Approximately 300 cases of industrial accidents and injuries were reviewed to determine causation. The study revealed that physical injury resulted from a psychological process which is defined and documented. The significance of this process is suggested by the fact that it was identified in almost every case. Since physical disturbance is a solution to the problems of the patient, he is unlikely to give up his illness. In addition, when chronicity supervenes, the patient actually seeks physicians who will not cure him and rejects others who appear capable. The use of illness as a solution to the problems of life is now reinforced by legal factors which make incapacity the cornerstone of continued financial support.