with the aggressive rapacity of the father; avoidance of rage at the deserting mother and rival siblings; sublimative or reactive alteration of these destructive and erotic strivings into a serving, preserving, and healing of others that constitute a reparative identification with the nurturing mother, an effort to please her and placate the father; re-emergence of the aggressive competitiveness as efforts to usurp the paternal prerogatives of knowledge and benevolent conquest disguised as service to others; eventual destruction for trespassing … too far into the paternal domain of knowledge… Similar patterns of conflict and resolution are demonstrated in the personal dynamics and professional conduct of physician patients and training analysands in whom the commitment to healing is great.'
Analysts who devote the major portion of their energies to therapy are denying similarity to the aggressive father in order to insure his protection. They also wish to please the mother through identification with her. In some analysts in training, the freedom to act with enlightened self-interest is so curtailed as to approach masochism. They are often excessively activ