Working is "not merely a state of employment but a state of mind," writes psychiatrist Dr. Jay Rohrlich in his book "Work and Love: The Crucial Balance."

"Nothing else with which we associate our selves can give us the sense of objective identity that work can," says Rohrlich. "When we can say, 'I did it,' we are enjoying the ultimate in self-definition."

Work, he says, "organizes, routinizes and structures our lives. It allows for the appropriate outlet of competitive strivings. It keeps us sane."

But sometimes, too, it drives us crazy. The modern dilemma, as sociologist Max Weber once said, is "Do we work to live or live to work?"

"More than anything else," says Kevin Sweeney, chairman of the American Center for Quality of Work Life, "people are looking for meaning in their life. And work being a large portion of their lives, they're looking for meaning in their work. They're looking for something bigger than themselves.

"If they don't find that, they get very frustrated and burned out."

The importance of having an interesting job was ranked "high" or "very high" by 69 percent of Americans in a 1982 Gallup poll -- far ahead of having many friends (54 percent), having a high income (37 percent) and having enough leisure time (36 percent).

"When someone asks you what you do," says David Oldfield, director of the Psychiatric Institute Foundation's Midway Center for Creative Imagination, "if you don't have something to say that sounds nice and worthy of admiration, it's embarrassing. It's those titles that mean so much to our self-esteem and our sense of who we are."

"A title, like clothes, may not make the man or woman," writes Studs Terkel in "Working," "but it helps in the world of peers -- and certainly impresses strangers."

Monday through Friday, most Americans spend about half their waking hours in offices, factories, classrooms and stores -- at a desk or on an assembly line, in a field or behind a wheel. In short, at work. The average work week dropped from 69 hours in 1870 to 40 hours in 1940, but has stayed almost unchanged since.

"Going to work and being on the job really consumes most of people's time," says Norman Fein- gold, a Washington clinical psychologist specializing in career development. "It dips in and spills over to the rest of their lives. It determines where you live and who you marry and your life style.

"In our society, your stature and recognition are determined by your work. When you drop out of the work force, you drop out of a great deal of the mainstream of America."

"We happen to be a work-oriented society," says Oldfield. "The American Dream is about work, overcoming obstacles and revolutionizing the world through technology and industry."

It wasn't always this way. The ancient Greeks thought work was fit only for slaves, a necessary evil that brutalized the mind. Early Christians saw work mainly as punishment for sin. Luther and Calvin helped establish the Protestant ethic of work as the path to salvation, and the Industrial Revolution reinforced the notion of labor as the source of economic value and progress.

The 20th-century American work ethic, though it's under some stress itself, seems like the classic cartesian credo with a twist: "I work, therefore I am."

Psychiatrist Rohrlich says many of the patients in his Wall Street practice -- mainly lawyers, stockbrokers and investment bankers -- seem involved with their work "to the virtual exclusion of all else." Not only is their work "single-minded," but their materials -- mainly numbers -- are less tangible than those of a shoemaker, an artist, an engineer, a salesperson or a doctor.

"Where else but on Wall Street," asks Rohrlich, "can one hear, as I did from a famous and enormously successful corporate financier, that 'paranoia is the key to high achievement in this business'?"

Washington perhaps?

What money is to the New York financial world, he acknowledges, politics is to Washington, D.C., a city notorious for its attention to status and job titles.

"Washington is the only place I ever lived where people ask you if you worked on Sunday," says Charles E. McLure Jr., a former deputy assistant secretary of the Treasury who quit last summer to move back to California. "And they're surprised if you didn't.

"Most people elsewhere would be surprised if you did. Most people would think you were nuts if you even asked."

McLure, a tax economist and self-described "quintessential academic," was the main author of Treasury's sweeping 1984 tax reform proposal that got rewritten to the point of unrecognizability last year by top Reagan advisers and Congress. From his scholarly perch at Stanford University's Hoover Institution, he looks back on his two frenetic years in Washington with a mixture of fondness, amazement and 3,000-mile relief.

"People in Washington are filled with a sense of their own importance," says McLure, who was raised in Texas and has also lived in Boston. "You get the feeling that they think the rest of the world couldn't exist without them."

He used to remind his colleagues that the Treasury Department had survived 200 years before they arrived, adding, "I guess they can make it without me here on weekends."

"I think Washington sort of pulls people with a combination of high expectations and a tremendous desire to excel and be recognized," says Robert Rosen, clinical psychologist at George Washington University Medical Center and director of the Institute on Organizational Health at the Washington Business Group on Health.

"Look at the titles in this city. The titles themselves reflect a desire to be recognized as important."

Even climate may be a factor, says Fred Best, president of Pacific Management and Research Associates in Sacramento, Calif., who has written five books on the sociology of work.

"In Washington, when the weather is real cold and dreary," says Best, who used to work for the federal government, "it's easier to stay inside and work your ass off. Here in California , when things get bad enough, I just take my tent and go up into the hills."

Whether work is a labor of love or just another four-letter word, of course, economic necessity forces all but the super-rich to work for a living. And despite all the tribulations of work, not working can take an even bigger toll.

The "social pathology of unemployment" was described in a 1984 congressional Joint Economic Committee report, based on studies of the recession of 1974-75 by M. Harvey Brenner, professor of health policy and management at the Johns Hopkins School of Hygiene and Public Health.

Brenner found that the 14 percent rise in unemployment during that recession was associated with a 2.3 percent increase in the overall mortality rate and increases in the death rates from cardiovascular disease (2.8 percent) and cirrhosis (1.4 percent), which is usually a result of excessive alcohol consumption. Brenner also found a 6 percent rise in the admission rate to state mental hospitals, a 6 percent rise in total arrests, a 1.1 percent rise in reported assaults and a 1.7 percent rise in homicides.

For the population as a whole, the report concluded, "stress induced by economic conditions can lead to shorter life, more illness and increased aggression for the employed as well as the jobless." Working too hard can have its own pathology. But simply working very hard does not make you a workaholic. Workaholism is an addiction. Workaholics are people who can't stop working even when they're not at work. They don't know how to relax. They resent weekends and sleep. Their slogan could be "Thank God It's Monday."

Psychiatrist Rohrlich draws a crucial distinction between devotion to work, which is usually healthy, and addiction to work, which is usually not.

Language itself is a problem, he says. English, which has plenty of synonyms for the verb "to work," has no active verbs derived from the noun "leisure." Words such as "vacate" and "retire" suggest withdrawal and inactivity. "Play," often considered the opposite of "work," suggests frivolity and lack of seriousness.

Although workaholism often is compared to alcoholism, Oldfield says, the public attitudes toward the two addictions are very different.

"There is an almost totally unified public opinion against alcoholism," he says. "But on workaholism, we're split. One side of our selves -- and, frankly, the corporate mentality -- says we should be workaholic. But on the other side, there's a little voice that says, 'You can't keep that sort of pace up. Your children are growing up without you knowing them. Your marriage is falling apart. You don't know what to do with yourself on weekends.'

"More people today are beginning to listen to that other voice."

Nor are workaholics necessarily efficient. They often delegate too little, demand too much and accomplish much less than they think. Many workaholics "are among the world's worst workers," according to Marilyn Machlowitz, a management psychologist and author of "Workaholism." And like alcoholics, they often are the first to deny their addiction.

The most dramatic change in the labor force in the past generation has been the increase in employed women, who now make up 44 percent of all workers. But the stresses of trying to balance work and family life, hard enough on men, are especially severe on women, who still bear most of the burdens of child care and earn only about 60 cents for every dollar earned by their male counterparts.

"What we've found is, they really do want it all," says Helena Lopata, professor of sociology at Loyola University of Chicago and author of a two-volume study of women in the labor force, "City Women: Work, Jobs, Occupations, Careers."

"They honest to goodness want to have a job and a husband and children. And they want to have it all in the same life stage. It's this squeeze at this one stage -- between 30 and 40 -- that is detrimental to marriage, and it certainly can't do much for health."

The problem, Lopata says, is the "inflexibility of our economic system. Society has not made it possible for people to lead both kinds of lives, except to do it on your own, individually.

"Our whole American economic system is geared to the women staying home."

The employe benefits plans of many companies, designed mainly for the "traditional" family -- with a male breadwinner and an unemployed wife -- are obsolete today. In 1985, fewer than 10 percent of American families fit that description.

"Businesses are slow in responding to the changing social values and family structure, but they're catching on," says psychologist Rosen. More and more companies are offering "cafeteria" benefits plans, allowing employes already covered by a spouse's health plan to choose other benefits, such as tuition assistance, flexible scheduling, wellness programs or day care.

The two most common complaints that psychologist Feingold hears from workers are: inability to get along with the boss, and a feeling of being trapped in an unsatisfying job.

For ambitious workers, restlessness and frustration with their current jobs are compounded by overtraining and all the talk about social mobility in the 1980s. They'd rather be in another job -- or even another field -- but they don't know how to get there. Switching careers in mid-life is easier said than done, Feingold warns.

"It may seem marvelous to be an artist in Albuquerque," he says, "but if it means your family's going to starve, you may think twice about it."

Still, he says, 30 million Americans are in the midst of a career change.

"There's a lot of churning in the market," he says.

Just when the baby-boomers are beginning to reach middle age, a shortage of middle management professional jobs looms. Some call it the "promotion squeeze."

"You have less demand for middle management, but lots of highly educated, middle managers striving for the top," says Rosen.

As director of the Washington Business Group on Health's Institute on Organizational Health, Rosen works with more than 200 large companies to make them "healthier." Healthy corporations, he says, minimize stress, monotony and exposure to toxic chemicals, including cigarette smoke. They offer opportunities for day care, flexible scheduling and career counseling and advancement.

The utopian hope voiced by some in the 1960s that work might become a choice rather than a necessity was "pretty idealistic," says consultant Best. But while most Americans still view work "as the basis of their existence," the monolithic 9-to-5 job is a thing of the past.

Proliferation of home computers, more flexible work schedules, growth of part-time workers and an increase in service and information jobs all have decentralized work and loosened employment patterns. How far that trend will carry is not clear.

The Midway Center's Oldfield compares the changing work ethic to a trapeze act.

"It's as if we've left one trapeze, and we're spinning in the air and have yet to grasp the new trapeze," Oldfield says.

Society's state of flux about work, he says, is exemplified by President Reagan, whose speeches articulate the nostalgic values of the classic American work ethic but whose laid-back work style is in no danger of being mistaken for workaholism.

"Ronald Reagan is the champion of that old trapeze," he says. "He's the champion of the work ethic, the champion of the myth of progress and techno-scientific utopia, the old American Dream."

But of Reagan's own style of work, Oldfield says, "It's wonderful. He's a perfect example of how you can defeat workaholism. Whatever you think of his politics, the man is real smart about work. He knows how to delegate. He knows his limitations. He talks all the time about teamwork."

One of the "profound challenges for our generation," Oldfield says, "is to learn the lesson our grandparents learned only when they retired. They're telling us: Don't make the mistake we made. Learn to smell the flowers as you go along."

Better yet, find a job that's more fun than drudgery.

"The people who are happiest," says psychologist Feingold, "are those who fuse work and leisure -- they're teaching or doing research or writing.

"They're doing the thing they love to do, and getting paid for it."