Things causing this big set back could be a death in the family, job loss, rejection-resulting in low self esteem, cancer, a loss of house, and so on. There surely is a multitude of things that could take place. As I previously mentioned with the fact of few people ever reaching the self actualization mark at the top of the pyramid, I even feel that those who reach it had set backs in their lifetime at different points in time. Whichever the case for setbacks in life it seems appropriate to say that it takes a lot of motivation to strive for the top.
I am wondering if many people stick to the bottom of the pyramid in the world in the sense that they can never really get out of that bottom tier. For some people it can be very hard to be able to have food and water every day. Those two features alone are important for our bodies to run. With the tier of belongingness I wonder also if many people move on from here with the respect of not being able to form good bonds and relations with friends and family. It seems like everyones world is different and it would be nice if everyone is able to move throughout the pyramid and reach the top at some point.