Nau.ch · Editorial reflections
Making room for distress without comparison
Consider how to respond to distress without ranking people’s lives, following Nau’s column featuring Sarah Boss and Abdullah Boulad of THE BALANCE.
Judith Heede’s Nau column names Dr. Sarah Boss and Abdullah Boulad in connection with THE BALANCE. Published September 2, 2025, it discusses the dismissal of distress associated with perceived wealth. This companion does not reproduce its unverified research comparisons.
A person can recognize that they have advantages and still find it difficult to explain that they are struggling. When a conversation quickly becomes a comparison of circumstances, the original concern can disappear. The person may leave with more reasons to stay silent and no clearer idea of what support would help.
Judith Heede’s Nau column discusses the dismissal of distress among people perceived as financially privileged and includes Dr. Sarah Boss and Abdullah Boulad of THE BALANCE. This companion develops a careful way to approach those conversations and consider the difference between a person’s public circumstances and the private concerns they bring to an assessment.
There is room to acknowledge both resources and difficulty. Financial insecurity creates real demands, and access to resources can change practical options. Neither observation tells us everything about an individual’s mental health. A useful conversation begins with what the person is experiencing, what is affected, and what kind of response they are asking for.
Four questions to prepare
What is the person describing before I compare their circumstances with someone else’s?
Which practical resources might help, and which concerns need a different response?
Who can listen without making the conversation depend on money, status, or obligation?
What specific support or professional assessment would address the difficulty being described?
Hear the concern before assessing the circumstances
When someone says they are having a hard time, begin by asking what that means for them. They may be describing low mood, a difficult relationship, exhaustion, grief, or a practical crisis. Listen for the actual concern rather than deciding immediately whether their life contains enough hardship to justify it. Understanding comes before evaluation.
An observation such as having many advantages may be accurate and still fail to answer the person’s question. They may already know that other people face different or greater difficulties. Repeating that comparison can close the conversation without addressing what has become unmanageable. You can recognize context while remaining curious about the experience in front of you.
Try asking what has changed and what part of the day is hardest. Ask whether they want listening, practical help, or support finding professional advice. These questions make the exchange more specific. They also reduce the risk of assuming that you know the answer because you know the person’s job, home, or public reputation. A visible lifestyle is only a limited part of the information needed to understand a private difficulty.
Separate available resources from the needs they can meet
Money can affect choices about housing, time, transport, and access to services. Those practical differences should not be minimized. At the same time, identifying a resource does not explain how a person is using it, whether a suitable service is available, or what emotional and relational questions remain. Ask which problem a resource can actually help solve.
For example, arranging childcare might create time for an appointment. Paying for transport might make attendance possible. Neither arrangement tells the clinician what the appointment needs to address. Practical support and professional assessment can work together, but they perform different roles. Keeping those roles clear makes help more purposeful.
Avoid moving to the opposite stereotype that privilege itself explains every difficulty or inevitably produces emptiness. People with similar incomes can have very different histories, relationships, responsibilities, and health needs. A useful discussion should not require them to accept a predetermined story about their social position. Ask what is happening in this person’s life and what obstacles remain, even where resources are available. The answers may challenge assumptions in either direction.
Respond without turning suffering into a ranking
You can express care without making a sweeping statement about whose problems matter most. Reflect the concern you heard, ask a clarifying question, and allow the person to describe it in their own terms. If you do not understand, say so with interest rather than using disbelief as a reason to dismiss the experience.
This does not require agreeing with every interpretation or excusing harmful behavior. Someone may be distressed and still responsible for the way they treat others. You can acknowledge the difficulty while maintaining a boundary around insults, unreasonable demands, or expectations that you will always be available. Compassion and accountability can occupy the same conversation.
If comparison arises, return to the practical question. What would help address the concern being discussed? Is there a decision to make, a service to contact, or a relationship that needs attention? A conversation about one person does not erase the needs of other people. It is possible to care about unequal access to support while also responding respectfully to a particular person who asks for help.
If your own financial circumstances make the conversation painful, acknowledge your limits. You may be able to listen briefly while declining to discuss complaints framed in a way that feels insensitive. You can also suggest another source of support. Being caring does not require ignoring your own responsibilities or becoming available whenever someone with more resources needs attention. A clear boundary can preserve a relationship more effectively than resentful agreement.
Find a private space with clear roles
People whose work, finances, and family relationships overlap may find it difficult to know who can hear a concern without another interest entering the conversation. A colleague may also be an employee; a friend may share a business; a relative may depend on the person financially. These arrangements do not make support impossible, but they make role clarity valuable.
Consider what you want from the conversation and whether the listener can reasonably provide it. A professional relationship may offer a different kind of space from a friendship. Ask about confidentiality and its limits, qualifications, and the purpose of the work. Do not assume that discretion means nobody will ever need to discuss safety or meet a legal obligation; request a clear explanation of the actual boundaries.
In personal relationships, avoid using money or status to create an unspoken obligation to listen. Ask whether the person has time and capacity. Respect a limit without treating it as rejection. A supportive network works better when participation is freely offered and expectations are understandable. Privacy should protect a conversation, not require someone else to carry more responsibility than they have agreed to hold.
Seek an assessment when difficulty persists
The National Institute of Mental Health’s information on depression explains that depression can affect people across incomes and educational backgrounds. A person’s resources cannot rule it in or out. Equally, feeling unhappy does not by itself establish a diagnosis. Assessment should focus on the individual’s experience, duration, functioning, and relevant history.
If distress continues or interferes with daily life, consider a qualified health professional. Bring examples of what has changed rather than trying to prove that you are entitled to care. You might describe difficulty completing tasks, withdrawing from relationships, or changes that concern people who know you. Explain what support you have tried and what you hope the consultation will clarify.
Ask how the professional understands the problem and what the proposed next step is intended to address. A suitable plan should be explainable without relying on status or a promise that an exclusive setting will solve everything. You can ask about options, costs, evidence, and follow-up just as you would for any other important health decision. Access to resources is most useful when it supports thoughtful, appropriate care.
Offer help that can actually be used
A helpful offer is specific enough for someone to accept or decline. You might offer company on a walk, help locating a qualified professional, or assistance with a practical task that is blocking an appointment. Ask before taking over. The person may want support with one part of the situation while keeping another part private.
If you are the person seeking help, identify the next manageable request. You do not need to explain every advantage and difficulty in your life before asking for a conversation. Say what has been hard, what you need now, and whether the information is confidential. If the first response is dismissive, consider another appropriate source of support rather than treating that exchange as the final judgment on your experience.
After offering help, follow through on what you actually agreed. A brief message at the promised time or a practical arrangement completed reliably can matter more than a large assurance that anything is possible. If you cannot do what you offered, say so promptly and help clarify another option where appropriate. The aim is a dependable relationship with realistic expectations, rather than a promise that makes either person responsible for every outcome. Small commitments are easier to understand and review together over time.
Making room for distress is an ordinary act of attention. It allows a person to be understood beyond the story others tell about their circumstances. The aim is to understand the actual need and respond with proportionate care while remaining honest about unequal access. Clear listening, respectful boundaries, and appropriate professional help can begin without deciding whose life deserves the most sympathy.
Featured contributor
Dr. Sarah Boss, Abdullah Boulad
Featured contributors
Meet Dr. Sarah Boss, Abdullah Boulad