A deep and painful gap exists between a person's suffering and the peaceful success of those who persecute him. While the individual is sick, in pain, and fearing for his life as a result of his sins [אבן עזרא], his enemies thrive. The primary approach among commentators is that these adversaries enjoy robust, secure lives filled with health and goodness [רש״י, רד״ק, המאירי, שטיינזלץ]. They grow in power, living long lives and multiplying in both children and wealth [מצודת ציון, מצודת דוד, רד״ק]. However, another perspective views this focus on life not as a description of the enemies' success, but rather as their ultimate goal: they relentlessly hunt the sufferer with the explicit intent to take his life [מלבי״ם].
As the suffering continues, the number of people who hate the individual only grows [רש״י, מצודת ציון]. This hatred is deeply rooted in falsehood. It may be entirely baseless, lacking any real cause or justification [רד״ק]. Alternatively, the hostility is built on lies and false accusations, driven by a complete misunderstanding of the sufferer's true actions [רש״י, מלבי״ם]. In understanding this conflict, a distinction is made between an enemy who seeks to cause physical harm and a hater whose animosity stems from a strong disapproval of the person's actions [מלבי״ם]. Adding to the sense of profound injustice is the reality that these adversaries continue to succeed and expand their influence, despite being people of deceit and wrongdoing themselves [המאירי].
This situation creates a complex internal dilemma regarding how to respond to such adversaries. If the sufferer openly admits that his illness and anxiety are worsened by watching his enemies thrive, this very confession will only give them another reason to rejoice in his misery. Showing distress over their success would ultimately cause the number of his haters to multiply even further [אלשיך].