During my career which has spanned thirty eight years, during which I have provided clinical services to literally thousands of patients of all ages with social anxiety, I have discovered that the biggest source of confusion for sufferers is understanding how ingrained the problem becomes. Adding to this confusion are marketing efforts and promises from the behavioral therapies; especially cognitive behavioral therapy, which states it is the “golden standard for treatment” for social anxiety. This statement is based on a gross over-simplification of the problem! The clinical reality is that a treatment architecture which basically dismisses the importance of the emotion-physiology; relying only on cognition and behavior, will reach the point of diminishing returns for most social anxiety patients. The following article offers insight.