In psychoanalysis the concept of envy describes a specific defence within an object relational structure that denies the subjectivity, need and entitlement of the other and is the antithesis of gratitude and satisfaction. Yet how far is envy both a representation of a psychological structure which is pathological and a culturally generated phenomenon? Should we not take into account the forces that amplify envy when considering the pathology of our ‘envious’ clients? With reference to social and political dynamics and a clinical vignette, this paper will consider whether envy can be as much a social disease as a psychopathology that requires psychotherapeutic treatment. It will look at three main areas. What are the conditions in our society that increase envious reactions? What are the economic and social consequences of envy, both negative and positive, and what of our own envy in relation to our colleagues and clients? Copyright © 2011 John Wiley & Sons, Ltd.