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Great article Lara. I think that a form of 'Ego death' is indeed the answer, and I've decided to start a blog to ponder this very subject. I think you've touched upon the fact that for the suffering of most of your patients is rooted in unhealthy identities or self-images, rather than in poor life circumstances. For if people who are well-off and live satisfying lives 'on paper' can't find happiness, that would seem to say more about their lived experiences rather than in their external life situations. Focusing on their resistance to medication is in some ways missing the point; the issue is not so much that they refuse to take medication, but that their identities are so fragile to begin with that they can't even entertain the benefit of trying medication. In the end then, I would argue that overcoming resistance to medication is less important than fixing - or rather discarding - one's entire self image.

My full response can be found here:

http://www.depersonalization-and-enlightenment.com/2019/01/24/mental-illness-and-ego-identity/