In a wish to abandon essentialism to contingency, this paper looks into whether the rural-urban binary could be a cultural burden so incompatible with the layered realities of advanced deprivation that instead of helping the deprived, it deprives the help of its carrying capacity. Departing from the idea that cultural mechanisms are capable of allowing for conceptual dichotomies to create oppression, this paper addresses the concepts of ‘rural’ and ‘urban’ as potentially counterproductive ideas in policy and planning when deployed in areas of severe social deprivation. Using a Swedish example, this problem is addressed in the context of a recently finalized development project, whose focus of approach shifted from ‘urban’ to ‘rural’. We demonstrate how ‘rural’ and ‘urban’ are not neutral spatial qualifiers but problematic filters superimposed onto the already problematic concept of “social sustainability”. Here, we draw on the principle of iatrogenesis, which denotes any benevolent action that inadvertently produces undesired outcomes. We argue that since many areas lack the presumed conceptual foundation for a specific brand of action, development programs labeled as ‘rural’ or ‘urban’ are not only likely to fail, but also to potentially cause harm. We conclude that more context-sensitive understanding of the human condition beyond inflexible labeling is needed in order to arrive at more adequate interventions.