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Most people aren't thinking about you. They're thinking about lunch. A ham and cheese sandwich, specifically. The speaker uses this to explain why social anxiety about what others think is usually overblown.

Most people aren't thinking about you. They're thinking about lunch. A ham and cheese sandwich, specifically. The speaker uses this to explain why social anxiety about what others think is usually overblown.
So the ham sandwich reference is I'm always thinking that they're thinking things about me, but in reality they're just thinking about what they're going to have for lunch. They're thinking about ham and cheese sandwiches.