15 patients with a severe degree of essential hypertension, which had not responded satisfactorily to pharmacological management, received an additional regimen of psychophysiological treatment. This schedule consisted of relaxation training, self-recording of the blood pressure by the patients and conversations geared at improving stress management. After 1 year 9 patients showed a lowered mean blood pressure from 162/106 mmHg to 141/95 mmHg (responders). 2 patients were excluded from the study and 4 patients failed to show any lowering of their blood pressure (non-responders). In 6 responders it was possible to reduce the dose of antihypertensive drugs by 8-71%. These results were confirmed over a 4-year follow-up period. Responders and non-responders did not differ with regard to their age, stages and duration of hypertension. Patients with a very high reactivity of blood pressure under psychological stress and a low frankness with regard to their own weaknesses and problems seem to respond to the therapy with a lower probability of success.