Good Science Fiction idea but horribly staged.
The story line here could be done in any Sci-Fi show. In fact, Outer Limits, with "The Refuge" did a similar story that aired about three weeks before this one. And, that story was remarkably staged. However, this one leaves a lot to be desired. And, that's one of my gripes. Although using Cirque du Soleil acrobats was innovative, the set was way too minimalistic. The acrobats just rolled around the floor rather than doing any of their high-wire specialties. In short, the set looked cheap. Something we'd expect from second season "Lost in Space." Ultimately, Voyager would stage a much better "shared unconscious" episode in Season 4, "Waking Moments."
Inhabiting the dream realm in this story is an adaptive program character known as "Fear" or introduced as the "Clown." In this world, to die or be killed by Fear/Clown is to also die in the suspended state. Kind of answers that question about dying in your dreams and then dying in real life…
Michael McKean plays Fear/Clown. He is a very talented actor and he clearly has a great time playing this part. However, like the set, he doesn't create anything special. There was such an opportunity here to make a truly "fearful clown" but the production group misses it. Since Fear refuses to release her crew in the suspended state, Janeway agrees to become the ultimate hostage for Fear. And, he agrees to this.
This is where my second gripe comes into place. Janeway enters the environment but isn't connected to it. She appears in front of Fear as a hologram where Janeway "confronts" fear. Essentially, she indicates she has learned to deal with Fear and therefore conquer it. However, she has not done this. She's only "cheated" Fear. Frankly, I'm okay with that concept. Sometimes confronting by cheating works well. See Kirk in Wrath of Khan. Ultimately, it means I like the concept of this episode but disagree with its execution. Potentially, this could have been one of the standout examples of Sci-Fi storytelling. Instead, it's only mediocre.