I Lucked Out

Thursday was the last session before my therapist’s vacations; the next one is going to be in three weeks. It doesn’t worry me, though, because I think I have sorted out everything in regards to starting university, and everyday life – as it is right now – doesn’t pose any insurmountable challenges anymore. And if something really bad happens, I can always call the psychiatric ambulance as I did back in May.
At the beginning of this month, my therapist going away would have been a problem; I really needed his support and expertise to keep me on track when I had to decide about my future. We role-played a scenario in which I had to defend myself and my credits in front of the docent, so that I’d be better prepared next time, and afterwards we went through a situational analysis of me telling my mother that I wanted to go back to university.

My newfound confidence is mirrored by my BDI-II score, which at 9 points was the second-lowest I’ve ever had. As always, my therapist started off by asking about the points, and when I told him, he commented that I might find him in the same area that day. It already is in the range a non-depressed person experiences during a stressful time (and for my therapist, it had been a very busy day) – the goal is to bring me to ca. 5 points and stabilize me there. Zero points are rather utopian even for people who never experienced depression; an ideal state that one might reach during moments of utmost optimism and bliss, but it does not pose any realistic long-term level of symptoms.

I asked how therapy is going to continue: the programme consists of 48 sessions, of which I have completed 26 so far. Usually, we would switch from the current rhythm of one session every other week (except for when either of us is away – then we try to have the session before the break) to one meeting per month around session 35. Optionally, one could ease the transition by drawing out the periods between appointments to three weeks from session 30 on. Towards the very end of the psychotherapy, the gaps become even longer.
If I followed the programme as intended, it would mean that by the end of the year, I’d switch to monthly sessions, but due to my return to university, we will probably opt for a different plan as I will need more support during the time of my first exams (ca. February – April). My therapist proposed an extracurricular meeting in October for figuring out an alternative treatment plan, so that I might go on longer intervals from November to January and then switch back to a tighter schedule for exam time.

It was a lucky coincidence that I found the programme at the hospital and that I actually qualified for it, because if I had undergone psychotherapy at a private practice, this week would have been my last: in Germany, health insurances usually only cover “short-term therapy” consisting of 26 sessions, anything beyond requires a special permission and is only granted if the client/patient still exhibits grave symptoms. Given my progress, I would not have qualified for additional treatment anymore: the extra-time, however, is something I need badly, because only this way I can make sure that I don’t relapse during the first semester back at university.
Health insurance is obligatory for university students in Germany (and the fees are lower for them): paying for sessions is completely out of the question for me, so without health insurance, I could not afford any of this. I am very, very grateful and feel extremely lucky that I can enjoy the luxury of such an extensive psychotherapy with a highly competent therapist with whom – most importantly – I get along very well.


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