Fear and phobia: A critical review and the rational-choice theory of neurosis

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.