Fear and Phobia: A Critical Review and the Rational-Choice Theory of Neurosis

Abstract

This article reviews the empirical status of theories of fear and phobia. Psychoanalysis received little support, as findings tend to refute its basic assumption that phobia results from repressed material. Although conditioning has its weaknesses, it appears to be the strongest explanation of simple phobia. Findings raise question as to whether interoceptive conditioning can account for the development of panic disorder and agoraphobia, as these disorders develop in the absence of environmental conditioning events. A significant body of research supports Clark's claim that catastrophic misinterpretation of bodily sensations are involved in both the development and treatment of panic disorder and agoraphobia. However, the causal relationship between the two remains unclear. Likewise, while biological factors certainly increase the vulnerability to developing fear and phobia, findings have not yet confirmed that these behaviors are controlled by biological mechanisms. A new theory, the Rational-Choice Theory of Neurosis (Rofé, 2010;Y. Rofé & Rofé, 2013), which preserves the psychoanalytic claim that bizarre phobias need to be explained within a theory that accounts for neuroses by one set of theoretical concepts, was used to resolve the theoretical confusion in this field.

Psikiyatride Rasyonel Seçim Teorisi

“…Because stress is not associated only with a certain type of neurosis; it can cause various types of neurotic disorders. For example, intolerable level of stress caused by marital problems or other domestic conflicts can lead to the development of obsessive ruminations, dissociative fugue and conversion disorder (Masserman 1946, Blanchard and Hersen 1976, Rofé and Rofé 2015. 3.…”

Which Diagnostic Approach Is More Valid? The DSM or the Rational-Choice Theory of Neurosis

“…This suggestion, however, has met serious criticism (e.g., see Clark, 1988;McNally, 1990;Rachman, 1990;Rofé, 2000Rofé, , 2015, such as the fact that hyperventilation, characterized by intense physiological sensations, does not invariably lead to a panic attack among panic disorder patients (e.g., see Gorman et al, 1994;Nardi et al, 2004;Sanderson & Beck, 1989). Similarly, only a minority of asthmatic patients develops panic disorder (Katon, Richardson, Lozano, & McCauley, 2004;Shavitt, Gentil, & Mandetta, 1992;Yellowlees & Kalucy, 1990), despite their frequent exposure to such intense bodily sensations.…”

“…Furthermore, the etiology of panic disorder and agoraphobia is still disputable among traditional theories of psychopathology, such as cognitive (e.g., Clark, 1986Clark, , 1988, medical (e.g., Uhlenhuth, Leon, & Matuzas, 2006), and psychodynamic (e.g., de Poderoso, Julian, & Linetzky, 2005) theories. A recent review article demonstrating the insufficiency of the traditional explanation of fears and phobia, including panic disorder and agoraphobia, was reported by (Rofé & Rofé, 2015).…”

“…It seems that a new theory, termed the Rational-Choice Theory of Neurosis (RCTN), that already proved its ability to integrate research and clinical data pertaining to treatment of neurotic disorders (Rofé, 2000(Rofé, , 2010, conversion disorder (Rofé & Rofé, 2013) and panic disorder, agoraphobia and other forms of bizarre phobia (Rofé & Rofé, 2015), is the right candidate to meet this goal.…”

“…Thus, contrary to traditional theories that use the same concepts for the explanation of all deviant behaviors, RCTN limits itself solely to bizarre deviant behaviors. Those behaviors that fail to meet RCTM's diagnostic criteria of madness, such as simple phobias, require other theories (see Rofé & Rofé, 2015).…”