In his early work Freud (1895b) made a clear distinction between anxiety neurosis, which he described in terms that closely parallel the current DSM IIIR definition of panic disorder, and psychoneurotic states. He viewed anxiety neurosis, along with neurasthenia, as “actual neuroses” with a somatic etiology, requiring a nonpsychological treatment (a change in sexual behavior). Psychoneuroses (phobia, obsessive compulsive disorder, hysteria), in which anxiety was psychically bound, arose from