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This essay examines the psychoanalytic debates about mental health and the nature of work that occurred in the aftermath of the Baltimorean psychiatrist Adolf Meyer's psychobiology and the mental hygiene movement. Indeed, while established narratives in psychoanalytic history often regard the mid-century American ego psychologists as offering a strong and influential theory of psychological adaptation, this essay brings into view a different theoretical lineage. Beginning with an account of Meyer's psychiatric theory, it shows that a series of eclectic psychoanalysts, writing on the outskirts of the American psychoanalytic establishment, responded to his psychosocial conception of adaptation. The first decades of the twentieth century produced a set of psychoanalytic, psychiatric and social models that attended exclusively to the productivity of the mentally healthy, opening up key questions about the nature of psychological cure, the politics of psychiatry and psychoanalysis, and the identity of the mid-century American worker. This essay discusses several important post-Meyerian psychoanalytic psychiatrists who offered sensitive criticisms of the adaptive model of mental health and the political economy it engendered, searching for alternatives by inquiring into how the psychical life of the American worker had been perniciously shaped by emergent labour practices – and indeed how analysis can help the subject work without making them return to work.