The rational-choice theory of neurosis: Unawareness and an integrative therapeutic approach.

Abstract

In agreement with Freud (1915aFreud ( , 1915b, patients' unawareness regarding the underlying causes of their behavior seems to be the key to understanding the development and treatment of neurotic disorders. However, Freud's concepts of the unconscious and repression have encountered serious problems that do not allow for their maintenance (see review by Rofe ´, 2008). An additional issue concerns the fact that none of the available theories can integrate the therapeutic effects of various interventions under a single theoretical framework. Both of these issues are addressed in this article by the rational-choice theory of neurosis (RCTN). RCTN maintains that patients consciously and deliberately adopt neurotic disorders when confronted with intolerable levels of stress. Unawareness is created through sophisticated cognitive processes, by which patients forget their own self-involvement. Subsequently, patients develop a self-deceptive belief that rationalizes the neurotic behavior, thereby preserving unawareness. According to this new theory, all therapies exert their effect either by disrupting patients' ability to preserve unawareness, increasing the cost of the symptom, decreasing the patient's emotional distress, or eliminating the stressor.

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

“…As noted previously, there is a unanimous agreement among researchers that a diagnostic approach guided by a theory, as suggested by RCTN, which already proved its ability to integrate research and clinical data pertaining to neurosis and psychosis (Rofé, 2000(Rofé, , 2010(Rofé, , 2016Rofé & Rofé, 2013), is preferable over atheoretical, arbitrary diagnostic approaches as proposed by the DSM.…”

“…Freud assumed the existence of an autonomous, unconscious entity that supposedly had the omnipotent ability to control the patient's daily functions. In contrast, RCTN claims that patients become unaware of their deliberate adaption and maintenance of their mad behaviors, both in neuroses and psychoses, as a result of a complex self-deceptive process (Rofé, 2000(Rofé, , 2010(Rofé, , 2016Rofé & Rofé, 2013).…”

“…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.…”

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

“…In the discussion section, it will be indicated that despite serious weaknesses, conditioning theory appears to be the strongest explanation of simple phobia. The Rational-Choice Theory of Neurosis (Rofé, 2010;Y. Rofé & Rofé, 2013), was suggested as the best explanation of bizarre phobia (e.g., chocolate phobia or panic disorder).…”

“…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.…”