In the new season of Limitless: Live Better Now with Chris Hemsworth, Dr. BJ Miller returns to guide the actor through one of his toughest challenges yet: building a tolerance for pain. Known for helping Hemsworth confront mortality in season one’s episode on acceptance, the palliative care physician now takes Hemsworth to South Korea to explore Eastern approaches to pain and discomfort.
Throughout the episode, Hemsworth confronts the line between distress and danger, questions the macho instinct to “push through,” and learns to see pain not as weakness, but as a normal part of life.
Read on to find out how this philosophy helped guide Miller’s appearance on the show, and how he invited Hemsworth – and viewers – to rethink how we define strength, endurance, resilience, and pain.
You’ve worked with Chris on Limitless before, with the other episode being about acceptance and tying in your work as a palliative care doctor. What stood out most as different or special about this episode?
Dr. BJ Miller: From the first season?
Yes. [Note: Miller’s season one episode revolved around acceptance, especially around aging and death.]
It’s similar in that we’re putting Chris into some extreme situations, and he’s learning ways to cope. So there are a lot of similarities [in that way], but versus trying to get someone to accept mortality – or at least kind of acknowledge it, work with it – that’s a little abstract still. I mean, none of us – depending on what you believe – has died yet, so preparing for something that none of us have done yet is one thing. But in this season, preparing for pain or working with pain is something we’ve all experienced. So in this way, it’s a different approach. [It’s] a little bit more accessible, a little less abstract.
As I mentioned, you’re a doctor. And in this episode, you and Chris go to South Korea to explore Eastern approaches to pain. From your perspective as a Western-trained physician, what are some of the differences between Eastern and Western medicine when it comes to understanding and treating pain?
The big one is that in Korea – and probably most any culture older than the US – is that pain is acknowledged to be a fact of life. It is part of the deal. And so right out of the chute, acknowledging the normalcy of pain as something that you work with in life is very importantly different from thinking that pain is this exotic animal that is coming to get you and that if you do everything just right, maybe you can avoid pain. That’s a major distinction and has a lot of fallout. I think the Western way ends up leading to a lot of shame and embarrassment and a sense of weakness for feeling something that otherwise is so normal.
Through your work in end-of-life care, you’ve spent time with patients at their most vulnerable. What are some lessons your patients have taught you about pain and how the body reacts during that time?
I guess a big one would be just how wildly different we are. So, yes, we’re all human. Yes, we all have joys and sorrows, and there’s a sort of uniformity or universal nature of the human experience. You might say universal themes, but then there’s this wild variation of how any of us experience these themes. And so the joy for me – or the fascination for me – being a physician and treating pain over the years has been to see how wildly different people respond to it and handle it, the meaning they make from it, et cetera. So I guess it’s these wild variations on very normal themes.
You dealt with immense pain after your accident. How did your relationship with pain evolve through your recovery, and how do you live with it now? [Note: Miller was electrocuted by a power line during his sophomore year of college, resulting in him losing both legs below the knee and his left arm below the elbow.]
We’ve all had pain since a very young age, one way or another, or experienced it. But I had my injuries when I was 19 – electrical burns, which are a particularly painful experience. So I watched myself early on try to resist, try to grit my teeth, to be unkind to myself. I thought, “If I hurt this much, I must be weak.” Or if I’m crying, that must be some sort of character flaw. And so early on in my pain experience, I was at odds with myself. I was at odds with my reality. And I was desperate. I would seek quick fixes and seek to kick the pain out of my experience. But eventually I got it clear that this was part of the ride, and this was going to be part of my life going forward. And so rather than trying to keep this intruder out of my house, it became more like, well, okay, if you’re not leaving, you might as well pull up a chair. I got with it and said, like, let’s figure out how to do this together. And dropping my own resistance to my pain had a paradoxical, or ironic, effect of actually lessening the pain. I think for a lot of us, that was a big lesson: that so much of the volume of our pain comes from our resistance to it. Not 100%, but a lot. And so that was a big lesson that I learned over the first couple of years.
In the show, we see how much the mind shapes what the body can endure. From your experience, how much of pain tolerance is mental? I noticed how in the show, you’ve almost trained your own brain to endure more pain.
So with all pain, there’s a distinction to be made between the mind and the brain. So all pain, most researchers would say, lives in the brain. Tells the brain to get involved. It’s just a signal. It’s an electrical signal moving through our nervous system. It’s our brain that decides whether it’s a threat or not. Add in our history and our narratives and our emotional state, and the brain produces what ends up being the sensation. And so there are many ways to affect that sensation. How we think, how we train our minds. And the mind is not an organ as much as a sort of narrative-making piece of consciousness. And so, by framing your pain and watching the stories you put around the experience, you can modulate the experience. And so I think in this way, your mind can really color the experience. And as you do meditation and other things, you can train your mind to get better at that. But again, I want to say that while the mind can color the experience in dramatic ways for sure, the mind is not so powerful that it can necessarily turn off the pain. And I also don’t want to leave anyone with the notion that if you’re hurting, well, it’s your fault because you didn’t find a narrative that works for you. So my point here is that you can affect experiences with your mind, but I don’t want to send a signal that it’s your fault if you’re hurting.
Yeah, I was particularly thinking about the scene in the show at the Korean BBQ restaurant where you lasted with the hot pepper longer than Chris did.
Yeah, yeah! And part of that just may be our wiring. He may actually have a different volume, or a signal that’s super loud for him in his nervous system. But to your point, I have kind of gotten into spicy food and into training myself over time to tolerate more. And I think the trick there is, you get the memo that this pain is not going to hurt you physically. It’s not a threat to your safety. And once you really understand that, then you can just play with it as a sensation and it’s not a threat.
When pain isn’t something you can control, like with chronic pain, what tools or mindsets do you recommend to people to adapt?
I think one thing to make sure of is whether this pain represents a threat to you or not. So that’s a good way to use the medical system. A lot of doctors aren’t very good at treating your pain, and there’s some pain we just can’t take away, but doctors can also be pretty helpful through physical exams and imaging other things, and making sure that it’s not a threat to your safety in some way. And so once you know that pain is not actually a threat to your safety, it may still hurt my hell, but then you can settle into it. You can talk to yourself through it. You can tell yourself that this is not going to kill you, this is not hurting you. You are safe. And if you get that memo of safety, your nervous system can relax, and then you can start working with the story weaving around that pain – what it means, what it doesn’t mean. You can take care to get really good sleep. You can take care in the rest of your life, so your social life is in check. So loving people in your circle who can share the pain with you. But if it’s a threat to you, it may be really important to not move. If you’ve got to say, a pain in your neck and you’re not sure whether it’s a threat, it’s a good idea to not move. But once you know that there’s not a threat, then sometimes movement is exactly what you need to mitigate the pain. So I think the major inflection point is threat or no threat? That gives you your marching orders. If it is a real threat, then you should stop what you’re doing and figure this out, period.
In the show, Chris mentions that he has mild scoliosis, and some of these challenges are extremely demanding on his spine. Were there ever concerns about the risk of injury? In a case like this, how do you weigh pushing limits vs respecting your body’s signals?
It’s a great question. It’s not always clear. Reading pain can be very difficult. It hurts. But there can be clues [as to whether] there’s actual injury involved. One would be if the pain lingers beyond the event or the moment or the hours [following]. If you’re more sore the next day, then it’s a little bit more likely that you’ve actually done some harm or some injury, even mild injury. There are qualitative differences in the pain. Sometimes, if pain onset is very quick and you’ve just done some sort of physical activity, then maybe be a little bit more ginger and careful until you can assure yourself that you didn’t do any harm. But to your question, it’s actually really tricky to know whether pain represents a threat or not. So acute pain, listen to it. Stop what you’re doing. Rest. And if the pain goes away very quickly, you’re probably fine. If the pain lingers, then you might want to get it checked out.
Chris is known for being tough, even when things hurt. What are your thoughts on the pressure, especially for men, to “push through pain” and be macho about it?
It’s a really important question, and I think we get ourselves into a lot of trouble by overdoing it. And Chris suggested that he’d done that over the years – that pushing through the pain, gritting through it. Almost like seeking pain was a badge of manliness and honor. So I think that the message for men is that we’ve got to get out of the idea that bearing pain is strength and feeling pain is weakness. We’ve really got to watch the stories we tell around pain. And that’s a cultural note as well as an individual note. And I would just say that tears are not weakness. Feeling pain is not weakness. It’s a normal human experience. So listen to your body and stop trying to override it.
Limitless is all about pushing boundaries in different aspects of life. And pain is a part of life. What is the biggest lesson you hope audiences take away from the episode?
That all pain is real. Some of its emotional nature, some of its existential nature, some of its physiological in nature. And any two people experience pain differently. So be careful of the projections and the judgments that you cast around your pain or anybody else’s.
Limitless: Live Better Now with Chris Hemsworth is streaming on Disney+ and Hulu today, and airs nationally August 25 on National Geographic.
