The write-off is: This person is crazy. Crazy people are other. Crazy people do scary things. Normal people can't communicate with crazy people. Crazy people don't get better. Perhaps craziness is contagious? Stop all association.
The blame is: That person is really messed-up and neurotic. That's a character flaw. People with character flaws need to change their character. If they don't or can't, they're morally lacking. People whose neuroses don't get visibly better are not trying hard enough or not doing what they are expected to. People who are having big problems but are not in an approved therapy program or taking approved drugs are not dealing with their problems. These people could be okay if they did things differently and were more like me. If they don't get better on my schedule, they're probably not trying very hard.
In the first case, people refuse to see that the very disturbed and ill person is even of the same species, and treat the sufferer as a wild animal or demon.
In the second case, the ailment is transferred from the medical to the moral sphere and then can be turned into a judgment. This shows a lack of empathy.
I get the impression that a lot of people see a neurotic problem and think of it like one of their own difficult days. They wonder why the person with the problem can't overcome it the way one overcomes a headache or a crappy day at work, and just move on. Somehow, being told that it's not that simple doesn't penetrate, even when it's a professional with experience who's doing the telling.
Trying to improve a head problem is like this for me: I have this huge tangle of fuzzy yarn and bubble gum and nuts and bolts and sleeping kittens and sharp spiky things, about the size of a cow. My job is to untangle it all without cutting the yarn, losing nuts or bolts, or hurting any kittens. I slowly untangle bits of yarn, occasionally setting aside a bolt or freeing a kitten or cutting myself with one of the sharp spiky things. This goes on for years.
Occasionally someone will wander in and ask when I'll be done, or explain that I'm doing it wrong. Some of them shake their heads and walk away mumbling about how fucked I am. More rarely I can pay someone to sit down and work on the project with me.
It's not clear if I'll get much of this untangled before time's up. But I didn't make this tangle, you know. None of us did.