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Angst, Phobie, Panik

Therapy Occasions

Fear, phobia, panic

Anxiety (disorder)

The most obvious symptom of an anxiety disorder is an unspecific, so-called "generalized" and persistent fear. It has little to do with environmental conditions, it often arises "just like that".

The content is often about unfounded worries and fears of future misfortunes or illnesses that affect the person themselves or people close to them. The affected person is often barely able to cope with his life and has little strength for a completely normal lifestyle.


One speaks of phobias when the fear is caused exclusively or predominantly by a clear, actually harmless situation. Typical forms can be found in agoraphobia (fear of leaving the house), social phobias (fear of scrutiny by other people), fear of spiders, fear of heights, fear of closed rooms, but also fear of exams.

As a result, this situation is avoided or only endured with fear. Just the idea that the feared situation could occur usually creates fear.

Common symptoms are:

  • palpitations

  • feeling weak

  • fear of dying

  • Fear of losing control

  • feeling of going insane.

Panic (disorder)

Significant characteristics are recurring severe anxiety attacks that are not limited to specific situations and are therefore not predictable. They start abruptly and reach a maximum within a few minutes.

They represent a great burden for those affected. It is not uncommon for those affected to present themselves to the hospital as an emergency, but then learn that they are organically healthy. This creates a further burden, since this information does not stop the panic attacks.


Dissociative experience, dissociative disorders

Dissociation is a psychological mechanism that can cause people to feel distant from their own experiences or their environment. It is like a protective mechanism of the brain that can be activated in situations of extreme stress or trauma. During a dissociative episode, people may feel that they are no longer properly aware of themselves or their surroundings, and dissociation can also lead to amnesia, where people lose parts or even whole events from their memory, sometimes temporarily, sometimes permanently. Some people describe it as "floating out of your body" or "being in a dream". After a dissociative episode, people can often feel exhausted or disoriented. It is important to know that dissociation is not a conscious choice, but an unconscious mechanism. Trauma-sensitive therapy or trauma therapy can help to reconnect with one's experiential world and deal with the triggers of dissociation. It may also be helpful to work on the underlying trauma to alleviate the symptoms.

Dissociative disorders can vary in severity and have very different symptoms and effects. This requires an accurate diagnosis and a very individualised approach to treatment. There is no THE dissociative disorder.


Burnout syndrome

Same fight every morning. They are reluctant to go to work, feeling like a failure because of it, feeling angry and disgusted with themselves. Guilt heightens, but at the same time indifference sets in. You become despondent about your own success, you withdraw. The daily feeling of tiredness and tension increases. Communication with others deteriorates, all strength and resources are used to maintain performance to some extent. Do you know these signs?


Phases of burnout syndrome

  1. overload phase

    • Change in sleep patterns (less becomes the norm)

    • Attention is focused on the main preoccupations

    • Compensatory behavior (eating/drinking) becomes normal

    • Too little movement

    • Denial of the overload / attempts at explanation

    • Increased conflicts due to deterioration in communication behavior

    • Decline in social skills/deterioration in relationships

    • Physical disabilities

    • susceptibility to infection

    • Diffuse constant pain

    • digestive problems

  2. alerting phase

    • Severe sleep disturbances

    • Restricted bodily functions, some of which are life-threatening

    • mental fixation

    • Self-determination and the ability to make decisions are severely restricted

    • Mental resources and ability to think are impaired

  3. knockout phase

    • High lack of drive

    • Bodily functions can no longer be controlled at will

    • Thoughts always revolve around a topic and become torture

    • afraid of the future

    • Concentration, memory and thinking disorders

    • Own control ability is blocked

    • Feeling of being switched off with inner restlessness at the same time

    • Emotionally unbalanced and irritable

    • Diffuse body symptoms, pain and digestive problems

    • functional disorders


Post Intensive Care Syndrome (PICS)

PICS (Post Intensive Care Syndrome) describes a variety of symptoms that occur after a life-threatening condition such as illness, accident or emergency. There was almost always a stay in the intensive care unit ("intensive care").  The symptoms can last for weeks or months without any significant improvement.


Symptoms may show up in the following areas:

  • Feelings/thoughts: Anxiety, depression, nightmares, difficulty concentrating,

  • Body: Fatigue, physical weakness, trouble sleeping, changes in appetite

  • Actions: Difficulty completing the daily duties

In a study it was shown that

  • 33% of patients on ventilators

  • 50% of all patients with serious infection (sepsis/blood poisoning)

  • up to 50% of patients who are in intensive care for at least a week

are at risk of developing Post Intensive Care Syndrome.


Furthermore, relatives can also develop this syndrome, this is referred to as PICS-F (Post Intensive Care Syndrome Family).


This topic is gaining in importance, especially after the current pandemic with its large number of people affected who have to be treated in intensive care.


Psycho-oncological advice

What does cancer mean to you? We will find your very personal answer to this question.

The focus of my counseling is the development of strategies to cope with this disease. Psycho-oncology deals with the consequences of cancer on the psyche of the patient.

The basis of my work is the deep understanding of the physical, mental and social influences on the development and course of cancer - the crucial point is: how do you deal with your disease?

Together we will carefully and gently dissolve your vicious circle of diagnostic shock, fear and tension. You will regain your strength and rediscover coping strategies that are already dormant in you.

The key for me is the concept of self-efficacy, ie with my support you develop and strengthen the conviction that you can achieve something yourself and that you can act and make decisions independently in difficult situations.
Research shows that people with a strong belief in their own competence have greater resilience in overcoming personal challenges and are less likely to develop anxiety disorders and depression. You can also use this for your cancer.

Upon request, psycho-oncological counseling includes all phases of the disease process:

  • Prevention and early detection

  • Phase immediately after diagnosis

  • Treatment

  • rehabilitation

  • aftercare

  • integration into everyday life

This offer is aimed at those affected and their families.


Trauma (mono/complex trauma)

The trauma expert and qualified psychologist Michaela Huber has described the special features of trauma therapy as follows:

"I think there are two fundamental difficulties. The first is that in a traumatic situation, people have had to go through unbearable things on their own that they could not digest, and in doing so have experienced existential loneliness, alienated from other people.
This requires an approach from caregivers who know specifically how someone who has experienced these states of emotional distress feels, how fragmented the person perceived and stored the situation, and how desperate they are trying to understand people and themselves and weed out the incomprehensible. That is the one big difficulty. The other is how to work with perceptual, memory and bodily material that reflect extreme states alienated from the everyday self. "

She further says:

"The physiology, i.e. the physical symptoms, is ultimately always the decisive factor, because the implicit or trauma memory is primarily organized somatopsychically. This means that a trigger such as a harmless smell or sight triggers extremely strong physical reactions. In addition, people in of their identity, and this applies above all to those who have been traumatized in a complex way, are extremely disturbed in the following respect: These people have extremely poor self-esteem, although they certainly have a lot of skills. They have numerous broken bonds and relationships in their biography and are very desperate about it, they have bodily states that they have no control over, they are very bad at regulating impulses and emotions despite trying desperately and they have trouble finding meaning in their lives and keep breaking down to the point of suicidal crises or serious ones Self-harm or self-injury. That characterizes complex traumatized people."

The text is taken without changes from an expert discussion with the psychotraumatologist Michaela Huber, led by Johanna Schwetz-Würth.

The entire conversation can be found belowthis link.

This article is licensed under the Creative Commons Attribution 4.0 International License (  authorizing its use, reproduction, modification, distribution and reproduction in any medium and format, provided you properly credit the original author(s) and the source, a link to the creative Include Commons license and indicate if changes have been made.


Dealing with your own trauma

Normally, what is experienced is processed by the brain and shelved. However, negative or even traumatic experiences can leave psychological scars. If these wounds are minor, the brain can deal with them unaided, just as the body heals a small cut on its own.

However, if these injuries are serious, they can exceed the self-healing powers of the brain - what has been experienced is stored in the brain in an unprocessed form (in a way, in raw data) and is repeatedly caused by similar situations in an uncontrolled manner.
This can lead to all conceivable disorders, fears and blockages: the rest of life is overshadowed by what you have experienced.

The psychological consequences of traumatic experiences are, of course, individually different. Nevertheless, people who have experienced a wide variety of traumatizing events show a large number of common symptoms: Many traumatized people suffer from a symptom pattern that is characterized by insomnia and nightmares, by social withdrawal and depressive lack of interest, by extreme irritability and excessive startle.

For the treatment of one-off trauma and post-traumatic stress disorder, an approach that requires relatively short treatment times is not sufficient. Rather, this treatment should be embedded in the framework of a phase-oriented concept:

  1. Phase: Stabilization & symptom reduction
    Clients are supported to cope better with everyday life. The focus here is on increasing mental energy in order to create strength and space for the next phase.

  2. Phase: Treatment of the traumatic memory
    A careful design of this phase leads to a cautious approach to the traumatic memory. Here have themselvesbrain spottingandEMDRproved to be a sensible and goal-oriented methodology.

  3. Phase: integration & rehabilitation of the personality
    Working at this stage is sometimes particularly difficult, but absolutely necessary. The past can be closed here. At the same time, there is room to practice the newly learned coping strategies.

Psychoonkologisch Beratung
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