Mindfulness in Depression Relapse Prevention – The Breath

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camh, Centre for Addiction & Mental HealthI’m taking part in a research study for CAMH into the use of mindfulness in preventing depression relapse. The study comprises of eight weekly sessions and in this post I’ll cover Session 3, and the subsequent daily practices. Use the links at the end to access posts on previous sessions and more on the background and premise of the study.

The sessions so far have shown me how to use mindfulness to exist in the present moment, revealing the small but significant experiences I was missing out on by being blind to the holistic experiences of my body. Being mindful encourages us to bring kindness, awareness and curiosity to our experiences. This sounds simple but in reality, autopilot guides a large part of our thoughts. Breaking through it requires focus and concentration.

Finding your anchor

The next step is to explore the breath as an anchor to the present. Potential relapse can unbalance the mind, losing it in the past or the future. Using breath to anchor your focus in the present stops this happening. By focusing on sensations in the body, I’m learning how to bring choice and awareness to how I deal with those sensations/discomforts. Choosing whether to breathe through them and explore/investigate/fully experience them or whether to form a conscious decision to shift position and stop them.

Choice and awareness

The principles of choice and awareness are things I haven’t used for a very long time. Choice was eliminated during my upbringing and the feelings this caused were so painful that I learnt to block my awareness of them. I became adept at distracting myself when they threatened to surface. I had built a defensive wall. Now I’m learning that giving yourself time and space to focus on breathing and on the sensations in your body is an act of great self-care and great self-compassion. I’m gradually learning to face what I fear instead of running from it. These exercises help me practice skills that, ultimately, I can use in my interactions with the world at large.

Finding what works best for you

The longer formal practices that are now a part of my daily home practice make it easier to call upon mindfulness in everyday life – they’re necessary to train the mind in new habits; a bit like changing your eating habits to lose weight healthily. Session 3 will help me decide what kind of practice works best for me. We explored two types: still and moving mindfulness.

The Sitting Meditation

Sitting meditationFinding a comfortable sitting position (either seated in a straight-backed chair or on the floor with cushions for support) I settled into a comfortable, yet alert posture. With closed eyes I concentrated my mind on the sensations of sitting – the feelings my body was conveying to me, a body-scan of sorts. After a short while the audio urged me to turn my attention to where I could feel my breath in the body – the stomach, the chest and the nose. Concentrating on these areas helps with feeling your breath more vividly and gives a more stable anchor for the mind. I began by exploring the sensations of breathing in the stomach, as though I were an alien in a human body, experiencing the sensations for the first time. I noted with interest and curiosity, the expansion and contraction of the stomach with each breath, the way my waistband tightened and grew slack against my skin, the pause between inhale and exhale. I attempted to hold this focus to the exclusion of all other sensations for about five minutes. My mind wandered and I acknowledged this and brought it back, as in previous exercises, without judgement or criticism. The audio reassured me that even if my mind wandered a hundred times, I need only return my attention a hundred times to the breath and just begin again. I tried not to let my focus on my breath affect its normal pattern.

Next I moved my attention to my lungs and performed the same inquiring observation there. After another five minutes, I shifted the focus to the sensations of breathing in my nose and throat and did the same thing. Finally, I settled my attention on one of those areas and used it as the primary focus while I opened my awareness to include the physical sensations throughout the whole body – places where it comes into contact with the chair, the floor, the feeling of my hands on my thighs. The aim was to get a sense of the breath and of the body as a whole.

After sitting for some time in this way, the audio advised that it’s not unusual to begin to experience some strong sensations – pain, discomfort, tensing or twisting. They draw the focus away from the breath and body as a whole and there were two ways we could approach them. One was by moving/readjusting the body to provide relief. If we chose this, we needed to form an awareness of the intention first, thereby bringing choice and mindfulness to the decision. The other way was to bring the focus of attention right into the area of intensity and to meet what was there with an attitude of openness and curiosity – exploring with gentle attention the nature of the sensations: how do they feel, where are they, do they change or move? If your mind is carried away by the intensity of the sensations, you can always return by refocusing on the movements of the breath. The entire exercise lasted thirty minutes.

Mindful Stretching

Mindful stretching works with the same principle of present moment awareness, but uses physical sensations to vividly anchor us in the experience and to allow us to notice when our mind has wandered elsewhere. It’s not designed to be a form of exercise or a means of testing your body’s limits – simply an observation of physical sensations.

Mountain poseThe stretches themselves were very simple. From a stable standing position (known as  mountain pose in yoga) we were instructed to raise our arms perpendicular to our sides, one palm facing up, the other facing down. I held this position for about five breaths, noting the sensations in the body. Another position required us to stand with arms perpendicular to sides, palms facing down, with one leg slightly raised out to the side. After holding this for a few breaths and noting the sensations throughout the body, we returned to mountain before executing the stretch again, this time raising the other leg. The final stretch instructed us to widen our stance with legs approximately a metre apart, then, hands on hips – keeping the hips facing forwards – we twisted the torso around so that our shoulders moved towards the left. After holding this position for a few breaths and noting the sensations, we returned to mountain pose before performing the stretch on the other side.

3-Minute Breathing Space

The final exercise was a three-minute practice that’s designed for use as the first step in dealing with a difficult situation, or when carried away by autopilot. It’s a form of mode-travel; helping the user to move between two different types of attention – open and welcoming, and narrow and focused. The first minute is spent noting thoughts and mental feelings, the second focuses on the breath. In the third the attention is expanded once again to include the whole physical body and the sensations it’s experiencing. Imagining an hourglass helps you to visualise how your attention narrows from a wide focus then expands again.

For the following week we were asked to practice the 3-Minute Meditation three times a day and to alternate the Sitting Meditation with the Mindful Movement so that we did one daily.

What did I notice?

There was one day when I didn’t manage to practice the longer formal meditation, but the 3-Minute Meditation soon became something I looked forward to. It’s brevity made it easy to slot in throughout the day, and upon completion I felt grounded and somehow graceful, as though my neck and limbs had become elongated. I noted in my practice log, “my neck feels long and my head feels balanced by my ear-lobes.” I also found it to be a great de-stressor, which is no surprise, as it was designed for use in difficult situations. It’s also easy to estimate three minutes, in fact sometimes I found I’d actually taken five. The amount of time is irrelevant, it’s the easy access to an anchor that’s important.


Because of the emphasis on self-awareness, I’m developing a new relationship with my body, based on observance and acceptance of what it is, rather than what I want or imagine it to be. It’s like suddenly discovering hidden depths in a friend you thought you already knew. I feel stronger and reassured by it and this combination is leading to greater confidence.

I enjoyed the Mindful Movement but found it hard to shake the feeling of “Am I doing this right?” When I tried to remember my aim, my mind would cloud and I would feel panicked that I couldn’t grasp a simple exercise. Writing this, I understand now that instead of thinking, “What’s my aim?” I should have just re-focused on the sensations in the body. Throughout the sessions we’re encouraged to focus less on the results of the practice and more on what we notice as we practice.

Because moving practice from online sessions into everyday life can be challenging, we’ll be covering some of the common problems – one per session. We were reminded that it’s natural to encounter difficulty, but that if we keep an open mind and suspend judgement, we have nothing to lose by giving this a go. I appreciated the message of encouragement, and I know that I’m already benefitting from mindfulness in my life.

Join me next week when I explore the landscape of depression… 

Related Links:

Research into the prevention of depression relapse
Mindfulness in Depression Relapse Prevention – 1 Autopilot & Raisins
Mindfulness in Depression Relapse Prevention – 2 The Body Scan


Whitby Shores, Whitby, Ontario

By Aisha Ashraf

An autistic Irish immigrant in a cross-cultural marriage, Aisha Ashraf is the archetypal outlander, writing to root herself through place and perspective. Published in The Rumpus, The Maine Review, River Teeth, HuffPost and elsewhere, her work explores the legacy of trauma, the nature of being an outsider and the narrow confines of belonging. She currently lives in Canada.


  1. This is very well done – including the reference to the judging mind which, in some cases, constant evaluates ones own experience by finding it “right” or “wrong”. That is such a condition to (lovingly) let go. I really appreciate your honesty and also your solution (come back to what is). Thank you.

  2. Hi Aisha

    This is interesting. I have heard of this technique before but not really tried. Thanks for a detailed description. I find my mindfulness in practising Chinese calligraphy …

    Noch Noch

    1. Hi Noch, thanks for the comment! Mindfulness and a thing of beauty to show for it – sounds good. I used to lose myself when I drew years ago, but I was forced to take a more “academic” path and now it just frustrates me as I feel I’ve lost my talent and therefore my confidence. Perhaps one day, I’ll be able to pick it up again…

  3. Someone else means of self-healing is to take on a positive mindset towards life. Numerous people are susceptible to pessimistic thinking, which is the reason they fail to understand the possibility of a solution to the problem. Taking on a useful and positive attitude will give an individual the strength to face the issues of life and look for a solution to the same.
    Mrs. Blinn

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