Help is of less help to those further down in society.  Some reasons why:

Psychological help often presupposes one has the resources to make a change.  Resources like:

• A ride to therapy, the doctor, and the pharmacy
• Money or insurance to pay for care and medication
• Stable housing and relationships where one has the option to get out of without losing their housing
• A friendship group that doesn’t revolve around vices and addictions

Therapists often have a poor understanding of those whose problems are beyond their control.  This is especially true because often these people have had middle class upbringings and have never been poor.  Those on the bottom know hyper individualism well because they are on the exhaust end of it!  Hyper individualistic solutions aren’t much help for those on the bottom because in order for their needs to be met (like a ride to the food pantry) another party is going to have to perform a sacrificial act.

Therapy (particularly Cognitive Behavioral Therapy) presupposes one’s negative thoughts about them self are distorted.  The further down one is the more one’s poor self image is validated by those around them.  Belief one has innate worth ends up becoming an impossible psychological burden when everywhere one goes there’re bombarded with the opposite.  Then they’re guilted for having negative thoughts about them self and goaded with the idea that somehow their life will be better if they just had a positive self image.  But positive self image is a key that unlocks the value one already has, it doesn’t create value in and of itself.  For example a pretty person has a lot to gain from going from poor to good self image but the improvement in self image isn’t giving the person anything extra, it’s just causing their good looks to shine more brightly.  This is because the expression of positive self image is charisma and charisma disproportionately helps those who are young and attractive.  If you are male, 45, and making minimum wage, more charisma isn’t going to get you dates or guy friends.

Therapy doesn’t work as well on those brought up in a disciplinarian environment (like many of those further down are).  It takes a good (translation: expensive) therapist to reparent a person who had a harsh upbringing.  Therapy has a different way of seeing things than someone brought up in a disciplinarian environment so a lot of times things that could help end up going over one’s head.  When one is brought up with the idea that everyone is basically evil and needs correction and punishment to set them straight and then they go to a therapist who says people do good because they know it’s the right and healthy thing, not out of fear of punishment it is bewildering.  It would be a good thing to have therapists that had extensive training on shepherding people who hold a disciplinarian world view (while not trying to change it) for those brought up in disciplinarian environments because many of these people are never going to change their ingrained views.

One must realize that in therapy for those further down often the bond with the therapist is more important than whether they are disseminated the precepts of psychology.  That’s the only thing that ever worked for me.