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Psycho-analysis has stressed the positive value of work in binding the individual to reality and in providing an outlet for sexual and aggressive drives. In so doing it has ignored two factors of ever-increasing importance in contemporary industrial civilization—mechanization of labour and mass production. The combined effect of these is increasingly to impose on the modern worker: (a) a return to infantile living conditions, in which he is surrounded by machinery, the size and complexity of which produces a sense of personal inadequacy and surrounding threat; workers react to such occupations by boredom and hostility or by retreat from reality into phantasy; (b) excessive demands for libidinal output; although work may provide opportunities for sublimation or co-incidence with defences against anxiety, it often arouses anxiety and hostility by realizing unacceptable phantasies, or resentment and hostility by failing to provide any opportunity for sublimation and self-expression; (c) a return to childhood emotional relationships, since the integration into a pattern demanded by mass production produces a situation in which security is purchased at the price of dependence and submission to authority.
The conclusion is drawn that mass production by engendering hostility and anxiety and encouraging withdrawal from reality is a source of precipitating causes of psychogenic illness and that industry would be a fertile field for research into their genesis. For instance it would be of interest to compare the incidence of hypertension in occupations which engender suppressed hostility with that in occupations which demand its expression, or the incidence of peptic ulcer in passive, receptive and active, expulsive or destructive occupations.