42. Autonomy as a part of the power process may not be necessary for every individual. But most people need a greater or lesser degree of autonomy in working toward their goals. Their efforts must be undertaken on their own initiative and must be under their own direction and control. Yet most people do not have to exert this initiative, direction and control as single individuals. It is usually enough to act as a member of a SMALL group. Thus if half a dozen people discuss a goal among themselves and make a successful joint effort to attain that goal, their need for the power process will be served. But if they work under rigid orders handed down from above that leave them no room for autonomous decision and initiative, then their need for the power process will not be served. The same is true when decisions are made on a collective bases if the group making the collective decision is so large that the role of each individual is insignificant 
43. It is true that some individuals seem to have little need for autonomy. Either their drive for power is weak or they satisfy it by identifying themselves with some powerful organization to which they belong. And then there are unthinking, animal types who seem to be satisfied with a purely physical sense of power(the good combat soldier, who gets his sense of power by developing fighting skills that he is quite content to use in blind obedience to his superiors).
44. But for most people it is through the power process—having a goal, making an AUTONOMOUS effort and attaining the goal—that self-esteem, self-confidence and a sense of power are acquired. When one does not have adequate opportunity to go throughout the power process the consequences are (depending on the individual and on the way the power process is disrupted) boredom, demoralization, low self-esteem, inferiority feelings, defeatism, depression, anxiety, guilt, frustration, hostility, spouse or child abuse, insatiable hedonism, abnormal sexual behavior, sleep disorders, eating disorders, etc. 
5. (Paragraph 42) It may be argued that the majority of people don't want to make their own decisions but want leaders to do their thinking for them. There is an element of truth in this. People like to make their own decisions in small matters, but making decisions on difficult, fundamental questions require facing up to psychological conflict, and most people hate psychological conflict. Hence they tend to lean on others in making difficult decisions. The majority of people are natural followers, not leaders, but they like to have direct personal access to their leaders and participate to some extent in making difficult decisions. At least to that degree they need autonomy.
6. (Paragraph 44) Some of the symptoms listed are similar to those shown by caged animals.
To explain how these symptoms arise from deprivation with respect to the power process:
Common-sense understanding of human nature tells one that lack of goals whose attainment requires effort leads to boredom and that boredom, long continued, often leads eventually to depression. Failure to obtain goals leads to frustration and lowering of self-esteem. Frustration leads to anger, anger to aggression, often in the form of spouse or child abuse. It has been shown that long-continued frustration commonly leads to depression and that depression tends to cause guilt, sleep disorders, eating disorders and bad feelings about oneself. Those who are tending toward depression seek pleasure as an antidote; hence insatiable hedonism and excessive sex, with perversions as a means of getting new kicks. Boredom too tends to cause excessive pleasure-seeking since, lacking other goals, people often use pleasure as a goal. See accompanying diagram. The foregoing is a simplification. Reality is more complex, and of course deprivation with respect to the power process is not the ONLY cause of the symptoms described. By the way, when we mention depression we do not necessarily mean depression that is severe enough to be treated by a psychiatrist. Often only mild forms of depression are involved. And when we speak of goals we do not necessarily mean long-term, thought out goals. For many or most people through much of human history, the goals of a hand-to-mouth existence (merely providing oneself and one's family with food from day to day) have been quite sufficient.