Ruth Fallenbaum's “The Injured Worker” focuses on something that not only the quotidian routine but also the inward focus of psychoanalysis inclines us to lose sight of: that in capitalism our search for empowerment ultimately disempowers us. Alienation is the psychology of class. It shows up as demoralization, shame, and inflamed psychesomas. It is a condition of institutionalized sadism that makes people “go postal.” “The Injured Worker” shows what we analysts must do when faced with the permanent trauma of alienation: patiently bear witness to our patients' tellings and retellings and, sometimes, get our hands dirty.