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The view presented is an attempt to integrate a number of diversified observations of clinical pathological, physiological and psychological nature into a consistent etiological picture of hypertension. Increased blood pressure is a utilitarian reaction of the organism preparing it and making it fit for flight or fight. In hypertensive patients neither takes place because of a paralysis of the emotions. Neither the passive dependent attitude nor the hostile impulses may be expressed freely; the two opposing emotional attitudes block each other. Social life of today requires an extreme control of hostile impulses and this may be the reason for the increased frequency of hypertension. The assumption is that the chronic inhibited rage may lead to a chronic elevation of the blood pressure. The therapeutic possibilities of the psychoanalytic method in essential hypertension cannot be as yet conclusively formulated. It has its greatest possibility of success during the early fluctuating phase and has therefore primarily a prophylactic value. Analysis may help to solve the pronounced conflict between passive dependent, feminine receptive tendencies and overcompensatory competitive aggressive hostile impulses which lead to fear and increased flight from competition back to the passive dependent attitude.