Life was basically impossible without Photoshop. The process and tools it took to get images and type set just the way you wanted took an eternity. There were no shortcuts! You needed a rapidograph pens, T-squares, rubber cement, exacto knifes and so much more just to do things Photoshop now does in one or two clicks.
The most insane thing to me was how long it took for type to get thrown into the layout. It took 24 hours and a relationship with a typographer just to get letters. And if you didn't like the kerning they gave you, you had to cut them up yourself. Good times!
Here's Lynda.com showing how things were done pre-Photoshop: