This article discusses key relations between psychological distress and bank tellers' working conditions in various bank offices in Rio de Janeiro. Different theoretical models are discussed: stress, the psychodynamics of the work, and the psychopathology of the work. The aim of this case study was to elucidate the role of the work process as a source of psychological distress among tellers in a large bank company. Analysis of the work process with its variability and difficulties showed that two highly stressful situations are 1) discrepancies in the amounts of money counted at the teller's window and 2) customer complaints or insults directed against the teller. Such situations arise from the work organization that forces tellers to streamline or skip security rules and blames them for "discrepancies" in the till. The form of work organization also fails to support tellers in answering customer demands appropriately. The context of low wages and major transformations favoring workers' isolation generates insecurity over their future, viewed as lack of individual recognition. An approach to tellers' actual working conditions allowed for an understanding of stress factors and their determinants.