It is important to recognize that none of us ever reaches a final state of self-knowledge: as long as we live, our self-understanding is capable of growing. What we really understand about ourselves and what we believe ourselves to need and want are never more than provisional, tentative. Additional experience, just the fact of living longer, very likely will lead you to perceive yourself differently and motivate you to modify your priorities and change your goals. WHERE ARE YOU NOW? Late in 1984, the National Institute of Mental Health released the first published results of the largest mental health survey ever conducted. The results are startling and are an unhappy commentary on our society and world. The report shows that 20 percent of Americans suffer from psychiatric disorders. Yet only one in five of these seeks help. The others live with their suffering. The most common problems are these: _Millions of Americans_ _Psychiatric Name of Condition_ _with This Disorder_ Anxiety disorders 13.1 Phobias 11.1 Substance abuse (alcohol, drugs, etc.) 10.0 Affective disorders (including depression and manic depression) 9.4 Obsessive-compulsive disorders 2.4 Cognitive impairment 1.6 Schizophrenia 1.5 Antisocial personality 1.4 The NIMH study also shows that women are twice as likely to seek help as men. Two interrelated inferences are commonly made from this previously known fact: women are often more accepting of their emotional state (men in our society are taught to disregard their feelings, part of _machismo_), and women are less willing to allow pride to stand in their way of getting help (women are less affected by the myth of self-sufficiency). {19} The NIMH report indicates, too, that the incidence of psychological problems drops by approximately half after the age of forty-five. The below-forty-five years are usually those of highest stress. Above forty-five, individuals tend to become psychologically better integrated. This probably reflects increased maturity and a more accepting, calmer attitude toward life. The lowest rate of emotional disturbance appears to be in people over sixty-five. Yet there are many thousands of individuals over forty-five, and indeed over sixty-five, for whom life remains a difficult inner struggle.