How to Live When You’re in Pain

Arthur C. Brooks and BJ Miller, a palliative-care physician, explore the difference between “necessary” and “unnecessary” suffering, and the paradoxical realities of human joy.

Black-and-white image of two hands holding
Getty / The Atlantic

As we wind down this series, a paradox remains in our pursuit of happiness: Joy comes to those who have known pain. In order to overcome struggle—breakups, illness, even death—we must first accept and acknowledge its inevitability. Exploring the darkness of our suffering may seem counterintuitive, but often it’s the only way to see the light.

In this week’s episode, Arthur C. Brooks sits down with BJ Miller, a palliative-care physician, to uncover how we can face our deepest fears, why we should accept our natural limitations as human beings, and how to make peace with the ebb and flow of joy and suffering in human life—an experience we all share.

This episode was produced by Rebecca Rashid and is hosted by Arthur C. Brooks. Editing by A.C. Valdez. Fact-check by Ena Alvarado. Sound design by Michael Raphael.

Be part of How to Build a Happy Life. Write to us at or leave us a voicemail at 925.967.2091.

Music by Trevor Kowalski (“Lion’s Drift,” “This Valley of Ours,” “Una Noche De Luces,” “Night Sky Alive”), Stationary Sign (“Loose in the Park”), and Spectacles Wallet and Watch (“Last Pieces”).

This transcript has been lightly edited for length and clarity.

Arthur C. Brooks: When you teach happiness, like I do, one of the biggest questions that people have initially: What is it? I mean, we all think we know what happiness is until you think about it. A lot of people, they assume that happiness is a feeling. A better definition of happiness is: It’s like a meal with three macronutrients. Just as a meal has macronutrients—or protein, carbohydrates, and fat—happiness is a feast with three macronutrients, and they are: enjoyment, satisfaction, and purpose.

I want to focus right now on that third macronutrient, on purpose. I probably don’t have to convince you that finding purpose or meaning in your life is required for you to be a happy person. You may have spent certain times in your life really having a great old time. Lots of pleasure, lots of enjoyment, but kind of aimlessly. And you most likely didn’t find that you were really, really happy.

Almost everybody, it turns out, when they’re asked what actually helped them understand their life’s purpose—which is part of happiness—paradoxically, they talk about periods of unhappiness. Here’s the conundrum within all of these ideas: To be happy, you need purpose. To have purpose, you need unhappiness. You need some pain. You need some sacrifice. You need some difficulty. And that’s what we’re going to talk about today. Because we need it to get the purpose and thus the happiness that we seek.

BJ Miller: You know, I’m all for happiness. It’s a beautiful thing. But first of all, it’s not always accessible. Second of all, it is deeply related to pain and other trouble. I don’t think happiness is the absence of trouble or absence of problems or the absence of pain. I think happiness and pain are really close bedfellows.

Brooks: BJ Miller is a hospice and palliative-care physician and the co-founder of the online palliative-care company Mettle Health. Dr. Miller’s professional field of palliative care deals directly with the healing of suffering rather than of disease itself—from physical pain to emotional struggles. You might wonder why I’m so interested in his work. I’m interested in anybody who’s a total subversive in their own field, and that’s BJ Miller.

Why is he interested in suffering and death himself? He had a near-death accident in his college years. He dealt with incredible pain and was forced to confront mortality head-on. BJ’s wisdom on pain and suffering, through his professional work and personal experience, helps us come to grips with the inevitable struggles of being human, which means sometimes being in pain and in every life, sooner or later, coming to an end. Why? So that we can be alive today in a more meaningful way.

Miller: We humans are sort of relatively oriented, so we know joy because we’ve known pain. And we need foils. We need points of contrast. And so death can provide us this point of contrast so that things like beauty and joy pop; they have something to push against and to relate to. So that idea of having a foil in life to understand what joy feels like because we know what its absence feels like.

Happiness is not so much just the pursuit of pleasure. It’s somehow the pursuit of being okay with reality. And reality happens to include things like pain and death. Death gives us this context for our life, this reason that time becomes a precious thing and where we place ourselves becomes important because it’s not unlimited. It also gives us this grand excuse that we know in a full life, we’re never going to get to everything. That’s not a failure. That’s just the truth of life being much larger than any one of us.

So death has a lot to teach us, and I would just say, you know, I’m neither for or against death. It just happens to insist upon itself. It exists. So therefore I need to deal with it. Happiness, I think, has something to do too, without it not being at odds with oneself. And one of the things we do—any, every, all selves do is die. So that’s just part of the package.

Brooks: Why would you go through your life never actually being alive until you die, because you’ve been denying the existence of death? It’s a weird psychological conundrum that you put yourself into under the circumstances, don’t you think? Why are you interested in this topic? What got you interested in the topic of death?

Miller: Well, because I finally came to realize that it exists, like I said it was, it’s like part of reality and that it was part of life, not the antithesis or the poacher of life, but part of life—that it’s in us. And so my pursuit of knowing myself and knowing life led me to trying to at least accept death.

I don’t know if we can know death—I’m not sure—but I guess you could say, Arthur, my interest in life led me to my interest in death because they are deeply related. And then more specifically, too, I mean, I came close to death myself when I was in college. I had an electrical accident that really bumped me up against my mortality as not an abstraction but as very much a reality that could happen any moment. And so that kind of forced me to look.

I had no choice but to look, you know. I think you can do these things by force or by choice. I was forced to look early on because I came so close to it. And that led me into medicine. But really, my interest has never been in death per se. Again, it’s just really in life. And it’s also been an interest in: What do humans do when they bump up against things they can’t change or they can’t control? And that, to me, has been really the primary grist more than death per se. It’s that how humans deal with and understand and work with and realize their own limitations. And how humans start to see life beyond themselves, which is a beautiful way to handle the idea of death.

You can start decentralizing your ego; you can start seeing life outside of yourself and feeling your connection to it and appreciation for it and your responsibility to it. So in my field, we talk about the end of life—like that’s the phrase, end of life—but it’s such a problematic phrase. Now life, life will keep going. Your life is going to end; my life’s going to end. This life will end. So it’s not the end of life. Life does not end, as far as we can tell it. It keeps on going. We—you or I—do not. So it’s the end of my life. Once you get over yourself, there is a sort of immortality happening, too, all around us.

Brooks: So when your patients come to you, I mean, there aren’t—I mean, your patients come to you because they’re facing the end of life—obviously, you’re doing hospice and palliative care. And my guess is that many of them come to you and they’re not very happy. Is it fear or regret or something else that’s actually leading people who are nearing the end of life who are unhappy to experience this unhappiness?

Miller: Palliative care really is the sort of clinical—it’s the science or a philosophy or an approach to care that deals with suffering versus deals with a disease. The problem, if you will, the thing we’re looking at, is suffering. And so a lot of people who I see in palliative care aren’t at the end of life. They are just struggling. They’re suffering. They’re trying to make sense of a world to them that does no longer makes sense, trying to incorporate a diagnosis into their sense of self.

A lot of the clients or patients I’ve seen over the years are nowhere near death. So one thing to appreciate is for listeners that palliative care is the sort of clinical pursuit of quality of life in the face of suffering. And we grew out of hospice, which is a subset of palliative care that is devoted to the end of life. So, just to say, you don’t have to be dying anytime soon to benefit from palliative care.

Now, having said that, the way I kind of work in my practice is in this sort of existential framework. Any time, whether or not we’re talking about death explicitly, it’s always in the air. And then my approach is to work kind of almost backwards, to sort of find a way to rope death and loss into the picture and then build from there. Sort of like: Life begins when you realize that you die. Not only do we have to die; we have to know we die in advance of our death, and that is a real mind bender.

What’s been fascinating with Mettle Health, we started this little group outside of the health-care system because as a clinical physician, your point is well taken, Arthur. People come to me because something is wrong. That’s how they find their way to palliative care or medicine in general.

So in some ways, my job in palliative care is to make them hate their life less or make them hurt less. But you start doing that even if that’s your goal. You start realizing that part of the antidote is finding meaning. Part of the antidote to pain of any kind is making sense of it or working with it, or somehow accepting it. So it’s always in the mix.

But now that we’ve set up Mettle Health outside of the health-care system, it’s been fascinating. A lot of people coming to us are caregivers, for one. They’re part of an ecosystem where illness is in the mix; they’re themselves not dying or sick, per se, but they need help. And some of our clients don’t even have an illness. They’re just going through a big transition in life, like a loss of a marriage or changing their employment or trying to move or trying to kind of get to new aspects of themselves. So there’s something very beautiful about this work.

Brooks: I like it. I like it nonetheless. And I will quote, you know, from your latest book where you say in the introduction, “There is nothing wrong with you for dying.” And it’s funny that we have to say that. But let’s take in context why we think that, with our medical-care system and how you’re very different than doctors I ordinarily talk to.

Doctors are in the business of keeping us alive, and therefore they set themselves up as enemies of death. And you’re saying, “Look, that’s wrong! That’s all wrong. You can’t be an enemy of something that’s a natural part of life and an inevitability, and something that if you keep running away from, it will ruin your quality of life.”

And so what you’re saying here—I mean, look, I want everybody in the audience to apprehend how incredibly subversive BJ Miller actually is to the entire medical establishment. You’re saying that our approach to suffering and death is actually hurting us. Is that correct?

Miller: Yes, you are correct. I absolutely agree with that statement. Yes. The medical model sort of pathologizes everything. But the problem with that is, you end up pathologizing normal states, like, it is normal to get sick; it is normal to die. We shouldn’t call that “pathological” because it’s like a judgment call. This is where you end up feeling like a loser or ashamed to be sick. You know, that’s deeply problematic.

So one of the things I’m trying to do is de-pathologize these states to unburden us of the shame of being sick. You know, this idea of: Not only do I have to feel bad, whether it’s pain or depression or whatever—you have to feel bad for feeling bad, you know, ashamed of yourself or feeling for suffering. That’s it. That’s man-made stuff that we foist on each other. It needs to be kind of undone.

And look, I mean, there’s a time for fighting, and there’s a time—there’s a “war on cancer,” and I get it. You know, that’s a way to mobilize a bunch of energy. And sometimes in a disease course, something may actually be fixable, correctable, and you may be able to forestall death and live a little bit longer. And there’s nothing wrong with that.

But let’s not fool ourselves. Death is still an inevitability, and it’s not this thing that happens to us. It’s not this foreign invader. It’s in us. Our cells are programmed to do this. So you cannot go to war with illness or war with death for very long before you are, in fact, at war with yourself. That’s just a true statement.

Brooks: You make this incredibly compelling case that to enjoy our life, we need to declare peace on death. That doesn’t mean we need to embrace death. It doesn’t mean we need to rush toward death, but we need to be at peace with the fact that it is part of life. So should we also declare peace on suffering, which is also inevitable?

Miller: Great question, Arthur. I do believe we need to declare peace or perhaps a truce on death—that smells right to me, and that is importantly different than loving it or ushering it in. And in fact, there are data to support that if you can find your way to accepting the fact that you die—i.e., accepting reality—that you might even live longer. When I was trained, the convention was, “Well you can go for a quality of life or quantity of life,” and then somehow you had to choose between the two. What we are increasingly finding is that that’s a false distinction. So part of the answer is to break up these false dichotomies.

In terms of declaring peace on suffering, well, for me, I still find it useful to split suffering into a couple of different kinds. So one is, we might call “necessary suffering”; it’s just the suffering that comes from being alive. Loss is just part of the deal. It will happen and, you know, and it’s going to hurt. So natural phenomena. One of the first things we do when we are born into this world is we wail. You might even consider the birthing process something of a trauma, coming out of the safety of the womb and all the certainty of it, into this world. And it is stunning that the very first thing a healthy child does is cry, is wail. I don’t think that’s a mistake or coincidence. So it does seem to be just an element of the human experience. That’s necessary suffering. You could try to change it, but good luck, you know?

And then there’s this other batch that you might call “unnecessary suffering” or “gratuitous suffering.” I’m all for coming to peace with the necessary suffering, but the unnecessary stuff that we casually—the pain we casually cause each other with our thoughts or our words. We say mean things. We disregard each other. We don’t see each other. We pressure each other to be something that we’re not. We do all sorts of things to each other and to ourselves. We steal from each other. We do all sorts of gnarly things. And that’s a very different kind of suffering.

I think we need to use our discernment to tease out the two. And no, I’m all for rooting out the unnecessary suffering. The health-care system has so many problems. It’s amazing, but it’s also dramatically dysfunctional. And as an invented thing, it’s inexcusable to me that the health-care system causes as much suffering as it does. It is—because it’s made up and because we know better, we should be able to design a better health-care system. And I am upset that we haven’t found our way to do that, and I will continue to be upset and I will continue to try to change that. I’m not at peace with that.

For me, this is a very important distinction, and it also kind of gets at the wisdom of the serenity prayer. Give me this sort of discernment to know the stuff I can change and stuff I can’t, because they beg for very different responses. If I can’t change something, including the suffering, well, my go-to is, what I try to do there, is to love it, that I want to love life so much that it’s not up to me to pick or choose which pieces of it I get to keep or not keep. If I can’t choose to change the natural suffering, I’m going to love it. That is very different from me, just casually causing suffering to myself or someone else through inattention or willful ignorance or whatever else.

Brooks: Okay, back to BJ Miller in a second. But right now, a quick timeout for science.

We’ve been talking in this episode about dying. I want to tell you now about a study that has really captured my imagination about this subject. This is a study that was published in 2017 in the journal Psychological Science. It was written by five social psychologists by the names of Amelia Goranson, Ryan Ritter, Adam Waytz, Michael Norton, and Kurt Gray. The article that they wrote is called “Dying Is Unexpectedly Positive.”

And here’s what the article says: In 2017, a team of researchers at several American universities recruited volunteers to imagine that they were on death row—that’s right—and then to write fictional last statements about their imagined feelings. Here’s the twist: The researchers then compared those posts with the last words of people who were actually facing capital punishment—people who really were on death row. The results, published in Psychological Science, were pretty stark: The writing of the people temporarily imagining death was almost three times as negative as that of those actually facing death—and this suggests that, perhaps counterintuitively, death becomes scarier when it is theoretical and remote than when it is a concrete reality closing in.

Brooks: And now back to BJ Miller.

Miller: It’s not just the patients who suffer from a thoughtless health-care system or an incomplete health-care system, or one that doesn’t apprehend its own or comprehend its own limitations. Doctors increasingly suffer from that. So it’s not doctors versus patients; it’s this medical system that’s a problem.

Poor doctors are trained in it. Poor doctors are asked to do so much, it’s obscene. Not just doctors—nurses, social workers, chaplains. I feel an endless amount of compassion, empathy, and love for people who are trying to work within this system. That’s different. So separating out the person from the system is important here too. The doctor suffers from that mentality as well. I know many doctors who are burned out because they’re fighting a war that they can’t win. And on some level, they know. On some level they know that they’re causing harm, on some level. So that’s one point.

And a second point here is what I would advocate as a fluidity or an agility to choose the construct that serves you in that moment. So fighting to stay alive; I fought to stay alive. You know, that made sense, and I wanted my doctors to fight too, in a way to protect this idea of me having a heartbeat. So the skillfulness is when to use which construct or which tool. That’s the skill that I would like us to develop. Going to war with illness on some level can make some sense, but you’ve got to know when to transition to a different mind frame or a different perspective.

Brooks: So what should our listeners do to start right now not being afraid of death?

Miller: Well, most of the people I know will have some fear. I wouldn’t necessarily advocate trying to become fearless. That may be putting on too much pressure. That may be an impossible request. Rather, get to know your fear; appreciate what it’s trying to protect you from, and be more than your fear.

So if you can have a relationship with your fear that you’re not so whipped around by it—a lot of people I’ve been with who go all the way to the end, you know, they’ll tell you they still have some fears. They don’t know, you know. There’s still scary moments, but they’ve made peace with having fear. I can almost say they defanged the fear by having a relationship with it and seeing it for what it is and for what it’s not. So one refinement to your question is: Part of it is maybe asking too much to be fearless.

So what I think we can do now is begin to relate to yourself, including the parts that are hard. Begin to have a relationship to your fear; begin to explore it, look at it, see what it’s trying to tell you. Welcome the clock into your life, in the sense that to realize that time is actually precious. And yeah, most of us aren’t likely imminently dying. But that’s not—we can’t even say that. I mean, I could go tonight, Arthur. And that’s not a trivial statement. That is a true statement.

So beginning to feel death’s proximity and not see it as something that happens to other people or some indeterminate future down the road. It’s around. It’s in you, and therefore it’s everywhere you are, possible at any time. Begin to welcome that thought into your bones. I think I find it very useful to see loss as proxies for death. Little deaths.

If death is scary because it’s this foreign thing, well, see if you can make it less foreign. Any day is filled with little losses. Loss of a thought or an idea of a relationship or a possibility. Or you know anything. Loss of hair. You know, Sunday nights are a little bit of a death. You know, to have to go back to the workweek, you know, and realizing that the workweek was what made the weekend so fun. You know, the interplay between the two, these kinds of things.

And then as you realize, as you’re an empathic human being, we’re not just like little individuals walking around in vacuums. Welcome your empathy when you feel loss versus when a friend or a friend of a friend dies. Or when you turn on the news and see what’s going on in the world, even deaths of people you don’t know, let yourself feel something there. That’s a little practice run for your own death.

I think the biggest one probably is: Acquaint yourself with nature. Try to invite this idea that you are nature, because nature has life and death swirling around together all the time. Go walk in the woods. You’ll see falling leaves; you’ll step on bugs; you’ll see, you know, it’s just death is everywhere, and it’s completely entwined with life. And if you can absorb that lesson, you’re really cooking with gas then, I think.

I think it’s worth noting that just the way we are wired as animals, our nervous system is in fact wired to fight or flight; that is a reflex we have. That’s not something we choose. But over time, I think that reflex can soften, and when that threat doesn’t go away—it’s one thing to stumble on a tiger in the jungle and sure, you want a fight or flight. But if that tiger’s living in your house and it’s not going to leave well, you need to adopt a different stance with that tiger.

Over the course of a lifetime, I do think we need to continue to work on ourselves to the point where we can move beyond a simple fight-or-flight response to death or to loss or to pain. So on some level, let’s give us all a break. You know, we’re wired for this stuff. It’s not just learned behavior. And then and then I think we, in particular, industrialized society, which has been so much about beating nature, man versus nature. That was all the stuff I learned in high-school literature; that was the lens: us versus nature. I mean, that is such a problematic statement, as though we are not nature, and we are suffering from that consequence all the time.

We have artificially disconnected ourselves from bigger realities, and those bigger realities include death. And then we continue, in this day and age, our messaging, that marketing, the advertisement, the lust for youth and a wrinkle-free face, and all this stuff plays into it. So some of it, I think, is just inborn, part of the deal, and a lot of it is learned, sort of the unnecessary suffering that we continue to foist upon the subject.

Brooks: You know, I teach at the Harvard Business School, and I talk to people who are just super-engaged with their careers and unbelievably successful. And you’re a doctor; you’ve seen the same thing. And people will say, “My life is my work.” And it sort of is; their life sort of is their work. And then something happens that happens to absolutely everybody, which is that they go into decline and decline is a form of death. And they actually aren’t literally afraid of their life ending, but there’s nothing more terrifying for them than their decline.

So how do you take what you know about death and the fear of death and embrace of death, and make it part of life and make it into some advice for some people who are deeply, deeply afraid of their own professional mortality? Their own success in life, their performance, these people who live for what they can do. What can you tell me about that?

Miller: The way we feel about ourselves in the world is often contextual and even your word, decline. We don’t have a better word, so it’s no shame in using it. But really all it is is change. It’s a decline in reference to this other place that you were. It’s decline, like disability. I’m only “disabled” in comparison to this standardized human thing that we’re supposed to be. I’m “disabled” compared to some standard that’s made-up. You’re in “decline” because you’re in reference to what used to be or what was.

And the truth is, if you can get really agile and really exercise your human prerogative to choose the frame for yourself. You know we compare and contrast ourselves to one another all the time to place ourselves: Are we good or bad? You know, that’s a referential—we need some frame of reference to know if we’re doing a good job or a bad job. Okay, fine, but realize as a human being, you also have the capacity to name your reference, to place the context. So if you want to belong in this world, you’ve got to find a way to look at the world in which you belong.

You know, if you want to continue to wring everything out of every cell and work as long as you can or be as long as you can. In America, we have this issue—we’re so identified with work. Maybe they just love their work. So we’re the source of bringing love; bring love to whatever you’re doing, whether it’s working or staring at a wall. So I don’t necessarily demonize anyone for loving their work or living for their work.

You’ve got to move your frame of reference with you as you “decline.” So I guess in answer to your question there, that would be my advice, is to continue to practice letting go or shifting, moving that frame of reference. That’s a creative act. We get to do that if we want to.

Miller: Our imaginations tend to be a little bit more rough than reality. So I couldn’t have imagined losing three limbs. I might have said something silly, like, “Gosh, no, let me die.” People did say that. Some people said that to my parents, like, encouraged my parents to let me go when I was in hospital because it would be such an awful thing to live without three limbs. I mean, geez, Louise. That’s just a limitation. That’s problems of imagination and a problem of their own fears, you know?

So one lesson is be careful of your imagination. Don’t believe your projections. We are way more durable than we generally give ourselves credit for. And once we’re actually in the situation, we find our way very often, you know, so I think that that is—I’ll have those fears too. I just put a little asterisk next to it, or I’ll just wink at that feeling, knowing that “we’ll see when I get there.”

You know, the same with death. Like, you know, I think I’ll be cool with my death when I’m there, given everything we’re talking about, but I reserve the right to freak out. I don’t know. I don’t, you know. That’s part of just all this embrace of reality and embracing things I don’t comprehend. And maybe I will. And down the road, maybe I won’t. I don’t know. But to just make sure I’m noting when it’s my imagination versus when it’s the reality.

We need to get much better at grieving. So part of shifting your frame of reference and keeping up with your life is grieving the losses as they come. That’s a way to metabolize loss, to honor what was, but then also to open your eyes to what you still have.

Brooks: I was out in Aspen, [Colorado,] which is a beautiful place, and I was thinking about how, you know, the life of an aspen tree, you know, how it’s so stately and solitary and, you know, it’s a single life. And somebody explained to me—and I did not know this—that an aspen grove is all one plant.

I mean, you see an aspen tree, that’s simply one shoot off the same root system, and it goes on and on and on. And when an aspen tree dies, that just means one shoot out of the aspen tree no longer exists in that particular state. Pando, in Utah, where you are right now—it’s 6 million kilograms of wood that looks like acres and acres and acres and acres of aspen trees. And what you’re saying—and it’s quite a Buddhist way of seeing the world, I think—that our individual life is in and of itself an illusion. Do you believe that?

Miller: Well, so you’re right, I am, by the way, just down the road from Pando. It’s just really around the corner for me, actually—it’s not far. Yes, I agree with what you’re saying, and I do see its overlap with Buddhism. I’m not Buddhist. I find Buddhism sort of irrefutable. It’s kind of hard to not be Buddhist on some level.

So Buddhism would be one way to frame that and get to that realization or just observation. You know, that’s not a belief system applied to Pando, to apply to that aspen grove. That’s just true. That just is; you can see it. So sure, Buddhism can get you there, but so can observation. So could science, in a way. And one way or another, it’s not a question of whether or not to believe it and just see it. It just is.

Brooks: This is an important point that you’re making, too, and it’s one that our audience, I think, has probably heard more than once from different guests and from me, which is, you know, you can live with the same priorities as protozoa, where there are certain things that freak you out and so you naturally try to avoid them. But that’s not going to make you happy. I mean, basically, your prerogatives that are born into you, that are natural to you, are to breed and stay alive. But Mother Nature doesn’t really care if you’re happy. And so you actually need to go beyond the way that you’re wired in a lot of cases.

And given the fact that we have the metacognition, the awareness of our lives and the awareness that we’re going to die, we might as well not get freaked out. We might as well actually go against our protozoan biological imperatives and choose happiness. And one of the ways to choose happiness is by actually coming to terms with the fact that our life is going to end at some point, that our life is scarce and we’re going to enjoy it and we might as well have a happy death as well, right?

Miller: Right on. I mean, I like to say when happiness is a choice, choose it! You know, I’m all for happiness. It’s a beautiful thing. But first of all, it’s not always accessible. Second of all, it is deeply related to pain and other troubles. I don’t think happiness is the absence of trouble or absence of problems or the absence of pain. I think happiness and pain are really close bedfellows, just like life or health, you might say, is not the absence of disease. I know a lot of walking zombies who don’t have any disease that doesn’t make them healthy per se. So these false divides, these either/ors, these are all problems of language and constructs. These are not natural phenomena. Some of the most miserable people I know, Arthur, are people who have everything.

And that includes—again, so much of your meta message here—that includes pain! I miss my legs. I loved my legs. I miss them. That hurt, you know. It will hurt when I lose my career. So that’s true too. Let that in. The way I got to where I am now is that I didn’t sidestep the pain. You got to go through it too. So let yourself feel those losses. Grieve them. You will see how much is left. You still have so much left.

Brooks: Thank you, BJ Miller, for blessing us all with these ideas and for the work that you’re doing. It’s been really wonderful to be with you.

Miller: Thank you, Arthur. It’s such a treat, man. I could talk to you for hours, and I really appreciate what you’re up to here. Thank you so much.

Brooks: We’re talking this week about death and pain and the necessary integration of suffering into our lives. So how are you going to put these ideas into practice?

Well, there’s an ancient Buddhist technique that can help you come to grips with these things that you fear, these things that you would naturally avoid. It’s a technique that comes from Theravada Buddhism.

If you’ve ever been in a Theravada Buddhist monastery, say in Sri Lanka or Thailand, you might notice that there are photographs, typically, along the walls of the monastery. But they’re not just photographs of beautiful scenery. No. Usually they’re photographs of corpses in various states of decay. Now, first you say, Oh, that’s horrible. Why is that? And that was my first reaction the first time I saw it too.

I asked and a monk told me, “Well, our monks contemplate these photographs. They look at these photographs every day and they say, That’s me. That’s me. Not very long from now.” And they do this so that they become comfortable with their inevitable fate, so it’s no longer scary so that the sting of death is actually removed by making it ordinary. They also engage in what’s called the maranasati meditation on death, which is really just an exercise to help you understand the meaning of life. The maranasati death meditation is a nine-part meditation, and here’s how it works.

It’s kind of alarming at first because it forces you to actually think about yourself dying and decaying, and it’s really very graphic and actually kind of gruesome at first. It walks you step-by-step through the actual process of physical decay. I’m going to spare you the details. You can look it up easily.

Here’s the point: When you meditate on your own death, very specifically, very graphically, your own death becomes kind of an ordinary, normal thing. You’ll begin to find that death is losing its grip on you. It’s losing its terror. The fear of death starts to just melt away, like any other ordinary thing. Now I know it sounds terrible at first, but you know that bad things are going to happen to you, that they are in fact ordinary. We make them extraordinary by trying to act as if they weren’t going to happen, by running away from them. And we do that because we’re afraid.

So let’s use the idea of the maranasati death meditation on some ordinary fears of pain that we might experience in our lives. One of the things that I talk about a lot with my students who are in their 20s is that the abject fear that they have of failure, mostly professional failure. See, a lot of my students are well educated. You know, they went to colleges that they wanted to go to, and they worked really hard. They know that things might not turn out the way that they expected and that just gives them real terror, so they try to avoid even thinking about it. Well, that’s the wrong approach. There are disappointments coming.

Are they terrible? Are they minor? I don’t know. But one way or the other, you should not be wasting your life by feeling terrified of something that is going to happen in one way or another, and a way to stop feeling terrified is to look straight at the worst case. Here’s an exercise I’m going to propose to you. Just using this as an example. Let’s say you’re 27 or 28 years old and you’re in the workforce, and you’re really terrified that things are not going to go as well for you in your profession and your career as you hope that they would. As a matter of fact, let’s say that things go just south.

Let’s do a version of the nine-part maranasati death meditation for your professional life. I want you to ponder these nine steps.

Step one: I feel my dreams growing more distant because what I hoped would come true in my career is simply not coming true.

Step two: People close to me start wondering, Why is she or he not more successful?

Step three: I start to see other people receiving the social and professional attention that I kind of thought I was going to get and I sort of hoped I was going to receive.

Step four: I have to accept work that I used to think was actually beneath me.

Step five: I’m making less money than my friends, and quite frankly, I don’t feel like I’m using my education.

Step six: I don’t really feel like I’m living up to my purpose or my potential in life professionally.

Step seven: You know, I think my parents feel sorry for me.

Step eight: I’m spending some time unemployed, and really, I feel like I’m losing my skills.

Step nine: I accept my diminished professional status as permanent.

Look, the point isn’t that this is something that’s going to happen. The point is that this or some part of this is possible, and the fear of that possibility just might be making your life less fulfilling and less enjoyable than it should be. But there’s a solution, which is facing the idea of this professional death—the worst-case scenario—head-on. If you do so, it’s going to take away the terror. It’s going to help you get on with your life and understand that even this is an ordinary thing.

Pain and disappointment, they’re ordinary things like any other ordinary thing. You can write a maranasati meditation for whatever it is that’s troubling you, whatever it is that wakes you up at night.

The point is this: If you don’t want to be managed by your fear, you have to manage your fear. You have to own your fear. Own your pain. Look at it directly. You’re strong enough. I know you are. Your fear will decline and you’ll start to see the transcendent purpose in the worst things and the best things and everything in between, because that’s part of a full life. What it was you were trying to avoid, you’ll embrace, and in so doing, you’ll start to enjoy the life that you’re living today.

Brooks: As we close out the series, I want to thank you all for taking the time to answer this question: When is the last time you remember being truly happy? I’ve been amazed by the wisdom in your simple and honest and heartfelt reflections. You’ve given me an incredible amount of knowledge. I hope the next time you reflect on this question, each moment of happiness is more frequent than the last. And for those of you still on the journey with me, I hope that your next moment of happiness is coming very soon.

Listener Submission 1: I remember a trip that my daughter and I took to Chicago in the summer of 2018, just feeling a sense of being outside of time where nothing really mattered except this little adventure that the two of us were having.

Listener Submission 2: We sat in the booth and got french fries and milkshakes, and we basically were just a group of guy friends together, making fun of each other, and I just had a real blast. And who would have thought that it would be something so simple?

Listener Submission 3: I bought some cheap plastic pendants and decorations and got a lot of takeout and invited over three friends. Then I realized it was only because of the fact that I was sharing it with my friends, that I was truly happy, that I was able to create something for someone else and to see someone else enjoy it.

Listener Submission 4: My mom and my brother came to Boston. We laughed. We hugged. We hula-hooped, and we danced our asses off. It felt like the mama duck and her two little babies.

Listener Submission 5: I was tutoring a little boy who is in first grade. He’s been having some difficulty reading. A few days ago, he was able to decode 10 words, and his joy was so palpable that I felt the happiest I’ve been in a long, long time.

Listener Submission 6: It’s just one of these miraculous, beautiful days by the ocean with my family. It was high tide. Most of the crowds were gone, and it was just this overwhelming sense of peace.

Listener Submission 7: I was sitting on my back porch with lights everywhere and a big, long table with all of my friends. Having that meal, everything just felt so wonderful and so bittersweet. I felt like, Why are we leaving this? How could we ever want more than this?

Listener Submission 8: You requested a recollection of when I remember being truly happy, and it’s pretty simple: when we had all four of our children, their mates, and our 11 grandchildren to help celebrate my wife’s 70th birthday. It was a week filled with happiness, but even more than that, a deep joy, the richness of life with the family.

Listener Submission 9: I remember thinking to myself, I could die right now, and I would be perfectly happy because I’ve really fully lived.

Brooks: The study from my university that began in the late 1930s asked: What are the practices of people who, when they die, they die happy? Well, it turns out that there’s a whole bunch of things that they did about, not drinking too much and having a healthy body weight, not smoking, and doing all that stuff. I got it. I got it. I got it. We all got that. But the most important thing by far was the relationships that they had.

If you want to reduce everything that we’ve talked about in the series down to just a couple of thoughts, or maybe just one thought, let me quote the man who ran that study for Harvard University, George Vaillant.

He was asked, “How do you summarize the way to be well and happy?” He said, “I can summarize that in five words. Happiness is love, full stop.” So if you want to finish this series contemplating the thing that is truly most important for you now, for you later, and on the last day of your life, you need to love more. You need to love fully. You need to love with abandon. You need to love everybody you possibly can. And see if you can make no exceptions to that rule. My friends, happiness is love, full stop. Thank you.