Being neither a Pollyanna, optimist, nor "preacher", I just share the following for whatever it's worth......
After telling a friend about my ALS, she responded with, "Well, you look good." I was shocked. My one time rejoinder, "At least I don't look like road kill", was churlish.
Further reflection on her comment explained it. I prepared myself for the next person. I responded nicely, "Thank you for the compliment"; or "That's kind of you to say that", or "Thank you. How have you been?", etc.
At least they haven't asked: "Are your affairs in order"? (not quite); "Do you have graves picked out?" (I've had them since college); "Designed your tombstone?" (I'm working on it); "Planned your service?" (almost completed); "Written your obituary?" (done - although I'm tempted to compose "The Life I Wish I'd Lived"); etc. As long as I can remove myself from the emotional component, I can respond logically even to those. Though, depending on circumstances, it could difficult.
For years, a friend mails me postcards of them: cross-country skiing; taking cruises; flying to vacationing places around the world, etc. I asked them to. Going means a lot to them and they love it. For them, it's sharing, not bragging. We'd be very disappointed if she stopped.
I'm happy for them. They are taking adventures we chose not to. I regret more what I agreed to NOT doing, than what they're doing. It's my own fault. I never insisted.
I realize others may have a different agenda or oblivious to possible consequences to our feelings. They don't practice "standing behind someone, seeing themselves from anothers' perspective." Long ago, when hurt by a friends response, my husband said, "Consider the source". He was right. She couldn't see it from my perspective. I never mentioned it. We're still friends. It took too much energy to stay hurt. I still rely on his response.
It's wise to dismiss hurtful or one-way friendships. They absorb emotional and psychological energy one doesn't have to give. If one chooses, it can be used to make new friends, or at least acquaintances. Writing scathing, un-mailed responses can free one up to move on. Ritually burning it may help, too.
I've done both.
As to the " 'It' could be worse" comment, If we put our mind to it, we could think of many worse situations we could be in. That isn't the point. I believe for each person suffering is suffering regardless of the cause. We can't quantify what another feels. It's the end result that shapes our response. Removing a glass shard from a child's finger can be just as frightening and painful as losing a limb. Since the latter has greater long term consequences, we agree it is worse. The sufferers, independently, may not see it that way.
People are trying to say something encouraging, without realizing how painful it could be. We want our difficulties to be acknowledged. We'd appreciate a hug; a hand patted; a "I will be thinking/praying of/for you; a phone call; card; e-mail; personal visit; food for PALS or CALS, etc.
We don’t want our situation dismissed or trivialized. Compassion, understanding, empathy, appropriate expressions of concern, or kindness, validates us. They encourage us as we cope anew each day.
May it be so. Let blessings abound. B.