Why “Others Have It Worse” Is One of the Most Harmful Mental Health Myths

“Wars are going on and people dying- one shouldn’t feel that way.” “Others have it so much worse than we do.” They are said more often than people realise, by other people or by the afflicted person, and they are whispered or shouted loud enough to get heard, but not loud enough to be taken seriously. The idea that is constantly reinforced is that one’s pain isn’t worth it enough to be seen. This form of comparative thinking, known as trauma invalidation, is one of the most prevalent barriers for people to seek mental health assistance (Vickerman & Margolin, 2009).

The notion that one’s own suffering isn’t that great because someone else, somewhere, is worse off establishes a hierarchy of suffering, but one that doesn’t match the way suffering is actually felt by the human brain and body. This article explores the reasons why pain cannot be meaningfully ranked, what happens when pain is ranked, and why the psychological response to a painful experience is of far greater importance than the ranking itself.

The Science of Pain is so Complex that it cannot be ranked 

It is a notion that suffering, which is what the suffering person experiences, must be objectively measurable; it must be more valid for one person than another person,  according to what they suffered. One person may react to the same event with a very different psychological response, depending on other factors such as their history of trauma, attachment patterns, social support, and their own neurobiological sensitivity, as well as their age at the time of the event and its predictable or unexpected nature.  Distress is real, and two people can have the same loss but have different distress responses (Bonanno, 2004).  

Trauma is not just about the event; it is about how it affects the person. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines trauma not only in terms of what it is, but how it affects the person. The effects of trauma can persist for long after the trauma has occurred, to the degree that the person has suffered from a disorder known as post-traumatic stress disorder (PTSD), and to the degree that the person may not have developed PTSD after what may seem to outside observers to be an extremely traumatic event (American Psychiatric Association, 2013). This is because trauma does not depend on what has happened. It is characterised by the response of the nervous system to the event.

In his research into how trauma is stored in the body, psychiatrist Bessel van der Kolk  (2014) defined trauma as “anything which exceeds the nervous system’s ability to cope,  and leaves the person feeling helpless, frightened, or profoundly alone. According to this definition, the triggering event does not have to reach the level of “objective severity”. A subjective attitude is what counts, whether the individual’s inner resources at this moment are overwhelmed. Trauma responses can be as extreme and devastating as a child who has endured a single acute physical event, because the nervous system doesn’t discriminate between crises. It just reacts to them. 

The idea of a small-t trauma, that is, a trauma that isn’t classically catastrophic but is nevertheless psychologically devastating, like being constantly criticised, an emotionally unavailable caregiver, bullying, or repeated rejections, has been embraced by a lot of clinical psychology. It is found that repeated small-t traumas can yield the same emotional dysregulation, negative self-belief and relationship problems as single large-T traumatic events or sometimes more, and these are often overlooked and unacknowledged (Shapiro, 2018). 

What Comparison Does to the Person in Pain 

The first psychological reaction to someone saying, or saying to themselves, to the person in distress that others have it worse than they do is not gratitude or perspective. It is shame. Shame is one of the more painful emotions, and is focused on a negative appraisal of oneself, not that they did something wrong, but rather that they are wrong, deficient, weak, ungrateful- for feeling this way. Brené Brown and others have consistently identified shame as one of the most significant inhibitors of help-seeking. Those who are feeling embarrassed about their pain are less likely to say so, to reach out for support and to get professional help (Brown, 2010). 

This is often accentuated by the intended meaning of the comparative statement. When people say things like “Others have it worse”, it’s usually to give comfort, to give perspective or to make the suffering person feel less alone in a difficult world. But the message is heard almost always the opposite: One does not have a serious enough experience to merit this attention. Research has clearly established the discrepancy between intention and impact in the literature on social support. When people provide poorly calibrated support that minimises, dismisses, or redirects another person’s experience without acknowledging it, they do not offer neutral support. It intentionally contributes to the other person’s suffering and erodes the trust that exists in the relationship (Bolger et al., 2000). 

The internal version of comparison (one that a person applies to themselves) becomes even more insidious because no external corrective challenges it. Someone who tells themselves over and again that they don’t have any right to feel what they feel ends up not trusting their own inner experience. Over time, emotional self-invalidation (dismissing one’s own feelings as too intense or unwarranted) contributes to greater emotional dysregulation (difficulty managing intense emotions), increases feelings of anxiety and depression, and reduces a person’s ability to form meaningful relationships in which authentic vulnerability is possible (Linehan, 1993).

Marsha Linehan (1993) developed Dialectical Behaviour Therapy (DBT) specifically to help individuals who experience extreme emotional responses and placed validation at the very core of the therapeutic model. Validation here is not agreeing that a situation is as bad as it feels, that a person’s response is the most logical, etc. It involves telling them that their reaction is logical, that, given what they have experienced, what they are going through and who they are, their reaction is understandable. According to Linehan’s research, invalidating environments regularly condemn, ignore, or punish emotions. These environments play a major role in the development of severe emotional problems, such as borderline personality disorder. The cure, both in therapy and in real life, is always and absolutely validation. 

The Real Cost: Consequences of Not Seeking Help

The real-world implications of internalised comparative thinking are serious. It often causes people to postpone or reject seeking help. Research has clearly established the consequences of delaying help. Untreated trauma does not remain frozen in time. Without proper support, distress after a particular event can often worsen over time. It may develop into chronic stress or depression. It can also lead to substance abuse, physical health problems, and major impairments in relationships and daily functioning (Kessler et al., 2005). The more time that passes between the onset of symptoms and receiving adequate support, the stronger the unhealthy patterns become. As a result, recovery takes longer.

Treatment delay research in mental health is amazing. The delay from the onset of a mental health problem to first professional contact is 11 years on average (Wang et al., 2005). Self-perception of the seriousness of one’s condition is one of the most consistent factors that delays seeking care. Other factors include access barriers, cost, stigma, and lack of awareness. People who decide to seek treatment often tell themselves that they are exaggerating, or that other people have worse issues than they do (Gulliver et al., 2010). 

This self-dismissal is not the person’s fault. It is a natural and inevitable consequence of a culture that treats suffering differently. Such a culture considers some forms of suffering acceptable. It views others as too minor to deserve attention or support. If mental health education, public conversation, and even compassionate private discussion suggest that only some mental health issues deserve help, people begin to believe it. As a result, they apply the same belief to themselves when they experience a mental health issue. The result is a vicious circle. The poorest and most vulnerable people are the most likely to believe they are unworthy of help.

CBT is a therapy that directly tackles the thinking patterns that perpetuate this cycle. One of the basic techniques of CBT is cognitive restructuring. It involves identifying unhelpful automatic thoughts. For example, a person may believe that their pain is not worth reporting. Individuals then challenge these thoughts. It may be important to help that person look at the pros and cons of this belief. They should also understand that the belief is not a fact. Healing cannot begin until they make an effort to examine the evidence for and against the belief. They cannot evaluate the evidence if they believe no evidence exists (Beck, 1979).

Conclusion

There is nothing wrong with saying “others have it worse”. At some point in every person’s life, and in the world at any time, someone is suffering from a greater problem than the one that he is facing. However, this observation does not mean anything to consider whether the person in front of us or the person in us deserves help, care and support. No two pains are alike. There is no need to compare distress to give it legitimacy to warrant a response. 

The nervous system does not take into account a list of suffering before creating anxiety, depression, and grief. It is sensitive to what it is seeing, and it needs help when it can’t cope with what it is seeing anymore. The decision to seek assistance is not based on the amount of harm that occurred. The effect on the affected individual determines it. There is nothing weak about validating pain, and there is nothing self-indulgent about it,  whether it’s one’s own pain or someone else’s. It’s the first step in the path towards healing. 

References +

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425596
• Beck, A. T. (1979). Cognitive therapy of depression. Guilford Press. 
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• Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American  Psychologist, 59(1), 20–28. https://doi.org/10.1037/0003-066X.59.1.20 
• Brown, B. (2010). The gifts of imperfection: Let go of who you think you’re supposed to be and embrace who you are. Hazelden Publishing. 
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• Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E.  (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry,  62(6), 593–602. https://doi.org/10.1001/archpsyc.62.6.593 
• Linehan, M. M. (1993). Cognitive-behavioural treatment of borderline personality disorder. Guilford Press. 
• Shapiro, F. (2018). Eye movement desensitisation and reprocessing (EMDR) therapy:  Basic principles, protocols, and procedures (3rd ed.). Guilford Press. 
• van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking. 
• Vickerman, K. A., & Margolin, G. (2009). Rape treatment outcome research: Empirical findings and state of the literature. Clinical Psychology Review, 29(5), 431–448.  https://doi.org/10.1016/j.cpr.2009.04.004 
• Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., & Kessler, R. C.  (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General  Psychiatry, 62(6), 603–613. https://doi.org/10.1001/archpsyc.62.6.603