Social anxiety is an emotional experience that arises during an individual’s interaction with others. Everyone wants to perform well in their interactions with others so as to be recognized, accepted, respected, envied and praised by others, and appropriate anxiety can remind individuals to make some preparations in advance and use their inner resources in the process of interaction so as to show their excellence, gain the appreciation of others, realize their sense of self-worth, and thus experience the feeling of having full self-esteem. Therefore, social anxiety is a necessary emotion for interpersonal communication, and there is no need to resist it. However, accepting social anxiety is not the same as ignoring it. If the intensity of anxiety is so great and lasts for so long that it hinders interpersonal interactions and causes persistent avoidance behavior, this is called “social anxiety disorder (SAD),” or commonly known as “social phobia. SAD can be triggered by a wide variety of situations, such as speaking at a conference, chairing a meeting, discussing in a group, meeting with friends, meeting with leaders or teachers, dating the opposite sex, speaking in front of acquaintances, asking strangers for directions, or returning goods to a store, etc. The individual can feel intense anxiety and fear, often accompanied by significant physical discomfort, such as The individual has a strong desire and urge to escape, shrinking up, putting the head down, closing the eyes, not daring to breathe, and wanting to find a crack in the ground. So whenever the individual encounters such scenes in the future, he or she will have anxiety and fear in advance and avoid participating in these interpersonal interactions as much as possible, which in extreme cases can cause complete social isolation. Of course, most people with SAD will consider this fear to be excessive or unreasonable, and avoidance over and over again will not help, and will encourage themselves to participate in interpersonal interactions with fear, each time but always repeating the experience of anxiety and fear over and over again, causing them great distress. Whether it is mild social anxiety, which is within the normal range, or SAD, which is a disease, psychodynamically speaking, the core of the process is a varying degree of “fear of self esteem being hurt” and “trying to maintain self esteem”. For example, people with SAD who are afraid to speak in public or to attend parties are afraid of not performing well, afraid of making a fool of themselves, and then afraid that others will criticize, pick on, and ridicule them, thus damaging their self-esteem; people with SAD who are afraid to interact with the opposite sex, or even to look at each other, are afraid that the other person will judge them badly, afraid that some of their thoughts about what they like about each other will be discovered by the other person, and afraid of being rejected, thus damaging their self-esteem. In social situations, the fears of SAD patients are aroused: they find out that “I am not good”, “I am incompetent”, “I am ignorant”, “I defective,” “I am inferior,” “I am sick,” …… etc. All of these fears reflect the fears that come when self-esteem is threatened. Some of the avoidance behaviors of people with SAD are motivated by a desire to “preserve self-esteem”. Giving up the opportunity to participate in group activities, refusing to speak in public, hoping not to be asked questions, and missing appointments because they are not feeling well are all similar behaviors that are “protective” of self-esteem, a defense mechanism that is seen in action, thinking that this weakness will not be discovered, ridiculed, or belittled by the other person, but in fact, this is a kind of In fact, this is a “cover-up” type of self-deception, this kind of self-esteem maintenance not only can not play a role, but will be prematurely leaked and given additional social anxiety image, this defense is counterproductive, but also can not really relieve social anxiety. If it were just defense, it would be fine if there were no pain, but human interaction is an innate human need, such as for survival, for occupation, and for the continuation of life. Defending results in deepening the conflict with the need to interact, and perpetuates SAD. Everything must be traced back to its source. Why is the self-esteem of people with SAD vulnerable? Why does the same situation trigger different levels of anxiety for different people? While genetic predispositions are important, early education and upbringing are even more important. A person whose self-esteem is constantly under attack during early childhood or subsequent growth (e.g., overly harsh demands or harsh accusations or denials from parents, ridicule and abuse from teachers and classmates, and being belittled for being inferior in terms of finances, grades, and appearance) is more inclined to show sensitivity and vulnerability to interpersonal situations. This is because deep down, they have formed a negative image of themselves: “I am not good”, “I am defective”, “I am not as good as others”, etc., and at the same time, deep down, they have an object of criticism, ridicule, and contempt. This fixed perception of oneself and others leads to selective attention to one’s own badness and negative evaluations of others in interpersonal interactions, and thus this pattern becomes more and more consolidated and biased. SAD is often caused by a social situation that jeopardizes the individual’s self-esteem and serves as a trigger event that triggers a fixed cognitive-behavioral pattern of SAD – “fear of self-esteem harm” and “vigorous defense of self-esteem”. . In summary, the focus of treatment for SAD is to help the patient restore his or her self-esteem. Both medication and psychotherapy will focus on transforming the SAD state into a non-SAD state. What can be done to help SAD patients restore their self-esteem? It starts with the treatment itself, respecting the person with SAD, paying attention to his or her inner conflicts, and recognizing the two forces that sustain SAD: 1. the “fear of self-esteem being hurt” and the “struggle to maintain self-esteem”. 2. The intrinsic need to interact with others. We work with patients to individually explore the psychosocial factors that create and sustain the development of SAD; to capture the inherent biased cognitive and unprotective behavioral patterns in specific anxiety/fear-inducing interpersonal situations; and to explore new, more rational cognitive and constructive behavioral patterns, using more mature defense mechanisms – sublimation rather than avoidance. -sublimation, rather than avoidance, to actually improve one’s quality and tolerance for frustration. On the one hand, it raises the threshold level of wounded self-esteem, and on the other hand, it creates an interpersonal environment that provides respect for the individual. This satisfies both the need for interaction and the feeling of having full self-esteem, and a non-SAD state is gradually created.