Sacraments of Healing
The Catechism’s introduction to the “sacraments of healing” is so good that the best service to be provided here is simply to cite it verbatim:
Through the sacraments of Christian initiation, man receives the new life of Christ. Now we carry this life ‘in earthen vessels,’ and it remains ‘hidden with Christ in God.’ We are still in our ‘earthly tent,’ subject to suffering, illness, and death. This new life as a child of God can be weakened and even lost by sin.
The Lord Jesus Christ, physician of our souls and bodies, who forgave the sins of the paralytic and restored him to bodily health, has willed that his Church continue, in the power of the Holy Spirit, his work of healing and salvation, even among her own members. This is the purpose of the two sacraments of healing: the sacrament of Penance and the sacrament of Anointing of the Sick. [1420-1421].
After listing the several names historically accorded this sacrament, the Catechism asks the fundamental question: “Why a sacrament of reconciliation after Baptism?” The obvious response is that man sins even after Baptism due to that “fragility and weakness of human nature,” with “the inclination to sin,” traditionally identified as “concupiscence.”1 This “struggle of Christian life” against the forces of evil is assisted “by the grace of Christ.” This process is “that of conversion directed toward holiness and eternal life, to which the Lord never ceases to call us” . Conversion, then, contrary to the Fundamentalists’ view, is not a “one-shot” deal; it is a life-long journey which involves both God and the Church. Holding a resurging neo-Pelagianism at bay, the Catechism warns that this effort “is not just a human work” but is preeminently a movement of that grace which enables one to “respond to the merciful love of God who first loved us” . Secondly, it is in truth the work of the whole Church. As St. Ambrose put it, in the Church, “there are water and tears; the water of Baptism and the tears of repentance” .
The section on “interior penance” contains many salutary reminders, like the following: “Jesus’ call to conversion and penance, like that of the prophets before him, does not aim first at outward works, . . . but at the conversion of the heart, interior conversion. Without this, such penances remain sterile and false; however, interior conversion urges expression in visible signs, gestures and works of penance” . But just what is this “interior repentance”? Nothing less than “a radical reorientation of our whole life, a return, a conversion to God with all our heart, an end of sin, a turn away from evil, with repugnance toward the evil actions we have committed.” That’s quite a mouthful, but there’s even more: “. . . the desire and resolution to change one’s life, with hope in God’s mercy and trust in the help of his grace” . For the third time, we shall again read that all this happens as “a work of the grace of God” , lest we think we can do this on our own or, equally important, lest we look at the immensity of the task and despair of its accomplishment. The following paragraph also recalls the fact that since Easter this work of conversion under the impulse of grace is, in a special way, the work of the Holy Spirit.
Next are given the three traditional forms of penance: fasting, prayer, and almsgiving. These form a unity, for “taking up one’s cross each day and following Jesus is the surest way of penance.” All this is rooted in the nourishment which comes from the Eucharist, for “it is a remedy to free us from our daily faults and to preserve us from mortal sins” [1434-6].
With the context properly set, one can now appropriately discuss the sacrament itself. Although every sin “is above all an offense against God, a rupture of communion with him,” it also has an ecclesial dimension which calls for a liturgical act to deal with it . Clearly, “Only God forgives sins,” but it is likewise true that “he gives this power to men to exercise in his name.” Why? “Christ has willed that in her prayer and life and action his whole Church should be the sign and instrument of the forgiveness and reconciliation that he acquired for us at the price of his blood. But he entrusted the exercise of the power of absolution to the apostolic ministry” [1441-2].
This communal aspect of forgiveness is well expressed by reference to the action of Christ Himself who, it is good to remember, “not only forgave sins,” but also “reintegrated forgiven sinners into the community of the People of God” . In handling the scriptural basis for the sacrament, as one might expect, Matthew 16 is treated, with a most helpful explanation of the power of the keys , as a fitting preface to a brief historical overview of the various forms this sacrament has taken down the centuries, albeit with a consistent and fundamental structure [1446-9].
The primary component of Penance is contrition, which is “sorrow of the soul and detestation for the sin committed, together with the resolution not to sin again” . It may be “perfect” [that is, springing solely from the love of God who has been “injured” by the sin] or “imperfect” [stemming from more human motives, like fear of eternal punishment in Hell].
The text observes that “confession to a priest is an essential part of the sacrament of Penance,” which is required to be received “at least once a year” when one is conscious of “serious sins.” Cautions are leveled about the necessity of this sacrament: “Anyone who is aware of having committed a mortal sin must not receive Holy Communion,2 even if he experiences deep contrition, without having first received sacramental absolution. . . . Children must go to the sacrament of Penance before receiving Holy Communion for the first time” 3; this direction needs to be part of the normal catechetical training and pastoral practice. The Catechism also notes: “Without being strictly necessary, confession of everyday faults (venial sins) is nevertheless strongly recommended by the Church. Indeed the regular confession of our venial sins helps us form our conscience, fight against evil tendencies, let ourselves be healed by Christ and progress in the life of the Spirit” .
Confessing is not enough; satisfaction must also be made. Thus, “the confessor proposes the performance of certain acts of ’satisfaction’ or ‘penance’ to be performed by the penitent in order to repair the harm caused by sin and to re-establish habits befitting a disciple of Christ” . “Only priests who have received the faculty of absolving from the authority of the Church can forgive sins in the name of Christ” , embodying within themselves the qualities of the Good Shepherd, the Good Samaritan, the merciful father of the prodigal son, and the just but merciful judge of the parable. A good confessor needs to have knowledge of both human and divine affairs; “he must love the truth, be faithful to the Magisterium of the Church, and lead the penitent with patience toward healing and full maturity.” Likewise, he must be a man of prayer and penance himself.4 The seriousness of the “seal of confession” is given due consideration as well. [1465-7]5
The effects of this wonderful sacrament are many: “reconciliation with God by which the penitent recovers grace; reconciliation with the Church; remission of the eternal punishment incurred by mortal sins; remission, at least in part, of temporal punishments resulting from sin; peace and serenity of conscience, and spiritual consolation; an increase of spiritual strength for the Christian battle” . Such an impressive array of benefits should lead anyone to deepen one’s appreciation for this sacrament and to inspire one to use it with regularity and devotion. A final point is made that “individual and integral confession of grave sins followed by absolution remains the only ordinary means of reconciliation with God and with the Church” .
In the next place, we find a presentation on the Catholic doctrine of indulgences, which “are closely linked to the effects of the sacrament of Penance” . The traditional definition is offered as “a remission before God of the temporal punishment due to sins whose guilt has already been forgiven.” It may be “partial” or “plenary” and “may be applied to the living or the dead.” Indulgences touch on personal responsibility, the everlasting bonds within the communion of saints, participation in the process of one’s own salvation.
Finally, we are brought through the liturgical rite itself. Much emphasis is placed on the importance of individual confession and absolution due, no doubt, to abuses of general absolution [1483-4]. In a more positive light, this discipline of the Church is presented as an element of the personalism demonstrated in the forgiving ministry exercised by the Lord Himself during His sojourn on earth: “Personal confession is thus the form most expressive of reconciliation with God and with the Church” . If confessors and penitents alike took this counsel to heart, the face of the Church and the earth itself could easily be renewed.
Many observers have noted that “in the old days,” the lines for confession were long while the lines for Communion were short. Now, the lines for confession are very short while the lines for Communion are inordinately long. The present pontificate has made much of the centrality of mercy in the life of the Church6 – and rightly so – but the fundamental problem is that, due to poor preaching and catechesis for decades, the average Catholic doesn’t see himself in need of mercy since his conscience has been malformed, with little to no sensitivity to the reality of sin. Until that pastoral problem is addressed, there will continue to be an imbalance between the two lines. Many Eastern Orthodox refer to the Sacrament of Penance as “the forgotten sacrament.” That should not be able to be said among us Catholics.
Not infrequently, “cradle Catholics” can grow immune to the graces of our Catholic birthright. One such example is the cavalier and even dismissive appreciation for the Sacrament of Penance. Perhaps this reflection from the convert, St. John Henry Cardinal Newman, can serve as a “wake-up” call:
How many are the souls in distress, anxiety, or loneliness, whose one need is to find a being to whom they can pour out their feelings unheard by the world? Tell them out they must; they cannot tell them out to those whom they see every hour. They want to tell them and not to tell them; and they want to tell them out, yet be as if they be not told; they wish to tell them to one who is strong enough to bear them, yet not too strong to despise them; they wish to tell them to one who can at once advise and can sympathize with them; they wish to relieve themselves of a load, to gain a solace, to receive the assurance that there is one who thinks of them, and one to whom in thought they can recur, to whom they can betake themselves, if necessary, from time to time, while they are in the world. How many a Protestant’s heart would leap at the news of such a benefit, putting aside all distinct ideas of a sacramental ordinance, or of a grant of pardon and the conveyance of grace! If there is a heavenly idea in the Catholic Church, looking at it simply as an idea, surely, next after the Blessed Sacrament, Confession is such. And such is it ever found in fact,—the very act of kneeling, the low and contrite voice, the sign of the cross hanging, so to say, over the head bowed low, and the words of peace and blessing. Oh, what a soothing charm is there, which the world can neither give nor take away! Oh, what piercing, heart-subduing tranquillity, provoking tears of joy, is poured almost substantially and physically upon the soul, the oil of gladness, as Scripture calls it, when the penitent at length rises, his God reconciled to him, his sins rolled away for ever! This is Confession as it is in fact.7
Anointing of the Sick
Before launching into a discussion of the Sacrament of the Anointing of the Sick itself, the Catechism offers a superb analysis of the place of sickness in human life. Noting the potential consequences for an individual when faced with personal suffering, it observes that “illness can lead to anguish, self-absorption, sometimes even despair and revolt against God.” It goes on, however, to highlight another possible effect: “It can also make a person more mature, helping him discern in his life what is not essential so that he can turn toward that which is.” And, most importantly, “very often illness provokes a search for God and a return to him” . The first set of responses to suffering is all too common today, leading people to turn to Dr. Death instead of God; it is the task of the Church to make sure that her sons and daughters see the values inherent in the second set and to act accordingly.
Taking account of the general Old Testament understanding of suffering as punishment for sin, the text also reminds readers that even there, especially with sacred authors like Deutero-Isaiah, “suffering can also have a redemptive meaning for the sins of others” . Jesus, as the Suffering Servant of God prophesied of old, “has come to heal the whole man, body and soul”; indeed, “his compassion toward all who suffer goes so far that he identifies himself with them: ‘I was sick and you visited me’ (Mt 25:36)” . But that concern of the Lord was not limited to His earthly life and ministry; it continues in and through the concerted efforts of His disciples in every age to alleviate suffering, wherever and whenever possible.8
In studying Christ’s means of curing people, one can see how He utilized signs like saliva, imposition of hands, mud and cleansing actions, and how the sick sought to touch Him because of the power which emanated from His sacred Person. In the same way, He carries on His healing ministry in the Church in the sacraments, by which the Lord “continues to ‘touch’ us in order to heal us” .
Why did Jesus not cure all the ills of the human family when He lived and walked among us? The Catechism provides a critically important answer: “His healings were signs of the coming of the Kingdom of God. They announced a more radical healing: the victory over sin and death through his Passover” [emphasis added, 1505]. This insight cannot be overemphasized since it deals with a perennial question: If God is almighty and all-good, why doesn’t He eliminate all suffering from the face of the earth? The response calls us to seek to understand the ways of God, whereby He would have us lift our sights from the merely temporal to the eternal.9
If our focus is limited to this world, the question is damning for God; if our eyes are set on something more and better, then we can begin to appreciate what is being said here. Several years ago, in celebrating a funeral Mass for an AIDS victim, I reminded the congregation, to their amazement, that dying of AIDS was not the worst thing that could have happened to their friend; dying in the state of mortal sin was and, thank God, the deceased had had the grace of repentance and many weeks of a full life in Christ before the Lord took him to Himself. In the so thoroughly secular environment that we inhabit, the Church’s teachings on suffering and death need constant restatement and reinforcement.
A powerful way in which the Church does that is through her ministry to the sick, particularly in the sacrament which exists with them in mind. In tracing the history of the sacrament from the first evidence in the Epistle of James , the Catechism admits that as the centuries went on, increasingly the Anointing of the Sick was restricted to the dying, hence, its preconciliar name of “Extreme Unction” [that is, Last Anointing]. That approach was changed, however, at the Second Vatican Council, which wished that the older and more original nature of the sacrament be restored [1512-1513].10
Who should be anointed? “The proper time for receiving this holy anointing has certainly arrived when the believer begins to be in danger of death because of illness or old age.” Furthermore, “each time a Christian falls seriously ill, he may receive the Anointing of the Sick, and also when, after he has received it, the illness worsens” [1528-1529]. Therefore, the sacrament is no longer envisioned as reserved for those in extremis. At the same time, it is not to be used in a frivolous manner for routine maladies or less-than-serious [even if not necessarily life-threatening] illnesses.
Who may anoint? Again, following the apostolic tradition begun in the Epistle of James, we hold that “only priests. . . are ministers of the Anointing of the Sick” ; this needs to be understood in these days of so much pastoral confusion over ministry to the sick as not a few religious or laity insist that they who tend to the day-to-day spiritual needs of a patient have a right to administer this sacrament. The Church disagrees in the clearest of terms. What is the work of the non-ordained members of Christ’s Body? It is their privilege and obligation to prepare the sick “to receive [the sacrament] with good dispositions” and to assist the sick with “their prayers and fraternal attention.”
How is the sacrament celebrated? Repeating what should be obvious but not always comprehended, this sacrament [precisely because it is a sacrament] “is a liturgical and communal celebration”; it may “take place in the family home, hospital or in church”; it may be done “for a single sick person or for a whole group of sick persons.” It is most appropriate that it be celebrated “within the Eucharist, the memorial of the Lord’s Passover.” When a Mass is not possible, it is good that this sacrament “be preceded by the sacrament of Penance and followed by the sacrament of the Eucharist.” Of course, for those who are dying, this reception of Holy Communion is one’s “Viaticum,” the food for one’s final journey – into eternity .
The sacramental rite calls for the proclamation of God’s holy Word and for the special sign of this sacrament which is “the anointing of the forehead and hands of the sick person (in the Roman Rite) or of other parts of the body (in the Eastern rite)”; this anointing with oil [blessed if possible by the bishop] is “accompanied by the liturgical prayer of the celebrant, asking for the special grace of this sacrament” .
And what are the effects or graces flowing from a worthy reception? They are manifold: “the uniting of the sick person to the passion of Christ, for his own good and that of the whole Church; the strengthening, peace, and courage to endure in a Christian manner the sufferings of illness or old age; the forgiveness of sins, if the sick person was not able to obtain it through the sacrament of Penance; the restoration of health, if it is conducive to the salvation of his soul; the preparation for passing over to eternal life” .
While all these benefits are valuable, in our time of diminished appreciation of the place of suffering, the grace to endure pain and discomfort for the good of others may be most crucial since it reminds the sick person of a sense of purpose and of having a place within the communion of saints, wherein one is assured of the prayers and support of the whole Church and in turn suffers with Christ for the good of all and out of love. This allows one to claim the sanctification which is rightfully that of a Christian and at the same time to increase the sanctification of others. If this notion were more firmly in place, it is doubtful that suffering and death would be the source of anxiety and even desperation which they are for so many in our society, with a regrettable number of Christians in that company as well.
Indeed, one of the most pressing pastoral challenges today is the need to offer a convincing catechesis on suffering and death. A Protestant female minister and friend of mine called me the day of Pope John Paul II’s death to offer her condolences, but she also made a telling observation: “I always loved this man, but I think the most important thing he did was to teach us how to die.” We saw him suffer for years as he soldiered on, with patience, courage and faith.
And so, I think it might be appropriate to conclude this reflection on the Anointing of the Sick with his concluding remarks from his apostolic letter, Salvifici Doloris (“On the Christian Meaning of Human Suffering, 1984):
This is the meaning of suffering, which is truly supernatural and at the same time human. It is supernatural because it is rooted in the divine mystery of the Redemption of the world, and it is likewise deeply human, because in it the person discovers himself, his own humanity, his own dignity, his own mission.
Suffering is certainly part of the mystery of man. Perhaps suffering is not wrapped up as much as man is by this mystery, which is an especially impenetrable one. The Second Vatican Council expressed this truth that “…only in the mystery of the Incarnate Word does the mystery of man take on light. In fact…, Christ, the final Adam, by the revelation of the mystery of the Father and his love, fully reveals man to himself and makes his supreme calling clear.” If these words refer to everything that concerns the mystery of man, then they certainly refer in a very special way to human suffering. Precisely at this point the “revealing of man to himself and making his supreme vocation clear” is particularly indispensable. It also happens as experience proves—that this can be particularly dramatic. But when it is completely accomplished and becomes the light of human life, it is particularly blessed. “Through Christ and in Christ, the riddles of sorrow and death grow meaningful.”
I now end the present considerations on suffering in the year in which the Church is living the extraordinary Jubilee linked to the anniversary of the Redemption.
The mystery of the Redemption of the world is in an amazing way rooted in suffering, and this suffering in turn finds in the mystery of the Redemption its supreme and surest point of reference.
We wish to live this Year of the Redemption in special union with all those who suffer. And so there should come together in spirit beneath the Cross on Calvary all suffering people who believe in Christ, and particularly those who suffer because of their faith in him who is the Crucified and Risen One, so that the offering of their sufferings may hasten the fulfilment of the prayer of the Saviour himself that all may be one. Let there also gather beneath the Cross all people of good will, for on this Cross is the “Redeemer of man,” the Man of Sorrows, who has taken upon himself the physical and moral sufferings of the people of all times, so that in love they may find the salvific meaning of their sorrow and valid answers to all of their questions.
Together with Mary, Mother of Christ, who stood beneath the Cross, we pause beside all the crosses of contemporary man.
We invoke all the Saints, who down the centuries in a special way shared in the suffering of Christ. We ask them to support us.
And we ask all you who suffer to support us. We ask precisely you who are weak to become a source of strength for the Church and humanity. In the terrible battle between the forces of good and evil, revealed to our eyes by our modern world, may your suffering in union with the Cross of Christ be victorious!
Related at CWR:
• “Lent and the Sacraments: Plumbing the effective signs of divine grace and life” (March 3, 2022) by Fr. Peter M.J. Stravinskas
• “Lent and the Sacraments: Baptism and Confirmation” (March 10, 2022) by Fr. Peter M.J. Stravinskas
• “Lent and the Sacraments: The Eucharist” (March 17, 2022) by Fr. Peter M.J. Stravinskas
1Chesterton summed it up quite succinctly when asked why he became a Catholic: “To get rid of my sins!”
2Which is why the infamous footnote in Amoris Laetitia is so problematic as it seems to imply that divorced-remarrieds can receive Holy Communion without foregoing the ongoing sinful state of adultery (since one or both of them are held to a previous marital bond).
3Older readers may remember that dreadful “experiment” of the 1970s, whereby children had their first reception of the Sacrament of Penance delayed by years – all on the faulty notion that seven-year-olds could not understand the reality of sin and that they would be traumatized by confession! Yet, they were supposed to understand the reality (and even greater mystery) of the Eucharist. As a teacher and school administrator in those days, I can attest to the trauma experienced by high-schoolers having to make their first confession, not about peccadillos like disobeying Mommy and Daddy but about things like drugs, sex, and alcohol. Thankfully, Pope John Paul II put a definitive halt to that ill-conceived practice.
4St. John Paul II often reminded priests that to be good confessors, they had to be good penitents, first. A survey some years ago revealed that the average priest in Germany approached the Sacrament of Penance about every seven years! And we wonder why the Church there is in such a mess.
5In all too many countries, the sacramental seal has come under assault. However, the obligation to maintain the confidentiality of a penitent’s confession is absolute, admitting of no exceptions, regardless of any pressure or coercion from civil authorities. Indeed, priests have died, rather than violate that sacred trust. At the same time, Catholics in general and Catholics in public office in particular must be ever-vigilant against any encroachments even being discussed about legislation to undermine or obliterate this sacrosanct bond between penitent and confessor.
6St. Faustina’s whole mission in life was to be “God’s secretary,” promoting the divine mercy. However, she is clear that the first mercy God gives is the grace to repent of one’s sins, precisely so as to be returned to His loving and merciful embrace.
7Present Position of Catholics, #16, “Confession.”
8From time to time, it is good for all of us to recall – and to remind the secularists in our society – that prior to the advent of Christianity, there were no hospitals or orphanages. It should come as no surprise, therefore, to learn that in the State of New York, the Catholic Church is the largest employer after the State, precisely because of her educational and social services.
9See God in the Dock by C. S. Lewis.
10The decree on this sacrament from the Council of Trent is instructive here because some would-be “conservative” or “traditional” Catholics balk at the current name of this sacrament, as well as those to whom it is presently administered.
So, the decree notes: “. . . it was also called by our predecessors in the faith, the Sacrament of the anointing of the sick, and also the Sacrament of the dying.”
The decree states that “Extreme Unction is not to be administered indiscriminately to all.” It further cautions: “. . . it is not to be administered to persons in sound health. . . this Sacrament is to be administered to those only whose malady is such as to excite apprehensions of approaching death.” But it also warns: “It is, however, a very grievous sin to defer the Holy Unction until, all hope of recovery being lost, life begins to ebb, and the sick person is fast verging into a state of insensibility. It is obvious that if the Sacrament is administered while consciousness and reason are yet unimpaired, and the mind is capable of eliciting acts of faith and of directing the will to sentiments of piety, a more abundant participation of its graces must be received. Though this heavenly medicine is in itself always salutary, pastors should be careful to apply it when its efficacy can be aided by the piety and devotion of the sick person.”
I would maintain that in the sixteenth century, any serious illness qualified as constituting “danger of death.” Today, I think it reasonable to consider that anyone requiring anesthesia for a surgical procedure is a proper subject for this Sacrament. To be sure, regularly scheduled “Healing Masses,” during which the Anointing of the Sick is administered indiscriminately and regularly to the same people, are problematic and fly in the face of both the letter and spirit of current discipline.
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