Mindfulness in Depression Relapse Prevention – Facing Difficulties

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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 5, 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.


In previous sessions, we learnt how to build up the mental muscle of attention using food, body and breath. This session taught us how to apply that muscle to something more challenging. We were shown how to practice a radically different way of relating to difficult experiences, especially those kinds that, in the past, might have triggered depression. Before, I would either have avoided thinking about or feeling these experiences (autopilot) or I would have been overwhelmed by them and swept away on a tide of emotion so intense I could become a danger to myself. This session showed me how to find a safe balance between those two states.

Introducing a difficulty into practice

Sitting straight but comfortably, with feet flat on the floor, I allowed my awareness to explore the sensations of my body settling into this position, before narrowing the focus to my breath where I felt it most. For me, this is usually my diaphragm, between the belly and chest. After a few minutes the audio suggested moving that awareness up my body to my ears and the sounds that they picked up, where I applied the same exploratory curiosity to what I could hear as I had previously to my breath; were the sounds high or low, near or distant, coming or going, loud or soft, etc.

After some moments the audio advised me to allow thoughts to come to mind. This part always causes me fleeting anxiety; after repeatedly bringing my mind back from wandering throughout the practice, this is the one moment I can guarantee there will be no single cogent thought in my head! But I try to relax, imagine myself leaning back to watch clouds go by and invariably something pops up. I observe the thoughts like clouds in the sky or images on a screen, transient things that I see but don’t become involved with.

The audio suggested I bring to mind some difficulty (preferably with an intensity of around 3 on a scale of 1-10) and label/identify the feeling it gave me, whether it was anger, fear, self-criticism, etc. Then I was asked to note the sensations present in my body. I noticed tension in my face, tears and what felt like a lump in my throat. It was suggested I try breathing into and out of the areas of discomfort and tension and, if it helped, to reassure myself by saying, “It’s already here, whatever it is – it’s already here; let me open to it.” I focused on the obstruction in my throat and found it softened quickly and disappeared, as did the tight feeling in my chest. After facing and dissipating the physical sensations resulting from difficulty/conflict, I returned my focus to breathing. It was then I realized my whole body felt kind of numb from the neck down – I consciously, mindfully relaxed and felt fluid again. The practice lasted thirty minutes from start to finish.

meditation, revelationI was surprised at the intensity of my reaction – I hadn’t expected to cry; although it was a different kind of crying. Usually for me, tears spring forth all too readily and become self-propagating: the more I cry the more upset I feel. A spring becomes a river and all rivers lead to the sea, until I’m in danger of drowning. But this time they were more of a by-product than part of the problem – I felt detached from them. Identifying the emotion made it seem more possible to deal with. Letting go of it to focus on breathing, becoming aware of my body as a whole, felt like I was reasserting my SELF. My breath had a grounding, strengthening power – I felt as though I was gathering my strength at my centre. The exercise reminded me I’m strong, unique and not ineffective, not a walkover. I carry the power within me to deal with difficult emotions. And, most importantly for me, I wasn’t swept away.

Changing our perception

After the exercise, there was a poem to listen to. Poems can be invaluable in their ability to offer vivid imagery with only a few lines, creating a strong impact on the reader, and it just so happens that Rumi is one of my favorites…

 The Guest House

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,

still, treat each guest honourably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice.
meet them at the door laughing,
and invite them in.

Be grateful for whoever comes,
because each has been sent
as a guide from beyond.

It really helped me to understand depression and difficulty differently – firstly, to see it as something separate from oneself, not intrinsic; and secondly, as an opportunity to learn. It’s that recurring theme of being mindful not judgmental.

3 Minute Coping Breathing Space

This exercise is similar to the 3 Minute Breathing Space, it consists of a minute spent on each section, but the focus in the first and last part is different.

  • The first minute is spent identifying what you’re experiencing and giving it a label.
  • The second minute focuses attention on the breath at the belly – all the way in and all the way out – to anchor you in the present moment.
  • In the last minute you expand your attention to take in strong sensations in the body and use breath to soften tension, and phrases to allow the experience to unfold (just as in the longer sitting meditation described at the beginning of this post).

The 3 Minute Coping Breathing Space gets us used to the idea of using mindfulness as a tool to manage difficulty, and makes it more easily applicable to real-time situations.  Designed to be the first resource in times of trouble, it creates a “breathing space” to stop the immediate recourse to reactive mode, directing us to mindful mode instead. Lasting only three minutes, it’s easy to give yourself permission to take that small amount of time to attempt it. The value of the 3 Minute Coping Breathing Space lies in carving out that time for yourself – not the end result. Ultimately, it can’t remove the problem, but it can allow you to experience it in a different way: mindfully and purposefully, instead of reactively and passively.

Putting it into practice

Mindful meditation
Image courtesy of Bryan Helfrich

For the week following this session, my daily home practice consisted of a formal sitting meditation, three 3-Minute Breathing Spaces and a coping 3-Minute Breathing Space if the opportunity arose. I had the chance to practice the Coping Breathing Space on the first day – something trivial got to me, threatening to steer my mood and self-esteem into a downward spin. I hid out in the garage (the one place where no-one thinks of looking for me) and spent three (or possibly more, who’s counting?) minutes identifying my emotion, concentrating on my breath and breathing into the physical feelings accompanying my emotions. Calmness returned pretty quickly so that, by the time I re-entered the house, I was totally composed. I know if I’d left things to fester the depression would have hung over me for a lot longer.

At the start of the week, I felt pain in my back and twisting in my knees during the longer sitting meditation. When I focused on it, it disappeared, or changed location. By the end of the week, it was occurring a lot less frequently.

I found that I was exaggerating my breath when I moved my focus from one location to the other so that I could better feel the sensations. I had to return my focus to my thoughts for a while then try again once my breathing had returned to normal. I discovered that better posture helped me feel my breathing more clearly in my body, making it easier to maintain focus.

I’m amazed and thrilled at the progress I’m making when it comes to learning to understand and live with my condition. Instead of trying to free myself from difficulties (which, let’s face it, is just setting yourself up for disappointment) I’m learning to deal with and see them differently. It truly is a revelation to me and I feel like SHOUTING IT FROM THE ROOFTOPS!!!! But I’ll content myself with trying to explain it in a way that I hope you’ll understand.

Join me next week, to draw a line in the sand and acknowledge that “Thoughts Are Not Facts”…


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
Mindfulness in Depression Relapse Prevention – 3 The Breath
Mindfulness in Depression Relapse Prevention – 4 Exploring the Landscape of Depression

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. I found this such a helpful post, I even implemented it yesterday. What I appreciate most is that it doesn’t suggest ignoring the negative thought/emotion but rather teaches you to recognize it and dispel it naturally by dissipating its strength. Keep writing, I’m reading!

    1. Great to know others are benefiting from this. You’re right in what you said about not ignoring the negative, mindfulness isn’t about achieving a problem-free life , it’s a practice to help us deal with it better. The biggest revelation for me has been realising that taking time for yourself isn’t selfish or trivial – those three minutes of being totally aware of just me are more nourishing than an entire day spent putting other people first. We need to care for ourselves before we can do the same for others.
      Glad you found it helpful, the 3 Minute Coping Breathing Space is perfect for those moments when things threaten to overwhelm us. You keep practicing – I’ll keep writing!

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