Ever felt awkward in a meeting or anxious at a party? You're not alone. Host Dr. Denise Millstine is joined by author Natalie Sue and psychologist Dr. Craig Sawchuk to discuss Natalie’s book HOPE THIS FINDS YOU WELL, which features a protagonist with social anxiety. The conversation delves into how anxiety manifests in everyday interactions, explains coping mechanisms like avoidance and alcohol use, and emphasizes that social anxiety is common, treatable — and often misunderstood.
Ever felt awkward in a meeting or anxious at a party? You're not alone. Host Dr. Denise Millstine is joined by author Natalie Sue and psychologist Dr. Craig Sawchuk to discuss Natalie’s book HOPE THIS FINDS YOU WELL, which features a protagonist with social anxiety. The conversation delves into how anxiety manifests in everyday interactions, explains coping mechanisms like avoidance and alcohol use, and emphasizes that social anxiety is common, treatable — and often misunderstood.
This episode was made possible by the generous support of Ken Stevens.
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Welcome to the Read. Talk. Grow. podcast, where we explore health topics through books. Our topic today is social anxiety disorder and our book is I Hope This Finds You Well by Natalie Sue. I'm your host, Dr. Denise Millstine. I'm an assistant professor of medicine at Mayo Clinic, where I practice women's health, internal medicine, and integrative medicine. I'm so excited about my guest today.
Natalie Sue is the bestselling and award-winning author of I Hope This Finds You Well. She's a Canadian author of Iranian and British descent. When she's not writing, she enjoys binging great and terrible TV, attempting pottery and procuring houseplants. She lives in Calgary with her husband, daughter and dog. Natalie, welcome to the show.
Thank you so much. Glad to be here.
Our expert guest today is a repeat. Dr. Craig Sawchuk is a psychologist and the chair of the Division of Integrated Behavioral Health within the Department of Psychiatry and Psychology at Mayo Clinic in Rochester, Minnesota. He's a professor of psychology at Mayo Clinic College of Medicine and Science. Craig, welcome back to the show.
Great. Thank you for having me back.
I hope this finds you well is a modern workplace novel of a quirky cast of characters at Super Shops, Inc., where the writing is on the wall for upcoming reorganization with likely layoffs. At the beginning of the book, the main character, Joleen, is caught venting her frustrations in a snarky email and assigned to sensitivity training with changes to her computer access.
Instead of limited security, she can suddenly see all of her colleagues’ emails and messages. Joleen learns that her prior strategy of showing up, keeping to herself, and not engaging with her coworkers has left her anything but invisible, and she has to confront why she acts the way she does at work, which is, in short, because of social anxiety disorder.
Okay, you both know how Read. Talk. Grow. works. We discuss books that portray health topics in an effort to better understand health experiences through story. In this case, we'll talk about social anxiety disorder. Natalie, congratulations on the huge success of your debut novel. Tell us your inspiration for the story.
Oh my goodness. Thank you so much. So my inspiration was I was working in an office and I was having a Teams chat one day and I noticed -- I was working in a government office, so I had some a little, a few more disclaimers than would be in a typical office. And one of them was that basically all the chats that happen on Microsoft Teams are not fully private, and that they could be monitored.
And I started to have a thought about who could be watching those chats and what would happen if they saw my chats. And then that's how the sort of “what if” idea for it came from. And because I'm such an idea breeds character writer, I really thought who would be kind of the worst person to get access to the emails, because if it was someone that was really popular in the office and stuff, it wouldn't go very far. They would just kind of tell someone. But, Jolene was a great character in the fact that she had no one to tell. And what would kind of make the most reckless choices possible. And so that's sort of how it all came to be.
Well, it's brilliant, if a bit diabolical, but we'll get into that. So it's really a fun book to read. Craig, tell us your reaction to the book.
Yeah, I really loved the book, and I really appreciate Natalie writing this because social anxiety, as we see throughout the book, the drive for the individual is to be invisible, to not be seen like at all. And even though they're not being seen, the thought bubble is always constantly going. They're constantly trying to read other people's minds, thinking what they're thinking about them, and they constantly feel under the microscope, in spite of their best efforts. And the reasons why I love books like this. And actually, the spirit of this podcast, is it helps to put a voice to the struggles that people have. And I can imagine Natalie, people reading this book that also struggle with social anxiety, they can really, really relate to what's going on here. So I thought it was fantastic.
Thank you so much. That's been one of my favorite parts of this experience, is connecting with the readers that were like, “I really, really felt that representation of the anxiety, even some of the physical things.” And it's been so rewarding hearing that for some people, like I got it right.
Right. And it's such a common condition, it affects about, you know, 12% of the population over the course of a lifetime. But one thing that really distinguishes social anxiety from the other salad bar flavors of anxiety is there's long, the longest delays that we see in seeking treatment. And it kind of makes sense from a social anxiety standpoint. If at the core the fear is being judged or negatively evaluated or criticized, it makes sense why people would delay seeking treatment. So that's why I think from a public health perspective, works like yours are like really, really helpful because people can relate to that.
That's so interesting that you say that about the delay in care. It makes a lot of sense and there's a lot of coping that I think people develop in social anxiety that we're going to dig into quite a bit with Jolene. So, Natalie, you don't even necessarily call Jolene’s experience social anxiety, but you mentioned anxiety, although this is a near perfect depiction of what social anxiety could look like. And I just wonder, is this something that you intentionally mapped out, or was Jolene's character just revealed to you as you went through the story with her?
Yeah, so I definitely want to give emotional truth to everything I write. And Jolene is a character who has social anxiety, but I also think it's because she's navigating an office and offices, like at the very beginning of the book, she says something like, offices are never really great for people with like, like anxiety. And yet we're the bad guys if we can't cope.
And that was something that I kind of wanted to tap into. So even though I don't have the exact same forms of social anxiety, and I definitely knew what kind of the emotional truth to it.
It rang familiar for you and that's so clear and how authentic she is depicted. Craig, that was really powerful for me to hear Natalie say that and and remind us of that in the book, that when you have social anxiety and then you're in an office, it's one of your hardest places, but you also are the person kind of carrying the burden of getting over it. Will you just react to that.
Yeah, that's a a common bind that as humans we find ourselves in. Because for right or for wrong, oftentimes the world is built around needing to be a social animal. You got to get along with other people. And and there's certain things that we have to do in life that really require being able to navigate relationships. Now, I think part of the cultural bias is, well, in order to be healthy, you have to be extroverted. And that is so wrong on so many levels. But I think oftentimes that's the burden that folks with social anxiety find, whether it be the temperamentally, they're more, introverted, a little bit more shy, or maybe have some social skills-related things could be difficult to navigate relationships. But even people that are extroverted can also be socially anxious around certain things as well too. But you just see it multiple places throughout, throughout the book is that she puts so much pressure on herself to try to avoid not being there, and then having to act and be there at the same time.
But I was really struck, you know, when I think about it clinically going through, she's having panic attacks and these intense surges of physical anxiety in these circumstances. There's so much thinking about what other people are thinking about me being judged, even re-experiencing those times when she's been called a loser. I mean, that's that is like really, really poignant. Sometimes they have these really poignant experiences of objectively being ridiculed and rejected by others and then behaviorally, and we'll probably get into this in a little bit, you see how she acts in response, either through like avoidance or using substances and other ways to try to mitigate that distress.
I wonder if you'll break down that continuum, Craig. So I heard you say introverted, shy. I think all of us universally have been in social experiences where we feel a little anxious or a little unsettled or out of our depth or something like that. And then there's social anxiety disorder. So can you kind of take us through what's just your personality or normal sort of performance stress that can occur? And then when does it actually become something where somebody might want to seek help?
Right. Because we can imagine that there's a lot of different kinds of social situations that are out there that can generate some level of stress or anxiety. And in fact, that can be motivating, like when we're applying for a job or, say, going out on a date or trying to get conversations going. I mean, it's just part of the normal human experience.
But at what point is that alarm system misfiring? So sometimes, you know, the intensity of the anxiety, whether it be the types of thoughts that we have or just the raw physical sensations of anxiety. Sometimes when that alarm goes off, it's too loud. So we're having panic attacks. And I think very early in the book, Jolene has like a I think it was a four-a-day panic attack, you know, at some point. So the intensity of that is a marker of, okay, this has become more of a clinical problem. Also, the difficulty is being able to turn off that alarm system. So once we get triggered just how long it it grinds people through feeling that uncomfortable and then the kind of the misfiring of the alarm, almost like a false alarm that the anxiety going off in situations maybe that don't necessarily warrant that amount of anxiety. So once it really starts to get in the way of a person's life, that's where we start to see some of these struggles. So we think about Jolene, you know, she was saying and once I got on my parents house, then I’ll have my own place, like I can be myself. And it sounds really ideal. But she's also very lonely as well, too.
It's kind of a trap that she finds herself in. She's just trying to keep to herself in the workplace, which can really hinder making some of those social relationships, or maybe even advancing in her own career. You can see how the anxiety plays out in trying to establish a romantic relationship. So there's lots of examples where there are certain things that people want to be able to do with their life, but the anxiety is so intense it keeps them trapped.
So it's an issue of proportionality, out of proportion to the stressor or the driver for what's making you feel that way. It's that persistence that you kind of, you said, can't turn it off. It's the misfiring, something that maybe shouldn't be anxiety provoking: going to your job that you've been in for several years shouldn't necessarily cause you anxiety on any given Wednesday. And then that interference with your ability to function. As a non-psychologist, that would be my summary of those who are listening to to recognize okay, when does it become something like you said, people with social anxiety disorder don't necessarily seek help as quickly as maybe somebody with a major depression would know clearly, okay, there's something here that that I want to get professional help with, Natalie, that the beginning of the book is, oh, poor Jolene, it's her birthday. She's called to an end of the day meeting, which she assumes is going to be a birthday cake and some singing that she's going to have to just withstand. But instead she's been caught sending some messages that are, while spot on, a bit snarky and, being read as aggressive. And her boss, who has his own issues, says that we have to get involved for the comfort of all. I wonder if you'll comment on how behaviors with social anxiety impact those who are around you.
Yeah, so I think for Jolene, she misreads a lot because of her anxiety and she believes so many people's thoughts are kind of different than they are. And I think that's how she kind of became in the hole that she's in, is that throughout, like her interactions with the office, her just kind of wanting to avoid a situation like a birthday party is her being kind of a Scrooge, you know? Or if she doesn't want to do any of the “fun” things, I'm using air quotes around the office, that's because it's honestly such a scary situation for her, and it comes off as she's just not playing the game in the office politics.
Yeah, even a coworker who's just had a baby comes in with her infant, and you see Joellen and just sort of cringe, feeling that she has to go and gush over the baby. But it's not natural for her. It's not what she wants to do. She's inclined to stay. Yeah, it's it's painful to watch her, but also, I think we all can, relate, at least to some degree, with which she's navigating. There's lots of coping strategies, Craig, with social anxiety, some are healthy, some are intentional, many are unhealthy, and things that are just learned automatically by some of these responses. What are some of the big ones that you see in the book for coping?
Yeah, before we talk about that, I just want to double back to what Natalie mentioned a second ago, because I think that those behaviors turn into like a self-fulfilling prophecy. She's already worried about procedures not fitting in. These situations are uncomfortable for other people see that. And they think she's like, pretty weird. So it could turn to that self-fulfilling prophecy, which just, you know, fills the head even more. But that's so such an important point. And you really saw a lot of this throughout the book is just different efforts that Jolene would engage in to try to cope with the situation. And, a lot of times when we look at any kind of anxiety disorder, social anxiety in particular, there's two ways your behavior changes when you're anxious.
One is the “not doing enough of something” kind of behavior. So that's the avoidance. The laying low, the desperately wanting to be invisible and transparent. Being left alone. The other direction that this can go is the “too much of something” kind of behavior. So this is where in this book we saw Jolene, where alcohol really played a role with that sometimes over engaging. And once she got a hold of the IT glitch, could see how over-engaged she wasn't doing those things. The trick is that whether it's it's not doing enough of something or doing too much of something like substance use, people aren't doing it to feel good. They're doing it to feel less bad.
And when do you really pay attention to the types of worst-case scenario thoughts that she was having, how she was really internalizing those negative messages herself, and the raw physicality? That totally makes sense. You drink alcohol not because necessarily it tastes great, because you don't want to care anymore. You don't want to think about this stuff. You want to escape out of your head and then if I don't even get into this situation to begin with, then I don't have to worry about it.
There was a couple of poignant times that you just slip this into the text, Natalie, where I think it was maybe the first time that she was at Angels, with Cliff. And there's something in there that for the first time, she notices that she is not thinking what other people think, and she's not as much inside her own head.
She is more in the moment. And that is such a rare experience for people with social anxiety. But that's when we think about, like the behaviors, they all serve a function. They really do. But a lot of times when anxiety is problematic, it's designed to make people feel less bad.
Yeah, I really like the point you made about how it becomes a self-fulfilling prophecy. Going back to that, just because when she does first kind of get access to the emails and she starts to see all her worst fears, sort of confirmed, and then it takes off from there, and then she's worried about what everyone's thinking up until she sort of starts to release it once she starts making that connection with Cliff. And at first when I was crafting their relationship, I knew he would be a significant relationship, but I wasn't sure if it would be a deep friendship or something more. And so it was a nice moment for her to see her in the having a milkshake, and for once kind of realizing that there is another way to live, like at least a peek into that.
Which is unusual and scary as well, too. There's a lot of a lot of, a lot of pressure can inadvertently come from that.
Absolutely. Because she's really boxed herself into her world and really set the rules for kind of how the world works around her and Cliff and kind of all the colleagues end up being, pulling the rug from underneath the life she's built.
And the truth is, she's pretending. But everybody's pretending in this novel, that things are not as they seem for anybody. I wonder if that's universal, but I think that's just part of the brilliance of your novel, Natalie, is that, you know, Jolene, I think, thinks she's the only one who has to show up and either avoid or, overdo, like Craig said. And it's driven by all of these thoughts and not that everybody in the novel has the same issues, but everybody is pretending to be or to be doing something that they're not. They're telling a story that they want the world to see. And I think that's really important for readers and for people thinking about mental health. Is that sometimes we get caught up in this story or being told versus what's really going on with these humans who are in your circle. Craig, do you want to comment on that?
Yeah. That is like such an excellent point because it's exactly what happens. Again when when you think about social anxiety, they really are in their own head, but they're also trying to get in the head of other people. Earlier on is talking about us the thought bubble, like we're looking at how they're looking at me or what they're doing or maybe not doing, but is through a biased lens. Because when you're thinking about your thoughts but it's filtering through a lens of anxiety, it's naturally going to be biased. You're going to focus in on things that maybe are a sign of rejection. You're naturally going to interpret, misinterpret certain things that are said or not said as being more personally threatening and more rejecting as well, too. And these information processing biases are super powerful in here.
So that's why I like spending a lot of time thinking about or thinking this is like such a huge part of the social anxiety experience, which makes it incredibly fortuitous, shall we say, that she actually does start to get inside people's heads, through the technical glitch so she can see what people are saying. But that still, I think part of the book is and that's still social construction, because sometimes people will type out their thoughts, and that may not always be what it means as well to or how they truly feel about things. It's still part of a social construction.
Absolutely. And that's such a good point that when I think when she realizes that everyone is sort of masking something or they have a work sort of personality, I think that that's a big moment for her as well.
Yeah, it's it's almost like a sociologic type of thing that some sociologists talk about. This personal construction in life. And it's almost like when the stage changes, your role changes as well, too. And they're like really good examples of that dominantly within the work space in here. But then also some of the familial dynamics as well. And then also like just even in the general apartment with, with Miley and interacting with her mom and other things too. So it's really interesting in the book how you change the stage and how that can also change how a person acts, reacts, or responds to various things.
I love working with the office as a scenery, just because I feel like it is such a good, almost social experiment that like a bunch of different personalities are put together and sort of forced to share a fridge and forced to get along with each other, like all that can kind of manifest from that and like the humanity that can kind of seep in. That's not like, you know, like that we learn about our colleagues in the sense that there's a little bit of overhearing a conversation, like a hushed conversation with someone's wife or something, you know, and you sort of like, learn all these things about your colleagues that you actually inadvertently shouldn't do and so or shouldn't know. And so I thought that was an interesting environment to play with.
Yeah. This is why it's an incredibly fortuitous, day, as I'm calling in from Scranton, Pennsylvania, home of the show, The Office.
I was going to say.
But but it's kind of like, you know, for right or for wrong. We spend a good portion of our normal, wakeful hours in that workplace, you know? And and those are the people that you interact with, that is your social group. And when you have, when that's the dominant amount of time that's spent in that particular environment, if it's really uncomfortable, if it really makes you nervous, if you're constantly feeling like you're under the microscope and having to be careful of what you do and what you say, you just think about how sensitizing that can be to anxiety. And remember, we were talking a little bit earlier on, there’s already an information processing bias going on where they're already focusing too much on the threat. So it can make it really, really uncomfortable when that much time is spent in that environment. So it makes sense when you get out of that environment, you just want to shut down or do something to soothe the system or to get into like not caring about things.
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Yeah, let's talk about that: shutting down, soothing the system. So I want to spend some time thinking about Jolene's relationship with alcohol. There's a line in the book where she says, “When I get myself into a doom spiral, there's no easy way out. It's going to be an evening of angst, and I will need booze to survive.” So we see her from the beginning of the novel, using alcohol alone in her space to excess. Natalie, can you talk about that component of Jolene's coping?
Yeah, so for Jolene, she uses alcohol. I think it's honestly one of the only coping mechanisms that she has come up with and that she can access whilst alone, and I think she just really uses it to numb her thoughts. I think that seems to be sort of the pattern she follows, like, especially like when she's saying that it seems to be that she knows that she needs to just kind of shut down all the spiraling thoughts that she's going to manifest if she doesn't do something to, like, numb it. And so her most unhealthy coping mechanism.
And you can see that track for her even developmentally over time, because we go back to the scene in Stanley Park when she was in high school in the underage drinking. So you see that going on there and the trauma that came out of that experience, how sensitizing that is to feelings of guilt and blame. And then Kyle, another character, a little bit later in the book that essentially comes back to haunt her at a later time, also at that time really blamed her for that particular situation.
But then you see that happening. There's another part, I think it was earlier in the book, too, around the alcohol use. It's a way that she could kind of have friends at the bar, but not like really get to know them, to just kind of be among them. And then once things almost got too familiar, then it's kind of like going back in the other direction.
But I think that's like, again, such an important point that alcohol plays over the course of time because again, it's really designed to make her feel less bad, but it's a trap that they get caught up and, and and that's why I like when we think of clinically when people come in for treatment again, it's it's not common that they will say I'm socially anxious, therefore I need treatment. They're usually coming in because of either substance use difficulties that they're struggling with, but even more commonly, depression. Because they are really struggling with navigating things in life and there's plenty of times where you could see Jolene just shutting down and just really having to push herself to get engaged with things, even take care of herself. And it's usually times like that is when we see people seeking care for that. But with a good clinical interview, sometimes we can really pick up social anxiety.
And yeah, that's a really good point. I didn't really make that link, but inadvertently until now, that all the big social moments of her life, like her high school traumas and then her trying to navigate the world on her own, and then now at the office, they all involve alcohol in different kind of ways. Like at one point it's helping her, she thinks, as the social lubricant but when she realizes that you have to get closer than just socializing at the bar, and then as soon as she pulls away and just uses that on her own to numb herself. Yeah. So it is interesting that you made that link because it's a good point.
Yeah, we see it clinically, trust me.
Well, and a curious point is when they're having a work party and she finds herself having a glass of wine with a coworker who is she's starting to appreciate a bit more, and she actually has this whole thought process about not wanting to drink in front of her coworkers, because it's come to this point where it's something she really does in her closed space, behind her door to excess when she's, I guess, trying to turn off those thoughts.
But I really love, Natalie, how you depicted the alcohol use and very sort of normal ways that are become part of the problem, of course, but this is not a book about alcoholism. This is really a book very much about social anxiety disorder. So Craig's point is also well made that this is where you might come to find out that this person in front of you is really struggling.
Another trigger is, well, let's talk about the trauma. So Jolene has a really sad event happen in her teenage years where she loses a friend. And this is something that's a wound that she continues to try to hide and has not completely healed. Craig, is that common with social anxiety that there's some early trauma or not necessarily?
Yeah. Classic psychologists response: Well, it depends. There's lots of different pathways, but it's not an uncommon one. So we think of, you know, teenagers think about what happens to our brain, just normal developmentally, we do already feel like we're under the microscope. There is already a lot of social pressure. And there's also, like, a lot more objective judging and meanness that goes on. And that's part of that developmental phase in life when we're trying to figure those things out. And we're also working so hard to try to fit in. So that's where you could see that Jolene and Ellie going in and her kind of encouraging Ellie, let's go to this party and they start drinking to try to fit in with things. And then when Ellie has the fall in Stanley Park and I know Stanley Park so well, it is not an easy place to navigate when it's dark out there. It is just a horrible, horrible event and you just without getting any of the negative feedback from others and the rumors that swirl around at that moment, Jolene just completely internalizes guilt and blame for all this, and this is something that haunts her all the way through her life. And only towards the back end of the book does she start to actually talk about the experience with somebody in a non-judgmental way, which was incredibly therapeutic for her.
Yeah, I loved how you put that, because when she has that traumatic experience, I really want to kind of portray how much, how little we know sort of of what other people were saying and how much was possibly in her head. Like, I kind of wanted to keep it vague and potentially be more in other people's or more in her head versus like what was actually evidence in front of her of what people were saying because she was already a social outcast. So she was kind of potentially using her thoughts, were potentially lying to her a little bit in her patterns.
Right. And you can imagine it when things like terrible things happen to good people in life, that how it gets responded to can really determine a path, that it sets people forward. So again, when you think about as an adolescent, being at a really vulnerable stage for internalizing these negative messages and having the blame placed on her and the rumors swirling around, which is, again, the exact opposite that anybody ever wants is that more negative attention, objective negative attention on them. How sensitizing it was at that point in her life that really veered things off in a different direction for her going forward. And you can see how it turns into difficulties managing relationships that fall outside of that tight comfort zone going forward.
I think another driver, Natalie, of her anxiety, is the family pressure that she's under. So she has loving parents who want the best for her, but that manifests as an expectation to have a certain job, have a certain title, be in a relationship. Can you talk about how that drives some of how Jolene feels?
Yeah, absolutely. She it's a little bit familial, but it's also a little bit cultural in the sense that she is the only child in her family. And she talks about how everyone, all the aunties in the aunty network, that gossip and stuff, all have pretty high achieving children. And I think she, at one point says there's a like a foot doctor or like an ear, nose and throat doctor, like some type of doctor in the family recently.
And so I think that her just going from high school, moving out and not really achieving what she, her parents probably would have wanted for her, and then being at threat of losing her job now and then, it's not even having the stable job anymore. And so for her needing to keep that job and at least keep up the somewhat lie to her parents, like the somewhat decent life that her parents don't have to worry about anymore, was a huge deal to her. So she had to interact with the colleagues at the job that she was so anxious of, because she had no other choice. Because outside of that, her parents would not approve.
Doing what you feel you should be doing and the pressure, you know, to do that. And as you're mentioning, Natalie was coming from a good place. I mean, is without question, her parents just absolutely love her. And there are expectations of where you should be at a different time, different stages of your life. And then how in an attempt to help out Arman and his circumstances, things get out of control very, very quickly of how the one lie has to lead to another, has to lead to another, and more and more acting pressure, you know, starts to build up. But when things ultimately fall apart, become completely transparent, I think it was a really, really good space in your writing where an unconditional love is still there. You know, when parents find out that, OK, so this, none of this was going on, you can still see that unconditional love coming to bear. So even when the most catastrophic things fall apart for Jolene, and that the love of her family still comes through in a non-judgmental way.
Absolutely. And that's the thing about her relationship with her mom. Throughout the book, her mom as a character definitely doesn't go through any arc or change, but how Jolene sees her and how she understands that her mom just really wants her, like deep down, all she really wants is for her to be OK. And that's because of love. Yeah. And so that's a really good way to put it.
That's so interesting. You say that her mom's arc doesn't change, which is true now that you've said that out loud. But one of the heartbreaking moments is when Jolene remembers going shopping for school supplies, and her mother tells her, oh, you don't need an eraser, just don't make any mistakes. And my heart is broken for Jolene as this young child who, of course you're going to make mistakes. That's how we learn. And she's just been set up with this idea that she has to be perfect, kind of fed by her own social anxiety.
That was an actual quote for my mom, but it was a joke. Like when my mom did it, she was. She was joking. Yeah.
You can see too, at least in the book, how she can remember that just like that. So when we're talking about information processing biases, there can be attentional biases. We just automatically pay attention to things that are more threatening. There's the interpretive biases. We tend to more likely interpret ambiguous things as being rejecting and threatening. But then there's memory biases. So all the times where we feel like we're being judged or scrutinized or have to be perfect, they can come to mind just like that. And that's such a good point, because it totally did not sound in the book when it was bringing that forward. Like mum is a perfectionist and has lately is really, really high standards. And the only reason why we love you is, is your performance. And we did not get that vibe at all. So I can imagine that that at the time was maybe an innocuous comment, but it kind of sticks as well too, if it fits in with the narrative of anxiety.
Well, and I think that's another interesting point of these innocuous or these seemingly small events. Like Craig, you talked a bit about how there's this thought bubble and then this action, and then that feeds into this belief that everybody's watching me or nobody likes me, or all these things. So one of the other points I thought was really probably a good point for us to learn from as people who do interact with others, is where Jolene first starts working, Super Shops, and she signs up to bring drinks to an event and instead of just, you know, bringing some sodas and calling it, she gets anxious and she brings more and more and more, and then her colleagues make fun of her. And this would seem like a very small event to somebody who is not dealing with social anxiety. They might just consider it to have been a bit of fun, kind of poking at the new kid who overbought the beverages. But yeah, this is one of the things that kind of drives her to this idea that she's just going to avoid interacting with people because it's so painful for her. Will you comment on those kind of seemingly minor events, Craig?
Yeah, there's another good example of too much of a behavior right there, just like over buying. And you can see it's a no-win situation for her, because the whole time it's like, that's not enough. I can see how that, behavior kind of plays out. And then. Yeah, and then she gets teased about that. They make comments about it, which further sensitizes that anxiety because regardless of how that situation would have played out, it's kind of one of those damned if you do, damned if you don't.
It's like she's always going to feel like I didn't do enough and that I did too much and I was like, too much. And there's like, it's a no-win situation because the anxiety is going to dictate that, either way this goes, you're going to feel bad and you actually see this again clinically a lot that anxiety works so hard in anticipation of social situations to try to psych us out: This is not going to go well. You're going to mess up, you're going to get there and you're going to feel like really, really uncomfortable. It works so hard on the front end to get people to avoid. And then when they actually do avoid getting into these types of situations, the anxious thinking turns 180 degrees and it's like, yeah, you should have gone. And then now you didn't go. People are going to think this, that. And so it's kind of like a no win situation. And then anxiety will continue to do what it does. Like even after social situations are over, we tend to replay them over and over and over again, just picking ourselves apart. We always try to think of anxiety will do what it can to create that cycle of feeling, thinking, behaving, to keep itself going. And you saw that so much throughout the book, so much throughout the book.
And Natalie, that even manifests in Jolene's dreams. She's about to give a presentation to her boss and you have her dreaming of, I think being in the conference room and forgetting to get dressed or something like that. Can you can you talk a little bit about that?
Yeah, we've all kind of had the dream where you're not quite ready for a test or something, like all of a sudden you're back in college and there's a test on that first day or but for Jolene, because she's so, her worst nightmare situation would obviously be something to do with standing in front of everyone and it going terribly and just how horrible it can be.
And so even something as small as getting the drinks for a potluck can kind of expand in her like thought processes into, well, some people might want milk and but then what about the people who don't want dairy but want milk? And. Yeah. And so she just she's so afraid of being singled out and being in front of a room like that, that almost anything that could lead that way, she will think it through.
I really want to highlight that this is a hilarious novel for listeners who are thinking, oh, this is all about social anxiety. It is really laugh out loud funny. And while Jolene has so many struggles and many dark thoughts underneath that is this amazing personality who is clever and funny and, you know, really is at her heart, well intentioned, if she makes some bad decisions. As we wrap up, I'm hoping you both will say some things that you want listeners to take away now knowing about social anxiety, take-away points would be great. Craig, you want to start?
Yeah, I think you know, some takeaway points at the start. At the end of the day, we're human, you know, and we're flawed. And whenever we're navigating social situations or being accepted or judged or evaluated by others, it's kind of like tolerating the uncertainty and acceptance. Now, part of the uncertainty is we honestly don't know what people are thinking. That's what's brilliant about this novel, is that for a brief period of time in her life, she actually got a good sense of the microscope being in the other direction, where she can actually see what's going on with people, and through that she learns the humanness of other people's struggles as well, too. But, you know, when we think about, like, some of the beliefs that, yeah, maybe I am being judged, maybe other people notice, but also maybe other people notice and they maybe don't care as much, or maybe they do notice, but maybe they, you know, attribute it to something else.
Or maybe people are more compassionate than we give them credit for. And you can see the words, the words like maybe and and might and, and it's, it's kind of helping to tolerate some of that uncertainty. And as the book progressed, there were like really poignant examples of having just confirming experiences, like getting through a presentation and actually doing a good job or able to go to, I think it was like the bowling alley was one where she actually wanted to go and just to be around people, and Cliff and his family that were just kind of hanging out. He didn't have to be on for anything. You could just kind of hang out. And it was through having some of these disconfirming experiences, on top of starting to see the social construction of life and what other people are struggling with too, and humanness that was really therapeutic as, going along. So just like with anything mental health, it's treatable. It is very treatable. But it can be tough because it's a lot of work but takes a lot of courage and bravery to be able to approach and working on these things. But they are work-on-able.
Beautifully said.
At the end of the book, Jolene mentions someone might be thinking something bad about me or somebody might be saying something bad about me. But all I can focus on is what's right in front of me. And that looks pretty okay. And I think that that's a really good way to go about things, because we don't really have a lot of evidence other than what's in front of us. And that without thinking of the other thoughts, it's really helpful for her to go through it that way.
I think that's brilliant. This has been such a great conversation. I want to thank Dr. Craig Sawchuk for being back on the show with us, and Natalie Sue for her brilliant I Hope This Finds You Well, listeners should go out and read this novel right away. Thank you both.
Thank you. Thank you.
Read. Talk Grow. is a product of the Women's Health Center at Mayo Clinic. This episode was made possible by the generous support of Ken Stevens. Our producer is Lisa Speckhard-Pasque and our recording engineer is Rick Andresen. Visit our show notes to see the books discussed today and for links to other health education materials. Follow us on social media like Instagram and Facebook. Or reach out directly to our email, readtalkgrow@mayo.edu with suggestions for books or topic ideas. We'd love to hear from you.
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