Our Mindful Mondays series provides ongoing coverage of the exploding field of mindfulness research. © Dan Archer

Sixty percent of people who experience a single episode of depression are likely to experience a second. Ninety percent of people who go through three episodes of depression are likely to have a fourth. But help is available: The 8-week Mindfulness-Based Cognitive Therapy (MBCT) program been shown to reduce the risk of relapse.

How does it work? To find out, researchers in the United Kingdom interviewed 11 adults who had experienced three or more episodes of severe depression, and had undergone MBCT within the previous three years.

They analyzed the interviews to create a model, published in the journal Mindfulness, to demonstrate how MBCT enables people to relate mindfully to the self and with others. The key, it seems, lies in the way MBCT enhances relationships: Less stress about relationships in turn helps prevent future episodes of depression. Three specific themes emerged from the study:

1. Being present to the self: Learning to pause, identify, and respond

Mindfulness practices of MBCT allowed people to be more intentionally aware of the present moment, which gave them space to pause before reacting automatically to others. Instead of becoming distressed about rejection or criticism, they stepped back to understand their own automatic reactions—and to become more attuned to others’ needs and emotions. Awareness gave them more choice in how to respond, instead of becoming swept up in escalating negative emotion.

2. Facing fears: It’s ok to say “no”

Participants also reported that they became more assertive in saying ‘no’ to others in order to lessen their load of responsibility, allowing them to become more balanced in acknowledging their own as well as others’ needs. The authors speculate that bringing mindful awareness to uncomfortable experiences helped people to approach situations that they would previously avoid, which fostered self-confidence and assertiveness.

3. Being present with others

Being present to others enabled people to bring more attention to relationships and to appreciate their time with others. They talked about how being present to others helped them let go of distressing histories, allowing them to relate to others in new ways. Disagreements also became more constructive, as participants were able to identify their communication problems, and were better able to take on another’s perspective and focus on potential solutions.

Study participants also described having more energy, feeling less overwhelmed by negative emotion, and being in a better position to cope with and support others. Getting through difficulties with significant others through mindful communication helped them feel closer, and having the energy and emotional stamina to spend more time with family members helped them grow together.

Many participants said that as time went on, the benefits of MBCT permeated their whole life. “Through relating mindfully to their own experiences and to others, they were feeling more confident and were engaging with an increased range of social activity and involvement,” write the authors.

The researchers write that in the future, interventions could place a more explicit focus on approaching relationships with mindfulness. This focus could reinforce the benefit of MBCT, and perhaps lead to even better outcomes in reducing the risk of relapse for people with chronic depression.