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I think the way we process information of any kind involves making comparisons. We wouldn't be able make any distinctions at all without some sort of internal calculation that allows us to understand where one entity ends and another begins, so advising people not to compare themselves to others strikes me as advice that is meant to be helpful, but that does not address the complexity of the human condition. I also don't think that we can rid ourselves of status concerns-there is evidence to suggest that these have been present in our evolutionary history for a very long time.

It would be nice if a public conversation in the world at large drew people's attention to ways in which we can reinforce the positive aspects of comparison. These might include an intention to value the efforts people at levels of the socioeconomic hierarchy make despite the challenges they face, even if their accomplishments are small or an attempt to pay attention to things people do, no matter how mundane, that are unique to them. I believe it would also be helpful if as a society we encouraged every one to pursue their dreams and not to accept the limits placed on them by historical circumstances. If we did this, perhaps eventually, after a period in which society was reconfigured to allow for a much broader section of people to experience autonomy and fulfillment in their working life, the middle class would not be so terrified of downward mobility because the floor would not be as connected in the imagination to the worst outcomes imaginable as it is now.

I wanted to respond because your description of the reasons people give for not wanting to take medicine is related to the reasons I would rather not take it, but doesn't include some steps in the decision making process that led me to avoid the medicines. I see the world like this: Suffering increases the chances you will have experiences that are negative and uncomfortable which leads you to be more prone to do things that others don't like. Responding to this reality, psychological theorists have categorized people's responses to suffering so as to separate the acceptable from the unacceptable or the healthy from the pathological. Psychological terminology designates people who exhibit certain characteristic as unacceptable.

I wish that we'd develop a response to suffering which acknowledges that we all suffer and that we all have different responses to suffering and also encourages us to support each as we deal with the pain of being human. People's actions stem from their experiences and once we see the world through this lens we can attempt to understand people in the context of their life stories. If this were the standard approach to dealing with suffering, and if there were a specific and clear result that was expected from taking a medication, then I'd be all for it.

As an example of a what I mean by establishing a direct connection between a medicine's impact and expected mechanism for improving life, I offer this: Setting aside the potential for addiction, if a person was told that they should take a small dose of an anti-anxiety medicine just as they were to starting to panic, that the calming effect of the medicine would be part of a kind of self-study program where you are examining your reactions and by doing so becoming better able to intervene during the earlier stages of a conditioned response that becomes harder to stop the further along it goes, then it would make sense to take the medicine.

My suffering been a barrier between me and the life experiences I believe are important like having a job where intellectual curiosity is an integral part of what I do, which in turn would allow me to interact with others who value using their intellectual curiosity. I have had a persistent sense of my own powerlessness and inability to shape my own life. If I were to turn to psychology, I would feel even more powerless because in order to be helped, I need to be designated unacceptable. I already feel separated from the life experiences that I want to have and so don't want to reinforce the distance between me and those experiences which I believe are worth pursuing. From past experience I know that the medicines available aren't given as part of a process of increasing self-knowledge.

Although the chronically unemployed may not express a desire for more money in their lives, I think that we should keep in mind that they don't represent all those who are poor in our country or in our world. We should also consider the fact that the life experiences of the medicaid patients are surely responsible for their lowered expectations. How can we not want to contribute to a world in which everyone has the opportunity to use their minds and explore their potential, even this world takes several generations to bring into being? Rather than identity, maybe the answer is to value and pursue meaning, the search for what matters, putting effort into ensuring that worldwide everyone's basic needs are met and then into supporting each other as we all explore our unique gifts.

I was so amazed to see that the author responded to some other comments. I am not sure if I will be so lucky because my comment is so long and it is pretty personal.