Trauma: Types, Causes, and Support in Berlin & Online

Trauma

As a psychological reaction to a highly stressful event, an extreme threat, or an exceptional situation, people can develop very different responses. The triggering event may be a single traumatic incident, such as an accident or natural disaster, or an ongoing or repeated traumatic experience, such as abuse.

In my practice, I frequently work with people who have experienced narcissistic abuse.

What is trauma – and what truly helps?
How can psychotherapy, including hypnotherapy, support the healing process?

Overview

• Trauma
• Your therapist
• What does hypnotherapy cost?
• Therapy duration
• Appointment booking
• You are not in Berlin or prefer an alternative to sessions in my practice?
• Preparing for your first session
• The first session
• How self-hypnosis can help you with PTSD
• Just ask me personally 

Trauma 

Traumaa are severe psychological and emotional injuries that result from extremely distressing or shocking experiences. These experiences are often so intense that they overwhelm a person’s normal capacity to cope and have a deep impact on emotional and psychological wellbeing. Trauma can be caused by a single, life-changing event as well as by ongoing stressors or repeated harmful experiences.

Traumatic experiences shape how a person perceives the world, thinks, and behaves, and they often mark a turning point in life. Especially in cases of severe trauma, the experience can become a painful center around which life seems to revolve. Life becomes easier to enjoy again when the trauma is gradually processed and integrated.

Because of this, trauma often requires professional therapeutic support in order to work through what happened and to ease the psychological and physical consequences.

Key characteristics of trauma

Here are some important characteristics of psychological trauma:

1. Cause

Trauma is caused by one or more events that feel extremely threatening, dangerous, or painful.
These events can be physical, emotional, or psychological in nature.

2. Subjective experience

How a person experiences the event plays a decisive role.
What is traumatic for one person may not necessarily be traumatic for another.

Trauma often develops when the person feels overwhelmed, helpless, and out of control in the situation.

3. Emotional response

Typical emotional reactions to trauma include intense fear, horror, feeling powerless, overwhelmed, and helpless.

These reactions can, in some cases, develop into longer-term mental health conditions, such as post-traumatic stress disorder (PTSD).

4. Long-term impact

Trauma can have deep and long-lasting effects on a person’s psychological and physical wellbeing.
Possible consequences include:

• Flashbacks
• Nightmares
• Anxiety
• Depressive symptoms
• Physical symptoms such as chronic pain

5. Changes in perception and behavior

After a traumatic experience, people often see themselves and the world differently.

They may:

• feel constantly on guard or in danger
• develop distrust toward others
• avoid places, people, or situations that remind them of the trauma

Examples of traumatic events

Natural disasters:
Earthquakes, floods, tornadoes

Accidents:
Serious traffic accidents, workplace accidents

Violence:
Assault, rape, domestic violence

War experiences:
Combat, bombardment, torture

Losses:
Sudden death of a loved one, miscarriage

Abuse:
Physical, emotional, or sexual abuse – especially in childhood

Possible psychological consequences

Trauma can lead to a wide range of mental health consequences, for example:

Post-traumatic stress disorder (PTSD)

A common consequence of severe trauma.
People may suffer from flashbacks, nightmares, and ongoing emotional tension or hyperarousal.

Complex trauma

This refers to repeated, long-term traumatic experiences, often beginning in childhood, which can lead to more complex and persistent psychological difficulties.

Forms of Trauma

There are different forms of trauma that are distinguished in psychotherapy.
They can vary in cause, duration, and intensity.
These different forms may lead to different psychological and physical effects and often require specific therapeutic approaches to support healing.

Here are some of the most common forms of trauma:

1. Acute trauma

A single, isolated traumatic event that usually happens suddenly and over a short period of time.

Examples:

• Natural disasters (earthquakes, floods)
• Accidents (car accident)
• Sudden losses (death of a close family member)
• Physical or sexual assault

2. Chronic trauma

Long-lasting or repeated traumatic events that occur over an extended period of time.

Examples:

• Ongoing abuse (physical, emotional, or sexual)
• Domestic violence
• War experiences
• Long-term neglect

3. Complex trauma

A specific form of chronic trauma caused by long-lasting, repeated, and often childhood-onset traumatic experiences.

Examples:

• Many years of abuse or neglect in childhood
• Human trafficking
• War-related traumatization

4. Developmental trauma

Traumatic experiences that occur during critical developmental phases, especially early childhood, and interfere with healthy development.

Examples:

• Neglect
• Abuse
• Growing up in a highly dysfunctional environment

5. Secondary or vicarious trauma

Traumatic impact that arises from being confronted with the traumatic experiences of others – often in helping professions.

Examples of people at risk for secondary trauma:

• Therapists
• First responders
• Physicians and medical staff
• Family members of trauma survivors

6. Transgenerational trauma

Traumatic experiences that are passed from one generation to the next, often through patterns of behavior, parenting styles, or the unconscious transmission of fear and stress.

Examples:

• Descendants of Holocaust survivors
• Families with a history of war experiences

7. Collective trauma

Trauma that affects an entire community or group, often as a result of major social or political events.

Examples:

• Wars
• Terrorist attacks
• Ethnic cleansing
• Major natural disasters

8. Accidental trauma

Trauma caused by unexpected, accidental events.

Examples:

• Traffic accidents
• Workplace accidents
• Medical complications

Anxiety and Trauma

Angst and trauma are closely and often mutually connected.
Both can be cause and consequence of one another:
trauma as a cause of anxiety, anxiety as a result of trauma,
and anxiety as a factor that makes experiences more likely to be perceived as traumatic.

In many people, anxiety and trauma form a cycle in which each can intensify or even trigger the other.
A deep understanding of both is essential for effective treatment.

Trauma as a cause of anxiety

A traumatic experience – especially when it is severe or repeated – can have a profound psychological impact and significantly increase the risk of developing anxiety.

After a traumatic event (for example an accident, abuse, or war experience), specific fears may emerge that are directly tied to the memories and emotional reactions linked to the trauma.

These fears may relate to the original situation or to similar situations that now feel threatening.
For instance, someone who has been in a serious car accident may develop pronounced anxiety about driving afterward.

Anxiety as a consequence of trauma

Trauma can destabilize a person’s mental health and create a lasting state of internal alarm.

This ongoing hypervigilance and tension can heighten both general and specific forms of anxiety.
Over time, this may develop into an anxiety disorder such as post-traumatic stress disorder (PTSD),
in which fear and a sense of threat are central symptoms.

Anxiety as a trigger for trauma

The connection also works in the other direction.

Pre-existing anxiety can make people experience situations as traumatic that might otherwise have been perceived as less overwhelming.
Strong fears – especially those that are already present in childhood or adolescence – can increase a person’s sensitivity and vulnerability to potentially traumatic experiences.

What they have in common

Anxiety and trauma are both associated with intense stress responses and emotional strain.

In many cases, effective treatment requires working with both the traumatic experiences and the associated anxiety.

Therapeutic approaches such as hypnotherapy, EDxTM, or EMDR (Eye Movement Desensitization and Reprocessing) aim to process and ease both the traumatic memories and the anxiety that is linked to them.

Anxiety and trauma are often part of a reciprocal cycle, where each can reinforce or even trigger the other.
A solid understanding of both phenomena is crucial for meaningful and lasting treatment.

How self-hypnosis can help you with PTSD  

Self-hypnosis has helped many patients with PTSD. Many sufferers usually report very quickly a noticeable improvement. Pondering, fears, mental and physical tension can be additionally reduced by self-hypnosis. Therefore, I teach my patients self-hypnosis to supplement the hypnosis sessions.

After positive trance experiences have been made with my support, self-hypnosis can be learned very quickly. This helps them to progress self-determined outside the therapy. It accelerates the process, deepens and consolidates the achievements. This also promotes the independence of the clients. A good therapist will be superfluous as soon as possible. Self-hypnosis is an excellent self-help method that can be used beyond the actual topic.

Meet Your Therapist

Specialized Care for Anxiety, Fear, and Trauma

With over 20 years of experience, I have focused my practice on helping individuals overcome fears, anxiety disorders, and trauma. Each week, I dedicate approximately 20 hours to empowering clients to break free from their limitations and achieve a higher quality of life.

A Trust-Based, Personalized Approach

Therapy is a personal journey. To build trust and provide transparency, I offer insights into my professional background and therapeutic philosophy in my profile. This openness sets the stage for a collaborative relationship, ensuring you feel supported and understood.

Flexible Language Options

To meet your unique needs, sessions are available in German and English. This flexibility ensures effective communication and comfort for all clients.

What does hypnotherapy cost?

Here are some organizational details. Please read them before the appointment reservation. People often ask, "How much does hypnotherapy cost?" What is meant by this are the presumed total costs, which result from the fee and the duration of the psychotherapy with hypnotherapy.

Fee for psychotherapy

Hourly Rates

The fees for a 60-minute psychotherapy session during regular business hours (Monday to Thursday, 10:00 a.m. to 6:00 p.m.) are as follows:

A. Online or telephone sessions: €189
B. In-person sessions at my office: €229
C. Flexible scheduling (short-term appointment changes up to 24 hours in advance for A or B: Additional €45 per session.
Psychotherapy services are VAT-exempt according to § 4 No. 14 a) UStG.

Terms and Conditions

Scheduling

General appointments are available Monday to Thursday, 10:00 a.m. to 6:00 p.m.
Sessions outside these hours, on weekends, or public holidays, incur a 35% surcharge.
The minimum session duration is 60 minutes, with additional time billed in 30-minute increments.

Rescheduling Policy

Sessions lasting up to 120 minutes may be rescheduled once, with at least 72 hours’ notice.
Longer sessions or sessions exceeding 120 minutes in a week require at least 14 days’ notice for rescheduling.
Missed or late cancellations are charged in full. Rescheduled sessions must be used within 12 months.

Alternatives for Missed Appointments

If you cannot attend in person, you can switch to an online video or telephone session at the scheduled time.

Payment Terms

Payment must be fully received via bank transfer 7 days before the appointment.
Cash payments on the day of the session may be allowed on a case-by-case basis; please inquire in advance.

Package Offers

Package deals are not available for psychotherapy services.

Travel Expenses

Travel, accommodation, and per diem expenses are charged separately.
For travel within Berlin, a minimum hourly rate applies.
Travel outside Berlin is billed based on time and effort, subject to individual agreement.

Personalized and Non-Transferable Services

All bookings are exclusively for one-on-one sessions and are non-transferable.

Right of Withdrawal

The provisions of the Distance Selling Act (Fernabsatzgesetz) apply to services booked by telephone, letter, email, or online form.

You may cancel a booking within 14 days of purchase without providing a reason.
If the service begins within the withdrawal period, the registration is considered a request to initiate service early.

Cost Coverage by Health Insurance Companies and Other Insurers

National health insurance companies typically do not cover psychotherapy fees. However, policies vary, so you must contact your insurance provider to clarify their specific guidelines and coverage options.

What You Need to Know

• Invoice Classification:
  You will receive an invoice from me, classified according to ICD-10 standards, to assist with any reimbursement claims.
• Prior Approval:
  Please discuss your therapy plans with your insurer in advance to avoid unexpected issues.
• Application Support:
  If additional documentation or applications are required by your insurer, we can address this together during our sessions.

For more information or assistance, feel free to reach out to me directly.

Therapy Duration and Expectations

Initial Session

The first therapy session lasts 90 minutes. This extended duration allows us to establish a foundation, understand your unique concerns, and set goals for your therapy journey.

Follow-Up Sessions

Subsequent sessions are typically 60 minutes long. The number of sessions required varies significantly based on individual personalities and specific circumstances.

Typical Session Range

• For anxiety disorders, clients often attend 3 to 8 sessions. After about the third session, we can usually assess this much more clearly. People and their stories are far too individual for one-size-fits-all statements.
• By the second session, many clients gain clarity about their commitment and therapy trajectory.

Personalized Guidance

After the initial sessions, I will provide an estimate of the number of sessions you may need based on your progress and my professional experience. This collaborative approach ensures that therapy is tailored to your specific needs and goals.

Appointment booking

Please read the important information before making an appointment with me, including the contraindications for psychotherapy with hypnotherapy. I have answered frequently asked questions for you. For the success of your therapy, this information is of crucial importance. If this attracts you, then you can find out about booking your appointment here. The better you are informed, the faster we can focus on you and your wishes.

To make an appointment, you can preferably contact me by e-mail (mail@noack-hypnose.de) or by using the contact form (privacy policy) as well as by phone 01577 704 53 56 or 030 - 864 213 69. You will then receive a confirmation of your reservation by e-mail. In this reply, you will find the details for the first session. This usually happens within 24 hours. If you do not receive a reply, it could be because an email has ended up in the spam filter. In such a case, please call me.

There are only a few practice hours available, and they want to be used well. The fee for individual session hours is therefore always to be paid in full by bank transfer, with payment received at least 7 days before the session.

Why at least 7 days in advance? I would like to do it differently, but this is the best practice. Appointments that have not been confirmed with payment received seven days in advance are noticeably more likely to be canceled. And the repeated callbacks take up a lot of time. Because of this, I'm currently faced with the decision of whether and how to either significantly adjust fees to absorb this or to consistently organize in a way that is fair to all parties. Because of this, I am also offering options in terms of shifting appointments with the fees.

There is a maximum of 20 hours a week available for psychotherapy, and any canceled appointment means patients are unable to benefit from psychotherapy help. I understand that it would be more convenient for you otherwise, but this solution is the fairest for all involved.

You can use real-time bank transfer (costs 25 Ct. at Sparkasse Berlin, for example) for time-sensitive appointments, and the transfer takes a few minutes, or we can make an appointment with appropriate advance preparation. If this is not an option for you, please let me know immediately so that I can assign your appointment. Otherwise, I appreciate your understanding and look forward to intensive cooperation.

You are not in Berlin or prefer an alternative instead of coming to me?

You are not in Berlin or do not want or cannot come to the practice for other reasons? Then it is worth reading the following information about the options:

a. Travel to Berlin

For clients traveling to Berlin, there is the possibility, if booked in advance, to hold 2 sessions on the same day. It should be discussed in advance by telephone whether this is a recommendable option, as it requires appropriate prerequisites. Any sources of additional pressure should be avoided in the interest of the therapeutic success.

Here you will find further information when considering to travel to me in Berlin.

b. Online sessions

At times a personal meeting is not possible. In such cases, a telephone session or a session with video support via the Internet is an alternative or supplement. I have been using this setting for many years, and many clients have achieved excellent results with it. These experiences make it easy to achieve very intensive sessions in this way as well. You are more flexible and can also use my support very promptly. There are currently reduced fees for such sessions.

You are also on the safe side regarding the coronavirus. By the way, this is also an option if you should be unexpectedly unable to attend a session personally.​

Just ask me personally.

Let's talk. Please read the privacy policy. If you are interested, you can contact me for questions and appointments via this contact form or by e-mail (mail@berlin-hypnosis.com). Make sure I understand what you are asking for.

You can find answers to frequently asked questions, such as fees, on the home page. There are also lots of articles and details about me (profile) to help you get an idea of who I am. This will also make it easier for you to decide if I am the right therapist for you and your problem.

Message

Remarks:

In the address bar of your browser, the URL should begin with "https://www.berlin-hypnosis.com/...". This indicates a secure connection (SSL). Whether you enter your real name is up to you.

Important Information Before Contacting Me

Read This First

Before reaching out, please take the time to review the detailed information on the following topics:

• Fees and Booking Procedures
• Contraindications for Hypnotherapy
• Answers to Frequently Asked Questions (FAQ)

About This Page

This page is designed to provide essential information for individuals interested in psychotherapy through hypnotherapy. However, it is not intended to replace professional psychotherapy, medical consultations, examinations, or diagnoses by a licensed medical practitioner.

My Role and Expertise

I am a hypnotherapist licensed to practice psychotherapy under the HPG (Heilpraktikergesetz). My work focuses on helping people manage anxiety, anxiety disorders and trauma. It is important to note the following distinctions:

• I am not a medical doctor.
• I do not provide medical diagnoses, prescribe medications, or make promises of healing.
• Psychotherapy with hypnotherapy is not a substitute for medical or psychiatric care where such intervention is necessary.

Contact Me

If you have any questions about psychotherapy with hypnotherapy, feel free to reach out. I am happy to provide more information and guide you on how hypnotherapy can support your journey to improved well-being.​

YouTube Channel

On my YouTube channel – Free of Fear & Trauma www.youtube.com/@help-anxiety – I regularly publish videos about anxiety, anxiety disorders, trauma and the effects of narcissistic abuse.

Please note: YouTube’s and Google’s privacy policies apply.

Step by Step

I’m gradually publishing content here—often based on the videos available on my German YouTube channel, www.youtube.com/@aengste.

If there’s a topic you’d like me to cover, feel free to let me know.

Published: March 1, 2008
Author: Karsten Noack
Revision: November 17th, 2025