Ruby Wax opens Sane New World by directly confronting a common assumption: that visible professional success and mental health struggle are mutually exclusive — using her own experience as a successful comedian who simultaneously battled serious depression as immediate, personal counter-evidence.

Her core argument from personal experience:

• Public achievement and private struggle frequently coexist, and Wax's own career success provided no protection against, and arguably even masked, her ongoing mental health difficulties
• The assumption that visibly successful people "have it together" creates additional isolation for those struggling privately, since their struggle contradicts others' — and sometimes their own — expectations
• Wax deliberately uses her own recognizable public success as a device to challenge readers' assumptions about who genuinely "needs help"

This opening immediately establishes the book's central destigmatizing project: if someone as outwardly accomplished as Wax struggled significantly with mental health, the implicit message is that struggle doesn't discriminate based on visible success, undermining any reader's private shame about their own difficulties despite apparent external success.