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The present work tries to resolve some specific difficulties contained in the history of occupational psychopathology, and, at the same time, to reform the field. Applied to professional stress, this attempt faces some obstacles such as the traditional exclusion of stress from occupational psychopathology and the relations between physiology and psychology. We approach these difficulties from the clinical analysis of activity, by testing models of stress on the material collected during a study conducted with a group of inspectors in the French National Railway company. Our methodology includes a co-analysis of work situations that open some potential areas of development for these professionals. The motives for action and the psychological function of the work team are essential for understanding dialogue movement and the development of the power to act. These elements seem to be necessary for the interpretation of empirical material and lead us to reformulate the classical models of stress. At the same time, the possibility of integrating stress in occupational psychopathology could herald a potential reform of the discipline, with the help of a clinical analysis of activity.